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Jiang AR, Wen LM, Ding JW, Zou RZ, Nie XB, Lin H, Chen J, Zhang WS, Dan LY, Zhu YX, Ren CM, Wu YY, Sheng LL, Chen DR, Liao GB, Zhao HY, Li JJ, Zuo Y, Chen J, Bai JY, Xu LB, Yu S. Magnifying image-enhanced endoscopy-only mode boosted early cancer diagnostic efficiency: a multicenter randomized controlled trial. Gastrointest Endosc 2023; 98:934-943.e4. [PMID: 37400038 DOI: 10.1016/j.gie.2023.06.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/30/2023] [Accepted: 06/27/2023] [Indexed: 07/05/2023]
Abstract
BACKGROUND AND AIMS Magnifying image-enhanced endoscopy (MIEE) is an advanced endoscopy with image enhancement and magnification used in preoperative examination. However, its impact on the detection rate is unknown. METHODS We conducted an open-label, randomized, parallel (1:1:1), controlled trial in 6 hospitals in China. Patients were recruited between February 14, 2022 and July 30, 2022. Eligible patients were aged ≥18 years and undergoing gastroscopy in outpatient departments. Participants were randomly assigned to the MIEE-only mode (o-MIEE) group, white-light endoscopy-only mode (o-WLE) group, and MIEE when necessary mode (n-MIEE) group (initial WLE followed by switching to another endoscope with MIEE if necessary). Biopsy sampling of suspicious lesions of the lesser curvature of the gastric antrum was performed. Primary and secondary aims were to compare detection rates and positive predictive value (PPV) of early cancer and precancerous lesions in these 3 modes, respectively. RESULTS A total of 5100 recruited patients were randomly assigned to the o-MIEE (n = 1700), o-WLE (n = 1700), and n-MIEE (n = 1700) groups. In the o-MIEE, o-WLE, and n-MIEE groups, 29 (1.51%; 95% confidence interval [CI], 1.05-2.16), 4 (.21%; 95% CI, .08-.54), and 8 (.43%; 95% CI, .22-.85) early cancers were found, respectively (P < .001). The PPV for early cancer was higher in the o-MIEE group compared with the o-WLE and n-MIEE groups (63.04%, 33.33%, and 38.1%, respectively; P = .062). The same trend was seen for precancerous lesions (36.67%, 10.00%, and 21.74%, respectively). CONCLUSIONS The o-MIEE mode resulted in a significant improvement in diagnosing early upper GI cancer and precancerous lesions; thus, it could be used for opportunistic screening. (Clinical trial registration number: ChiCTR2200064174.).
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Affiliation(s)
- Ai-Rui Jiang
- Department of Gastroenterology, the Second Affiliated Hospital, Army Medical University, Chongqing, China; Department of Gastroenterology, The People's Hospital of Wansheng District, Chongqing, China
| | - Li-Ming Wen
- Department of Gastroenterology, Sichuan MianYang 404 Hospital, Sichuan, China
| | - Jian-Wei Ding
- Department of Gastroenterology, The People's Hospital of Tongliang District, Chongqing, China
| | - Rui-Zheng Zou
- Department of Gastroenterology, The People's Hospital of Chongqing LiangJiang New Area, Chongqing, China
| | - Xu-Biao Nie
- Department of Gastroenterology, the Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Hui Lin
- Department of Gastroenterology, the Second Affiliated Hospital, Army Medical University, Chongqing, China; Department of Epidemiology, Army Medical University, Chongqing, China
| | - Jing Chen
- Department of Gastroenterology, Chongqing University Three Gorges Hospital, Chongqing, China
| | - Wei-Sen Zhang
- Department of Gastroenterology, The Affiliated Hospital of Guizhou Medical University, Guizhou, China
| | - Liang-Ying Dan
- Department of Gastroenterology, The People's Hospital of Tongliang District, Chongqing, China
| | - Yu-Xia Zhu
- Department of Gastroenterology, The People's Hospital of Chongqing LiangJiang New Area, Chongqing, China
| | - Chun-Mei Ren
- Department of Gastroenterology, Sichuan MianYang 404 Hospital, Sichuan, China
| | - Ying-Yang Wu
- Department of Gastroenterology, the Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Lin-Lin Sheng
- Department of Gastroenterology, the Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Ding-Rong Chen
- Department of Gastroenterology, the Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Guo-Bin Liao
- Department of Gastroenterology, the Second Affiliated Hospital, Army Medical University, Chongqing, China; Department of Gastroenterology, The 901 Hospital of Chinese People's Liberation Army Joint Service Support Unit, Hefei, China
| | - Hai-Yan Zhao
- Department of Gastroenterology, the Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Jian-Jun Li
- Department of Gastroenterology, the Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Ying Zuo
- Department of Gastroenterology, the Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Jie Chen
- Department of Gastroenterology, the Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Jian-Ying Bai
- Department of Gastroenterology, the Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Liang-Bi Xu
- Department of Gastroenterology, The Affiliated Hospital of Guizhou Medical University, Guizhou, China
| | - Shuang Yu
- Department of Gastroenterology, Chongqing University Three Gorges Hospital, Chongqing, China
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Matsuno K, Miyamoto H, Shono T, Waki K, Tateyama M, Naoe H, Miyamaru S, Murakami D, Orita Y, Morinaga J, Tanaka Y, Gushima R. Efficacy of a new traction method using ring-shaped thread for endoscopic submucosal dissection in the pharynx. Esophagus 2023; 20:256-263. [PMID: 36456753 DOI: 10.1007/s10388-022-00971-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 11/09/2022] [Indexed: 12/04/2022]
Abstract
BACKGROUND Endoscopic submucosal dissection (ESD) is a minimally invasive treatment for pharyngeal cancers. However, pharyngeal ESD is sometimes technically challenging because of the narrow and complex space in which to work. Traction is important to complete the procedure efficiently. Here, we report the technical details and efficacy of a new traction method for pharyngeal ESD using ring-shaped thread and grasping forceps. METHODS We analyzed pharyngeal ESD performed between January 2016 and March 2021 at our Institute. We designated cases resected using ring-shaped threads "Group R" and those resected without ring-shaped threads as conventional "Group C", and compared the technical outcomes between them. Multivariate analysis and the inverse probability treatment weighting (IPTW) method using propensity scores were adjusted by confounding variables. RESULTS We analyzed 89 lesions from 68 patients, of which 46 were in Group R and 43 in Group C. Median procedure time and median dissection speed were significantly shorter in Group R than C (37 min vs. 55 min, and 16.0 mm2/min vs. 7.0 mm2/min, respectively, both P < 0.05). These results were confirmed by both multivariate analysis and after IPTW adjustment. All lesions were resected en bloc, and the complete resection rate was not significantly different between Group R and C (91.3% vs. 79.1%, P = 0.14). There were no treatment-related adverse events in either group. CONCLUSIONS The traction method using ring-shaped thread increases the efficiency of pharyngeal ESD. This simple new traction method should be a useful option for pharyngeal ESD.
