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Nakajo K, Inaba A, Aoyama N, Takashima K, Kadota T, Yoda Y, Morishita Y, Okano W, Tomioka T, Shinozaki T, Matsuura K, Hayashi R, Akimoto T, Yano T. The characteristics of missed pharyngeal and laryngeal cancers at gastrointestinal endoscopy. Jpn J Clin Oncol 2022; 52:575-582. [DOI: 10.1093/jjco/hyac036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 03/03/2022] [Indexed: 11/14/2022] Open
Abstract
Abstract
Objectives
Understanding the miss rate and characteristics of missed pharyngeal and laryngeal cancers during upper gastrointestinal endoscopy may aid in reducing the endoscopic miss rate of this cancer type. However, little is known regarding the miss rate and characteristics of such cancers. Therefore, the aim of this study was to investigate the upper gastrointestinal endoscopic miss rate of oro-hypopharyngeal and laryngeal cancers, the characteristics of the missed cancers, and risk factors associated with the missed cancers.
Methods
Patients who underwent upper gastrointestinal endoscopy and were pathologically diagnosed with oro-hypopharyngeal and laryngeal squamous cell carcinoma from January 2019 to November 2020 at our institution were retrospectively evaluated. Missed cancers were defined as those diagnosed within 15 months after a negative upper gastrointestinal endoscopy.
Results
A total of 240 lesions were finally included. Eighty-five lesions were classified as missed cancers, and 155 lesions as non-missed cancers. The upper gastrointestinal endoscopic miss rate for oro-hypopharyngeal and laryngeal cancers was 35.4%. Multivariate analysis revealed that a tumor size of <13 mm (odds ratio: 1.96, P=0.026), tumors located on the anterior surface of the epiglottis/valleculae (odds ratio: 2.98, P=0.045) and inside of the pyriform sinus (odds ratio: 2.28, P=0.046) were associated with missed cancers.
Conclusions
This study revealed a high miss rate of oro-hypopharyngeal and laryngeal cancers during endoscopic observations. High-quality upper gastrointestinal endoscopic observation and awareness of missed cancer may help reduce this rate.
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Affiliation(s)
- Keiichiro Nakajo
- Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Kashiwa, Japan
- Cancer Medicine, Cooperative Graduate School, The Jikei University Graduate School of Medicine, Tokyo, Japan
| | - Atsushi Inaba
- Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Kashiwa, Japan
| | | | | | | | | | - Youhei Morishita
- Department of Head and Neck Surgery, National Cancer Center Hospital East Hospital, Kashiwa, Japan
| | | | | | | | | | | | - Tetsuo Akimoto
- Cancer Medicine, Cooperative Graduate School, The Jikei University Graduate School of Medicine, Tokyo, Japan
- Department of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, Kashiwa, Japan
| | - Tomonori Yano
- Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Kashiwa, Japan
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Mabe K, Inoue K, Kamada T, Kato K, Kato M, Haruma K. Endoscopic screening for gastric cancer in Japan: Current status and future perspectives. Dig Endosc 2022; 34:412-419. [PMID: 34143908 DOI: 10.1111/den.14063] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 06/15/2021] [Accepted: 06/17/2021] [Indexed: 12/18/2022]
Abstract
The revised 2014 Japanese Guidelines for Gastric Cancer Screening approved gastric endoscopy for use in population-based screening. Thus, it is expected that gastric cancer will be detected earlier, and gastric cancer mortality further decreased, with the widespread use of endoscopy and Helicobacter pylori eradication therapy. However, due to an increasingly aging population and relatively low gastric cancer screening rates, gastric cancer remains the leading cause of cancer death in Japan. While the era of endoscopic gastric cancer screening has begun, it does present challenges, such as limited/varying regional availability of endoscopists. This review describes the history of gastric cancer screening in Japan, achievements in endoscopic gastric cancer screening in Japan and Korea, efforts underway to improve screening by stratifying individuals according to gastric cancer risk, and initiatives by the Japan Gastroenterological Endoscopy Society aimed at improving screening, including the implementation of a board certification program for screening endoscopists.
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Affiliation(s)
- Katsuhiro Mabe
- Junpukai Health Maintenance Center-Kurashiki, Okayama, Japan
| | | | - Tomoari Kamada
- Department of Health Care Medicine, Kawasaki Medical School, Okayama, Japan
| | - Katsuaki Kato
- Cancer Detection Center, Miyagi Cancer Society, Miyagi, Japan
| | - Mototsugu Kato
- National Hospital Organization Hakodate National Hospital, Hokkaido, Japan
| | - Ken Haruma
- Junpukai Health Maintenance Center, Okayama, Japan.,Division of Gastroenterology, Department of Internal Medicine 2, Kawasaki Medical School, Okayama, Japan
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Gardner JR, Campbell JB, Daigle O, King D, Kanaan A. Operative and postoperative outcomes in elderly patients undergoing endoscopic sinus surgery. Eur Arch Otorhinolaryngol 2020; 278:1471-1476. [PMID: 33141253 DOI: 10.1007/s00405-020-06453-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 10/21/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE Chronic rhinosinusitis (CRS) is increasingly common in the elderly population (≥ 65 years old). Compared to their younger counterparts, differences exist in the etiology of CRS and outcomes of Endoscopic Sinus Surgery (ESS) for elderly patients. The aim of this study is to determine if differences in surgical outcomes are present between these two patient populations to facilitate patient pre-operative counseling by their healthcare providers. METHODS Retrospective chart review conducted at a single tertiary care center for patients undergoing ESS between June 2014 and June 2019. Patients were classified into two cohorts (adult and elderly) based on age (< 65 and ≥ 65 years old). Demographics, surgical, and postoperative variables were extracted from our institution's electronic medical records. ANOVA and t-test analysis were performed to determine the presence of significant differences between the two cohorts. SNOT-22 scores were used to determine QOL improvements. RESULTS Compared to the adult cohort, elderly patients had significant QOL improvement after surgical treatment (p = 0.001), but had a similar successful response to treatment (p = 0.74). Elderly patients had no difference in the incidence of operative/perioperative complications (p = 0.89) or intraoperative or postoperative bleeding (p = 0.301, p = 0.62), but had an increased incidence of postoperative infection (p = 0.000). CONCLUSION ESS remains an effective treatment modality for the management of CRS, and a safe practice for elderly patients despite the increase in complexity of their medical comorbidities and polypharmacy. QOL improvements are significant, though patient counseling should take into account that improvements may not be as pronounced as in younger patients.
