Rigid Esophagoscopy Has Low Utility in Staging for Head and Neck Cancer

Rigid esophagoscopy for evaluation of patients with head and neck squamous cell carcinoma (HNSCC) is safe but has low utility for cancer staging and detection of nonmalignant esophageal disease, according to a study published in JAMA Otolaryngology – Head & Neck Surgery.¹

Researchers led by Patrick McGarey Jr, MD, of the University of Virginia Health System conducted a retrospective study of 582 patients who had undergone rigid esophagoscopy for HNSCC staging from July 2004 to October 2012.

A literature review was performed and the National Cancer Institute’s Surveillance Epidemiology and End Results (SEER) database was queried in order to assess for incidence of synchronous esophageal malignant neoplasms.

In a total of 601 staging rigid esophagoscopies that were performed in 582 patients, there were 9 complications, including 1 esophageal perforation.

The procedure had to be aborted in 50 cases. Among the remaining 551 completed esophagoscopies, the researchers found no abnormal findings in 523 patients, and nonmalignant pathologic findings were identified in 28 patients.

Incidence of synchronous esophageal malignant neoplasms upon literature review and SEER data analysis was found to be very low and has decreased from 1980 to 2010 in North America.

“Screening esophagoscopy should be limited to patients with HNSCC who are at high risk for synchronous esophageal malignant neoplasms,” the authors concluded.

Reference

1. McGarey Jr PO, O’Rourke AK, Owen SR, et al. Rigid esophagoscopy for head and neck cancer staging and the incidence of synchronous esophageal malignant neoplasms [published online ahead of print December 3, 2015]. JAMA Otolaryngol Head Neck Surg. doi: 10.1001/jamaoto.2015.2815.