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Affiliation(s)
- Kenshi Matsuno
- Department of Gastroenterology and Hepatology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-Ku, Kumamoto, Kumamoto, 860-8556, Japan
| | - Hideaki Miyamoto
- Department of Gastroenterology and Hepatology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-Ku, Kumamoto, Kumamoto, 860-8556, Japan
| | - Takashi Shono
- Department of Gastroenterology and Hepatology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-Ku, Kumamoto, Kumamoto, 860-8556, Japan
- Department of Gastroenterology, Kumamoto Chuo Hospital, Kumamoto, Japan
| | - Kotaro Waki
- Department of Gastroenterology and Hepatology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-Ku, Kumamoto, Kumamoto, 860-8556, Japan
| | - Masakuni Tateyama
- Department of Gastroenterology and Hepatology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-Ku, Kumamoto, Kumamoto, 860-8556, Japan
| | - Hideaki Naoe
- Department of Gastroenterology and Hepatology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-Ku, Kumamoto, Kumamoto, 860-8556, Japan
| | - Satoru Miyamaru
- Department of Otolaryngology-Head and Neck Surgery, Kumamoto University, Kumamoto, Japan
| | - Daizo Murakami
- Department of Otolaryngology-Head and Neck Surgery, Kumamoto University, Kumamoto, Japan
| | - Yorihisa Orita
- Department of Otolaryngology-Head and Neck Surgery, Kumamoto University, Kumamoto, Japan
| | - Jun Morinaga
- Department of Clinical Investigation (Biostatistics), Kumamoto University Hospital, Kumamoto, Japan
| | - Yasuhito Tanaka
- Department of Gastroenterology and Hepatology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-Ku, Kumamoto, Kumamoto, 860-8556, Japan.
| | - Ryosuke Gushima
- Department of Gastroenterology and Hepatology, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-Ku, Kumamoto, Kumamoto, 860-8556, Japan
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3
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Matsueda K, Ishihara R, Morishima T, Okubo Y, Kawakami Y, Sakurai H, Nakamura T, Tani Y, Miyake M, Shichijo S, Maekawa A, Kanesaka T, Yamamoto S, Takeuchi Y, Higashino K, Uedo N, Michida T, Matsunaga T, Ohno Y, Sobue T, Miyashiro I. Impact of endoscopic surveillance on mortality of metachronous esophageal and head and neck cancer after esophageal endoscopic resection. J Gastroenterol Hepatol 2022; 37:2098-2104. [PMID: 35997074 DOI: 10.1111/jgh.15984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/20/2022] [Accepted: 08/12/2022] [Indexed: 12/09/2022]
Abstract
BACKGROUND AND AIM As more superficial esophageal cancer (EC) patients are being treated with endoscopic resection (ER), it is important to understand the outcomes, including survival data, of patients who develop metachronous EC and head and neck cancer (HNC). We aimed to evaluate the long-term surveillance and survival outcomes of metachronous EC and HNC after esophageal ER. METHODS This study included 627 patients who underwent ER of superficial esophageal squamous cell carcinoma from 2008 to 2016 and were generally followed by annual or biannual esophagogastroduodenoscopy up to 2019 at Osaka International Cancer Institute. Data on metachronous cancer development and causes of death were collected from an integrated database of hospital-based cancer registry and Vital Statistics of Japan. RESULTS During a median (range) follow-up period of 67.4 (3.8-142.7) months, 230 patients (36.7%) developed 500 metachronous ECs and 126 patients (20.1%) developed 239 metachronous HNCs, post-ER of index EC. The 3-year, 5-year, and 7-year cumulative incidences were 25.8%, 36.0%, and 43.6% for metachronous EC and 10.9%, 16.0%, and 26.9% for metachronous HNC, respectively. No patients died of metachronous EC, and only seven patients (1.1%) died of metachronous HNC. The 3-year, 5-year, and 7-year disease-specific survival rates were 99.8%, 99.6%, and 98.6%, respectively. CONCLUSIONS The incidences of metachronous EC and HNC increase with time over 5 years after esophageal ER; therefore, surveillance endoscopy should be continued over 5 years. Endoscopic surveillance is useful for survivors after esophageal ER given the high incidence and extremely low mortality of metachronous EC and HNC.