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Affiliation(s)
- J Reed Gardner
- Division of Rhinology and Allergy, Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences (UAMS), 4301 W Markham St # 543, Little Rock, AR, 72205, USA
| | - Jessica B Campbell
- Division of Rhinology and Allergy, Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences (UAMS), 4301 W Markham St # 543, Little Rock, AR, 72205, USA
| | - Olivia Daigle
- Division of Rhinology and Allergy, Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences (UAMS), 4301 W Markham St # 543, Little Rock, AR, 72205, USA
| | - Deanne King
- Division of Rhinology and Allergy, Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences (UAMS), 4301 W Markham St # 543, Little Rock, AR, 72205, USA
| | - Alissa Kanaan
- Division of Rhinology and Allergy, Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences (UAMS), 4301 W Markham St # 543, Little Rock, AR, 72205, USA.
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Schindler A, Baijens LWJ, Clave P, Degen B, Duchac S, Dziewas R, Farneti D, Hamdy S, Michou E, Pokieser P, Speyer R, Walshe M, Verin E, Rommel N. ESSD Commentary on Dysphagia Management During COVID Pandemia. Dysphagia 2020; 36:764-767. [PMID: 33111204 PMCID: PMC7592131 DOI: 10.1007/s00455-020-10194-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 09/23/2020] [Indexed: 02/06/2023]
Abstract
Since the World Health Organization declared the COVID-19 pandemic a Global Public Health Emergency, experts in swallowing are seeking guidance on service delivery and clinical procedures. The European Society for Swallowing Disorders provides considerations to support experts in swallowing disorders in clinical practice. During the COVID-19 pandemic, assessment and treatment of patients with oropharyngeal dysphagia should be provided, while at the same time balancing risk of oropharyngeal complications with that of infection of patients and healthcare professionals involved in their management. Elective, non-urgent assessment may be temporarily postponed and patients are triaged to decide whether dysphagia assessment is necessary; instrumental assessment of swallowing is performed only if processing of the instruments can be guaranteed and clinical assessment has not provided enough diagnostic information for treatment prescription. Assessment and management of oropharyngeal dysphagia is a high-risk situation as it must be considered an aerosol-generating procedure. Personal protective equipment (PPE) should be used. Telepractice is encouraged and compensatory treatments are recommended.
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Affiliation(s)
- Antonio Schindler
- Phoniatric Unit, Department of Biomedical and Clinical Science "L. Sacco", University of Milan, Milan, Italy
| | - Laura W J Baijens
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.,GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center,, Maastricht, The Netherlands
| | - Pere Clave
- Gastrointestinal Physiology Laboratory. Hospital de Mataró, Universitat Autònoma de Barcelona, Mataró, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain
| | | | - Stephanie Duchac
- SRH Hochschule für Gesundheit, University of Applied Health Sciences, Campus Karlsruhe Benzstr. 5, Karlsruhe, Germany
| | - Rainer Dziewas
- Department of Neurology, University Hospital Münster, Albert-Schweitzer-Campus 1, Munster, Germany
| | - Daniele Farneti
- Audiology Phoniatric Service - ENT Department, Infermi Hospital of Rimini - AUSL Romagna, Rimini, Italy
| | - Shaheen Hamdy
- GI Sciences, School of Medical Sciences, Clinical Sciences Building, University of Manchester, Salford Royal Hospital, Salford, M6 8HD, UK
| | - Emilia Michou
- Department of Speech Language Therapy, School of Rehabilitation Sciences, University of Patras, Patras, Greece
| | - Peter Pokieser
- Unified Patient Program, Teaching Center, Medical University of Vienna, Vienna, Austria
| | - Renee Speyer
- Department Special Needs Education, University of Oslo, Oslo, Norway
| | - Margaret Walshe
- Department of Clinical Speech and Language Studies, Trinity College Dublin, The University of Dublin, Dublin 2, Ireland
| | - Eric Verin
- Rouen University Hospital, University of Rouen, 3830, Normandy, EA, France
| | - Nathalie Rommel
- Dept of Neurosciences, ExpORL, Deglutology and University Hospital Leuven, University of Leuven, Leuven, Belgium. .,Dept Gastroenterology (Neurogastroenterology and Motility), University of Leuven, Leuven, Belgium.
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