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Affiliation(s)
- Katsunori Matsueda
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan.,Department of Gastroenterology, Okayama University Hospital, Okayama, Japan
| | - Ryu Ishihara
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | | | - Yuki Okubo
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Yushi Kawakami
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Hirohisa Sakurai
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Takahiko Nakamura
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Yasuhiro Tani
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Muneaki Miyake
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Satoki Shichijo
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Akira Maekawa
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Takashi Kanesaka
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Sachiko Yamamoto
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Yoji Takeuchi
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Koji Higashino
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Noriya Uedo
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Tomoki Michida
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Takashi Matsunaga
- Department of Medical Informatics, Osaka International Cancer Institute, Osaka, Japan
| | - Yuko Ohno
- Division of Health Science, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Tomotaka Sobue
- Division of Environmental Medicine and Population Sciences, Department of Social Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Isao Miyashiro
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
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4
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Miyamoto H, Naoe H, Morinaga J, Sakisaka K, Tayama S, Matsuno K, Gushima R, Tateyama M, Shono T, Imuta M, Miyamaru S, Murakami D, Orita Y, Tanaka Y. Clinical impact of gastrointestinal endoscopy on the early detection of pharyngeal squamous cell carcinoma: A retrospective cohort study. World J Gastrointest Endosc 2021; 13:491-501. [PMID: 34733409 PMCID: PMC8546562 DOI: 10.4253/wjge.v13.i10.491] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 07/26/2021] [Accepted: 09/17/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND In recent years, with the growing availability of image-enhanced gastrointestinal endoscopy, gastroenterologists have contributed to the early detection of pharyngeal squamous cell carcinomas (SCC).
AIM To clarify the clinical characteristics of pharyngeal SCCs detected by gastrointestinal endoscopy.
METHODS This is a retrospective cohort study conducted in a single-center, a university hospital in Japan. We retrospectively assessed the clinical records of 522 consecutive patients with oropharyngeal or hypopharyngeal SCC who were examined in our hospital between 2011 and 2018. The lesions were classified into two groups: Group GE (detected by gastrointestinal endoscopy) and Group non-GE (detected by means other than gastrointestinal endoscopy). The clinical characteristics were compared between the two groups. Continuous data were compared using the Mann–Whitney U test. Pearson’s χ2 test or Fisher's exact test was used to analyze the categorical data and compare proportions. The Kaplan–Meier method was used to estimate the cumulative patient survival rates.
RESULTS In our study group, the median age was 65 years and 474 patients (90.8%) were male. One hundred and ninety-six cases (37.5%) involved the oropharynx and 326 cases (62.5%) involved the hypopharynx. Three hundred and ninety-five cases (75.7%) had some symptoms at the time of diagnosis. One hundred and forty-five (27.8%) cases had concurrent ESCC or a history of ESCC. One hundred and sixty-four (31.4%) cases were detected by gastrointestinal endoscopy and classified as Group GE. The proportions of asymptomatic cases, cTis-1 cases and cases with no lymph node metastasis were significantly higher in Group GE than Group non-GE (61.6% vs 7.3%, P < 0.001, 32.9% vs 12.0%, P < 0.001 and 69.5% vs 19.0%, P < 0.001). Endoscopic laryngo-pharyngeal surgery or endoscopic submucosal dissection were performed in only 0.6% of the lesions in Group non-GE but in 21.3% of the lesions in Group GE (P < 0.001). Overall survival was significantly longer in Group GE than in Group non-GE (P = 0.018). The 2-year and 4-year survival rates were 82.5% and 70.7% in Group GE, and 71.5% and 59.0% in Group non-GE, respectively.
CONCLUSION Gastrointestinal endoscopy plays an important role in the early detection and improving the prognosis of pharyngeal SCCs.
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Affiliation(s)
- Hideaki Miyamoto
- Department of Gastroenterology and Hepatology, Kumamoto University Hospital, Kumamoto 860-8556, Japan
| | - Hideaki Naoe
- Department of Gastroenterology and Hepatology, Kumamoto University Hospital, Kumamoto 860-8556, Japan
| | - Jun Morinaga
- Department of Clinical Investigation, Kumamoto University Hospital, Kumamoto 860-8556, Japan
| | - Kensuke Sakisaka
- Department of Gastroenterology and Hepatology, Kumamoto University Hospital, Kumamoto 860-8556, Japan
| | - Sayoko Tayama
- Department of Gastroenterology and Hepatology, Kumamoto University Hospital, Kumamoto 860-8556, Japan
| | - Kenshi Matsuno
- Department of Gastroenterology and Hepatology, Kumamoto University Hospital, Kumamoto 860-8556, Japan
| | - Ryosuke Gushima
- Department of Gastroenterology and Hepatology, Kumamoto University Hospital, Kumamoto 860-8556, Japan
| | - Masakuni Tateyama
- Department of Gastroenterology and Hepatology, Kumamoto University Hospital, Kumamoto 860-8556, Japan
| | - Takashi Shono
- Department of Gastroenterology, Kumamoto Chuo Hospital, Kumamoto 860-8556, Japan
| | - Masanori Imuta
- Department of Radiology, Kumamoto University Hospital, Kumamoto 860-8556, Japan
| | - Satoru Miyamaru
- Department of Otolaryngology-Head and Neck Surgery, Kumamoto University Hospital, Kumamoto 860-8556, Japan
| | - Daizo Murakami
- Department of Otolaryngology-Head and Neck Surgery, Kumamoto University Hospital, Kumamoto 860-8556, Japan
| | - Yorihisa Orita
- Department of Otolaryngology-Head and Neck Surgery, Kumamoto University Hospital, Kumamoto 860-8556, Japan
| | - Yasuhito Tanaka
- Department of Gastroenterology and Hepatology, Kumamoto University Hospital, Kumamoto 860-8556, Japan
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5
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Ohmori M, Ishihara R, Morishima T, Tabuchi T, Okada H, Ohno Y, Sobue T, Miyashiro I. Excessive risk of second-cancer incidence and cancer mortality in patients with esophageal cancer. J Gastroenterol 2021; 56:434-441. [PMID: 33576870 DOI: 10.1007/s00535-021-01767-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 01/29/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Second primary cancers have impact on survival in patients who achieved cure for the first esophageal cancer. We, therefore, assessed the risk of incidence and mortality for second primary cancer by calculating standardized incidence ratio (SIR) and standardized mortality ratio (SMR) in patients with superficial or localized esophageal cancer without lymph node metastases as the first cancer (index cancer). METHODS Data on cancer development and subsequent causes of deaths were collected from integrated database of the Osaka Cancer Registry and the Vital Statistics of Japan. Records with information on patients with index esophageal cancer diagnosed between 2004 and 2013 were extracted from the database. Then, SIR and SMR for second primary cancers that developed in other organ were calculated with the reference to the general population during the same period. All probability values are two-tailed. RESULTS Of 473,784 case records, 3022 cases of patients with index esophageal cancer were identified. Significantly higher SMRs/SIRs for cancers in mouth/pharynx, larynx, pancreas, and leukemia were confirmed with the values of 10.78/16.16, 8.56/6.44, 2.33/2.31, and 3.96/4.42, respectively. Significantly, higher SIRs for stomach, lung, and skin cancers were confirmed with the values of 2.84, 2.36, and 3.38, respectively, while SMRs were not significantly higher in these cancers. CONCLUSIONS Significantly higher risks for mouth/pharynx, larynx, pancreas, and leukemia as second cancers were clarified. Careful surveillance for these cancers is required for esophageal cancer patients.
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Affiliation(s)
- Masayasu Ohmori
- Department of Gastroenterology and Hepatology, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.,Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Ryu Ishihara
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan.
| | | | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - Hiroyuki Okada
- Department of Gastroenterology and Hepatology, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yuko Ohno
- Department of Mathematical Health Science, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Tomotaka Sobue
- Division of Environmental Medicine and Population Sciences, Department of Social Medicine, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Isao Miyashiro
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
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6
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Swei E, Wagh MS. Endoscopic submucosal dissection in the pharynx: Let's start at the very beginning! Gastrointest Endosc 2021; 93:828-830. [PMID: 33741087 DOI: 10.1016/j.gie.2020.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 09/07/2020] [Indexed: 02/08/2023]
Affiliation(s)
- Eric Swei
- Division of Gastroenterology, University of Colorado-Denver School of Medicine, Aurora, Colorado, USA
| | - Mihir S Wagh
- Division of Gastroenterology, University of Colorado-Denver School of Medicine, Aurora, Colorado, USA
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7
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Zwakenberg MA, Halmos GB, Wedman J, van der Laan BFAM, Plaat BEC. Evaluating Laryngopharyngeal Tumor Extension Using Narrow Band Imaging Versus Conventional White Light Imaging. Laryngoscope 2021; 131:E2222-E2231. [PMID: 33393666 DOI: 10.1002/lary.29361] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/09/2020] [Accepted: 12/18/2020] [Indexed: 01/03/2023]
Abstract
OBJECTIVE/HYPOTHESIS Comparing detection and extension of malignant tumors by flexible laryngoscopy in the outpatient setting with laryngoscopy under general anesthesia using both White Light Imaging (WLI) and Narrow Band Imaging (NBI). STUDY DESIGN Prospective study. METHODS Two hundred and thirty-three patients with laryngeal and pharyngeal lesions underwent flexible and rigid laryngoscopy, with both WLI and NBI. Extension of malignant lesions (n = 132) was compared between both techniques in detail. RESULTS Sensitivity of NBI during flexible endoscopy (92%), was comparable with that of WLI during rigid endoscopy (91%). The correlation of tumor extension between flexible and rigid laryngoscopy was high (rs = 0.852-0.893). The observed tumor extension was significantly larger when using NBI in both settings. The use of NBI during flexible laryngoscopy leads to upstaging (12%) and downstaging (2%) of the T classification. CONCLUSIONS NBI during flexible laryngoscopy could be an alternative to WLI rigid endoscopy. NBI improves visualization of tumor extension and accuracy of T staging. LEVEL OF EVIDENCE 3 Laryngoscope, 131:E2222-E2231, 2021.
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Affiliation(s)
- Manon A Zwakenberg
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Gyorgy B Halmos
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jan Wedman
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Bernard F A M van der Laan
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Otorhinolaryngology, Head and Neck Surgery, Haaglanden Medical Center, The Hague, The Netherlands
| | - Boudewijn E C Plaat
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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8
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Shinozaki T, Katada C, Shiga K, Asakage T, Yokoyama T, Yano T, Oda I, Shimizu Y, Takemura K, Ishikawa H, Yokoyama A, Muto M. Effectiveness of planned surveillance for detecting second primary head and neck cancers after endoscopic resection of esophageal squamous cell carcinoma. Jpn J Clin Oncol 2020; 50:1162-1167. [PMID: 32533160 DOI: 10.1093/jjco/hyaa087] [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: 04/10/2020] [Accepted: 05/19/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Second primary head and neck cancers after endoscopic resection of esophageal squamous cell carcinoma adversely affect patients' outcomes and the quality of life; however, an adequate surveillance schedule remains unclear. METHODS We analyzed 330 patients with early esophageal squamous cell carcinoma who underwent endoscopic resection and were registered in the multicenter cohort study to evaluate adequate surveillance for detection of second primary head and neck cancers. Gastrointestinal endoscopists examined the head and neck regions after 3-6 months of endoscopic resection for esophageal squamous cell carcinoma and subsequently every 6 months. An otolaryngologist also examined the head and neck regions at the time of endoscopic resection for esophageal squamous cell carcinoma and at 12 months intervals thereafter. RESULTS During the median follow-up period of 49.4 months (1.3-81.2 months), 33 second primary head and neck cancers were newly detected in 20 patients (6%). The tumor site was as follows: 22 lesions in the hypopharynx, eight lesions in the oropharynx, two lesions in larynx and one lesion in the oral cavity. The 2-year cumulative incidence rate of second primary head and neck cancers was 3.7%. Among them, 17 patients with 29 lesions were treated by transoral surgery. One patient with two synchronous lesions was treated by radiotherapy. Two lesions in two patients were not detected after biopsy. All patients were cured with preserved laryngeal function. CONCLUSIONS Surveillance by gastrointestinal endoscopy every 6 months and surveillance by an otolaryngologist every 12 months could detect second primary head and neck cancers at an early stage, thereby facilitating minimally invasive treatment.
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Affiliation(s)
- Takeshi Shinozaki
- Department of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa, Japan
| | - Chikatoshi Katada
- Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Kiyoto Shiga
- Department of Head and Neck Surgery, Iwate Medical University School of Medicine, Morioka, Japan
| | - Takahiro Asakage
- Department of Head and Neck Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tetsuji Yokoyama
- Department of Health Promotion, National Institute of Public Health, Wako, Japan
| | - Tomonori Yano
- Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Kashiwa, Japan
| | - Ichiro Oda
- Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
| | - Yuichi Shimizu
- Department of Gastroenterology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Kenichi Takemura
- Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
| | - Hideki Ishikawa
- Department of Molecular-Targeting Cancer Prevention, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Akira Yokoyama
- Clinical Research Unit, National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka, Japan
| | - Manabu Muto
- Department of Therapeutic Oncology, Kyoto University Graduate School of Medicine, Kyoto, Japan
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9
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Ishihara R, Arima M, Iizuka T, Oyama T, Katada C, Kato M, Goda K, Goto O, Tanaka K, Yano T, Yoshinaga S, Muto M, Kawakubo H, Fujishiro M, Yoshida M, Fujimoto K, Tajiri H, Inoue H. Endoscopic submucosal dissection/endoscopic mucosal resection guidelines for esophageal cancer. Dig Endosc 2020; 32:452-493. [PMID: 32072683 DOI: 10.1111/den.13654] [Citation(s) in RCA: 185] [Impact Index Per Article: 46.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 01/23/2020] [Indexed: 01/17/2023]
Abstract
The Japan Gastroenterological Endoscopy Society has developed endoscopic submucosal dissection/endoscopic mucosal resection guidelines. These guidelines present recommendations in response to 18 clinical questions concerning the preoperative diagnosis, indications, resection methods, curability assessment, and surveillance of patients undergoing endoscopic resection for esophageal cancers based on a systematic review of the scientific literature.
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Affiliation(s)
- Ryu Ishihara
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Miwako Arima
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Toshiro Iizuka
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Tsuneo Oyama
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | | | - Motohiko Kato
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Kenichi Goda
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Osamu Goto
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Kyosuke Tanaka
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Tomonori Yano
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | | | - Manabu Muto
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | | | | | | | | | - Hisao Tajiri
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Haruhiro Inoue
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
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10
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Lee J, Chen KM, Chang C, Liu Y, Yang C. Endoscopic submucosal dissection for superficial pharyngeal squamous cell carcinoma. ADVANCES IN DIGESTIVE MEDICINE 2020. [DOI: 10.1002/aid2.13195] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Jyong‐Hong Lee
- Division of Gastroenterology, Department of Internal Medicine Show Chwan Memorial Hospital Changhua Taiwan
| | - Kwei Ming Chen
- Division of Gastroenterology, Department of Internal Medicine Show Chwan Memorial Hospital Changhua Taiwan
| | - Chi‐Hsien Chang
- Division of Gastroenterology, Department of Internal Medicine Show Chwan Memorial Hospital Changhua Taiwan
| | - Yu‐Tsai Liu
- Division of Gastroenterology, Department of Internal Medicine Show Chwan Memorial Hospital Changhua Taiwan
| | - Chi‐Chieh Yang
- Division of Gastroenterology, Department of Internal Medicine Show Chwan Memorial Hospital Changhua Taiwan
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11
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Kato M, Hayashi Y, Uema R, Saiki H, Kimura K, Inoue T, Sakatani A, Yoshii S, Tsujii Y, Shinzaki S, Hida E, Iijima H, Takehara T. Usefulness of a dedicated mouthpiece for the Valsalva maneuver to visualize the hypopharynx during transoral endoscopy. Endosc Int Open 2020; 8:E536-E543. [PMID: 32258376 PMCID: PMC7089799 DOI: 10.1055/a-1099-9130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 12/02/2019] [Indexed: 12/30/2022] Open
Abstract
Background and study aims Patients with esophageal squamous cell carcinoma (SCC) are at high risk of developing second primary SCCs in the hypopharynx. However, such second primary tumors are difficult to observe because of lumen closure. The Valsalva maneuver using a dedicated mouthpiece is a promising technique to visualize the hypopharynx during transoral endoscopy. In the current study, we investigated the utility of this method. Patients and methods The current study was a randomized, controlled, crossover trial. Patients with esophageal SCC were randomly assigned first to undergo pharyngeal observation using the dedicated mouthpiece followed by observation using a conventional mouthpiece, or vice versa. The primary endpoint was complete visualization of the hypopharynx, which was assessed blindly by three external evaluators. Results A total of 68 pharyngeal examinations were analyzed - 34 with the dedicated mouthpiece and 34 with a conventional mouthpiece. Complete visualization was achieved in 68 % of the examinations (23/34) using the dedicated mouthpiece, whereas none of the examinations using the conventional mouthpiece achieved complete visualization of the hypopharynx. Observation scores of the oropharynx were not significantly different between both types of examination ( P = 0.50). No serious adverse events (AEs) occurred. Conclusions Endoscopic view of the hypopharynx was markedly improved by the Valsalva maneuver using the dedicated mouthpiece, with no serious AEs. This procedure should be included in the endoscopic examinations for the patients with esophageal SCCs.
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Affiliation(s)
- Minoru Kato
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yoshito Hayashi
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Ryotaro Uema
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Hirotsugu Saiki
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Keiichi Kimura
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Takanori Inoue
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Akihiko Sakatani
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Shunsuke Yoshii
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yoshiki Tsujii
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Shinichiro Shinzaki
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Eisuke Hida
- Department of Biostatics and Data Science, Osaka University Graduate School of Medicine, Suita, Japan
| | - Hideki Iijima
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Tetsuo Takehara
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Suita, Japan
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12
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van de Ven S, Bugter O, Hardillo JA, Bruno MJ, Baatenburg de Jong RJ, Koch AD. Screening for head and neck second primary tumors in patients with esophageal squamous cell cancer: A systematic review and meta-analysis. United European Gastroenterol J 2019; 7:1304-1311. [PMID: 31839955 PMCID: PMC6893998 DOI: 10.1177/2050640619856459] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 05/20/2019] [Indexed: 12/18/2022] Open
Abstract
Background Esophageal squamous cell carcinomas (ESCCs) are often accompanied by head and neck second primary tumors (HNSPTs). The prognosis of patients with an additional HNSPT is worse compared with patients with only ESCC. Therefore, early detection of HNSPTs may improve the overall outcome of patients with ESCC. The purpose of this study was to investigate the yield of endoscopic screening for HNSPTs in patients with primary ESCC. Methods We conducted a systematic literature search of all available databases. Studies were included if ESCC patients were endoscopically screened for HNSPT. The primary outcome was the pooled prevalence of HNSPTs. Results Twelve studies, all performed in Japan, were included in this systematic review with a total of 6483 patients. The pooled prevalence of HNSPTs was 6.7% (95% confidence interval: 4.9–8.4). The overall heterogeneity was high across the studies (I2 = 89.0%, p < 0.001). Most HNSPTs were low stage (85.3%) and located in the hypopharynx (60.3%). The proportion of synchronous (48.2%) and metachronous (51.8%) HNSPTs was comparable. Conclusion Based on our results, HNSPT screening could be considered in patients with primary ESCC. All studies were performed in Japan; it is therefore not clear whether this consideration applies to the Western world.
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Affiliation(s)
- Sem van de Ven
- Department of Gastroenterology and Hepatology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - O Bugter
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - J A Hardillo
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - M J Bruno
- Department of Gastroenterology and Hepatology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - R J Baatenburg de Jong
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - A D Koch
- Department of Gastroenterology and Hepatology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
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13
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Zwakenberg MA, Dikkers FG, Wedman J, van der Laan BFAM, Halmos GB, Plaat BEC. Detection of high-grade dysplasia, carcinoma in situ and squamous cell carcinoma in the upper aerodigestive tract: Recommendations for optimal use and interpretation of narrow-band imaging. Clin Otolaryngol 2018; 44:39-46. [DOI: 10.1111/coa.13229] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 05/05/2018] [Accepted: 09/09/2018] [Indexed: 01/26/2023]
Affiliation(s)
- Manon A. Zwakenberg
- Department of Otorhinolaryngology/Head and Neck surgery; University Medical Center Groningen; University of Groningen; Groningen the Netherlands
| | - Frederik G. Dikkers
- Department of Otorhinolaryngology; Academic Medical Center; University of Amsterdam; Amsterdam the Netherlands
| | - Jan Wedman
- Department of Otorhinolaryngology/Head and Neck surgery; University Medical Center Groningen; University of Groningen; Groningen the Netherlands
| | - Bernard F. A. M. van der Laan
- Department of Otorhinolaryngology/Head and Neck surgery; University Medical Center Groningen; University of Groningen; Groningen the Netherlands
| | - Gyorgy B. Halmos
- Department of Otorhinolaryngology/Head and Neck surgery; University Medical Center Groningen; University of Groningen; Groningen the Netherlands
| | - Boudewijn E. C. Plaat
- Department of Otorhinolaryngology/Head and Neck surgery; University Medical Center Groningen; University of Groningen; Groningen the Netherlands
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14
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Wu C, Gleysteen J, Teraphongphom NT, Li Y, Rosenthal E. In-vivo optical imaging in head and neck oncology: basic principles, clinical applications and future directions. Int J Oral Sci 2018; 10:10. [PMID: 29555901 PMCID: PMC5944254 DOI: 10.1038/s41368-018-0011-4] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 12/29/2017] [Accepted: 01/10/2018] [Indexed: 02/05/2023] Open
Abstract
Head and neck cancers become a severe threat to human's health nowadays and represent the sixth most common cancer worldwide. Surgery remains the first-line choice for head and neck cancer patients. Limited resectable tissue mass and complicated anatomy structures in the head and neck region put the surgeons in a dilemma between the extensive resection and a better quality of life for the patients. Early diagnosis and treatment of the pre-malignancies, as well as real-time in vivo detection of surgical margins during en bloc resection, could be leveraged to minimize the resection of normal tissues. With the understanding of the head and neck oncology, recent advances in optical hardware and reagents have provided unique opportunities for real-time pre-malignancies and cancer imaging in the clinic or operating room. Optical imaging in the head and neck has been reported using autofluorescence imaging, targeted fluorescence imaging, high-resolution microendoscopy, narrow band imaging and the Raman spectroscopy. In this study, we reviewed the basic theories and clinical applications of optical imaging for the diagnosis and treatment in the field of head and neck oncology with the goal of identifying limitations and facilitating future advancements in the field.
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Affiliation(s)
- Chenzhou Wu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - John Gleysteen
- Department of Otolaryngology, University of Tennessee Health Science Center, 38163, Memphis, TN, USA
| | | | - Yi Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | - Eben Rosenthal
- Department of Otolaryngology and Radiology, Stanford University, 94305, Stanford, CA, USA.
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15
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Mizushima T, Ohnishi S, Shimizu Y, Hatanaka Y, Hatanaka KC, Kuriki Y, Kamiya M, Homma A, Yamamoto K, Ono S, Urano Y, Sakamoto N. Rapid detection of superficial head and neck squamous cell carcinoma by topically spraying fluorescent probe targeting dipeptidyl peptidase-IV. Head Neck 2018; 40:1466-1475. [PMID: 29509281 DOI: 10.1002/hed.25126] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 11/15/2017] [Accepted: 01/26/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND A fluorescent probe glutamylprolyl hydroxymethyl rhodamine green (EP-HMRG), which becomes fluorescent after cleavage by dipeptidyl peptidase-IV (DPP-IV), has been reported to be useful for the detection of esophageal cancer. Thus, we investigated whether head and neck squamous cell carcinoma (HNSCC) can be detected by spraying EP-HMRG. METHODS Fluorescence imaging of 17 cases of HNSCCs resected using endoscopic or surgical resection was performed ex vivo after spraying EP-HMRG, and then the fluorescence intensity of the tumors and normal mucosa were measured. RESULTS Iodine-voiding lesions became fluorescent within a few minutes after the application of EP-HMRG in 12 resected tumors without a history of radiotherapy but this was not observed in the normal mucosa. Fluorescence intensity in tumor lesions was significantly higher than normal lesions. However, 5 other tumors that developed after radiotherapy did not have sufficient contrast against normal mucosa. CONCLUSION Fluorescence imaging with EP-HMRG would be useful for rapid detection of superficial HNSCC without a history of radiotherapy.
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Affiliation(s)
- Takeshi Mizushima
- Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Shunsuke Ohnishi
- Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Yuichi Shimizu
- Division of Endoscopy, Hokkaido University Hospital, Sapporo, Japan
| | - Yutaka Hatanaka
- Department of Surgical Pathology, Hokkaido University Hospital, Sapporo, Japan
| | - Kanako C Hatanaka
- Department of Surgical Pathology, Hokkaido University Hospital, Sapporo, Japan
| | - Yugo Kuriki
- Laboratory of Chemical Biology and Molecular Imaging, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mako Kamiya
- Laboratory of Chemical Biology and Molecular Imaging, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Akihiro Homma
- Department of Otolaryngology - Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Keiko Yamamoto
- Division of Endoscopy, Hokkaido University Hospital, Sapporo, Japan
| | - Shouko Ono
- Division of Endoscopy, Hokkaido University Hospital, Sapporo, Japan
| | - Yasuteru Urano
- Laboratory of Chemical Biology and Molecular Imaging, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Japan Agency for Medical Research and Development (AMED)-CREST, Tokyo, Japan
| | - Naoya Sakamoto
- Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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16
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Kataoka S, Omae M, Horiuchi Y, Ishiyama A, Yoshio T, Hirasawa T, Yamamoto Y, Tsuchida T, Fujisaki J, Yamada K, Igarashi M. Synchronous triple primary cancers of the pharynx and esophagus. Clin J Gastroenterol 2017; 10:208-213. [PMID: 28315155 DOI: 10.1007/s12328-017-0734-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 03/09/2017] [Indexed: 12/24/2022]
Abstract
A 72-year-old male with nausea and heartburn was found to have early pharyngeal squamous cell carcinoma, superficial and advanced esophageal squamous cell carcinoma and early esophageal adenocarcinoma by esophagogastroduodenoscopy. Computerized tomography demonstrated left cardiac lymph node swellings. We prioritized the treatment for esophageal squamous cell carcinoma, as this was the most advanced cancer among the triple primaries. The patient underwent neoadjuvant chemotherapy for esophageal squamous cell carcinoma followed by esophagectomy. Four months after esophagectomy, endoscopic submucosal dissection for pharyngeal squamous cell carcinoma was performed. This is a first report of pharyngeal squamous cell carcinoma, esophageal squamous cell carcinoma and esophageal adenocarcinoma occurring as triple primary cancers in a single patient. Smoking-induced tumor formation through DNA methylation is a common risk factor for patients with triple primary malignancies, being an example of epigenetic field cancerization induced by exposure to carcinogenic factors.
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Affiliation(s)
- Seita Kataoka
- Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-81-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Masami Omae
- Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-81-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
| | - Yusuke Horiuchi
- Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-81-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Akiyoshi Ishiyama
- Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-81-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Toshiyuki Yoshio
- Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-81-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Toshiaki Hirasawa
- Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-81-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Yorimasa Yamamoto
- Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-81-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Tomohiro Tsuchida
- Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-81-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Junko Fujisaki
- Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-81-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Kazuhiko Yamada
- Department of Surgery, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Masahiro Igarashi
- Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-81-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan
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17
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Volgger V, Felicio A, Lohscheller J, Englhard AS, Al-Muzaini H, Betz CS, Schuster ME. Evaluation of the combined use of narrow band imaging and high-speed imaging to discriminate laryngeal lesions. Lasers Surg Med 2017; 49:609-618. [PMID: 28231400 DOI: 10.1002/lsm.22652] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND OBJECTIVE Laryngeal lesions are usually investigated by microlaryngoscopy, biopsy, and histopathology. This study aimed to evaluate the combined use of Narrow Band Imaging (NBI) and High-Speed Imaging (HSI) in the differentiation of glottic lesions in awake patients. STUDY DESIGN Prospective diagnostic study. MATERIALS AND METHODS Thirty-six awake patients with 41 glottic lesions were investigated with both NBI and HSI, and the suspected diagnoses were compared to the histopathological results of tissue biopsies taken during subsequent microlaryngoscopies. Of the 41 lesions, 28 were primary lesions and 13 recurrent lesions after previous laryngeal pathologies. RESULTS Sensitivity, specificity, positive predictive value, and negative predictive value in the differentiation between benign/premalignant and malignant lesions with both NBI and HSI accounted to 100.0%, 79.4%, 50.0%, and 100.0%. Sensitivities and specificities were 100.0% and 85.7% for HSI alone, and 100.0% and 79.4% for NBI alone. Regarding only primary lesions the results were generally better with sensitivities and specificities of 100% and 81% for NBI, 100% and 84.2% for HSI and 100% and 85.7% for the combination of both methods, respectively. CONCLUSION NBI and HSI both seem to be promising adjunct tools in the differentiation of various laryngeal lesions in awake patients with high sensitivities. Specificities, however, were moderate but could be increased when using NBI and HSI in combination in a subgroup of patients with only primary lesions. Although both methods still have limitations they might ameliorate the evaluation of suspicious laryngeal lesions in the future and could possibly spare patients from repeated invasive tissue biopsies. Lasers Surg. Med. 49:609-618, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Veronika Volgger
- Department of Otorhinolaryngology, Head and Neck Surgery, Klinikum der Universität München, 81377, Munich, Germany
| | - Axelle Felicio
- Department of Otorhinolaryngology, Head and Neck Surgery, Klinikum der Universität München, 81377, Munich, Germany
| | - Jörg Lohscheller
- Department of Informatics, Trier University of Applied Sciences, Schneidershof, 54208, Trier, Germany
| | - Anna S Englhard
- Department of Otorhinolaryngology, Head and Neck Surgery, Klinikum der Universität München, 81377, Munich, Germany
| | - Hanan Al-Muzaini
- Department of Otorhinolaryngology, Head and Neck Surgery, Klinikum der Universität München, 81377, Munich, Germany
| | - Christian S Betz
- Department of Otorhinolaryngology, Head and Neck Surgery, Klinikum der Universität München, 81377, Munich, Germany
| | - Maria E Schuster
- Department of Otorhinolaryngology, Head and Neck Surgery, Klinikum der Universität München, 81377, Munich, Germany
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18
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Morimoto H, Yano T, Yoda Y, Oono Y, Ikematsu H, Hayashi R, Ohtsu A, Kaneko K. Clinical impact of surveillance for head and neck cancer in patients with esophageal squamous cell carcinoma. World J Gastroenterol 2017; 23:1051-1058. [PMID: 28246479 PMCID: PMC5311094 DOI: 10.3748/wjg.v23.i6.1051] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 11/24/2016] [Accepted: 01/18/2017] [Indexed: 02/06/2023] Open
Abstract
AIM
To evaluate the clinical impact of surveillance for head and neck (HN) region with narrow band imaging (NBI) in patients with esophageal squamous cell carcinoma (ESCC).
METHODS
Since 2006, we introduced the surveillance for HN region using NBI for all patients with ESCC before treatment, and each follow-up. The patients with newly diagnosed stage I to III ESCC were enrolled and classified into two groups as follows: Group A (no surveillance for HN region); between 1992 and 2000), and Group B (surveillance for HN region with NBI; between 2006 and 2008). We comparatively evaluated the detection rate of superficial head and neck squamous cell carcinoma (HNSCC), and the serious events due to metachronous advanced HNSCC during the follow-up.
RESULTS
A total 561 patients (group A: 254, group B: 307) were enrolled. Synchronous superficial HNSCC was detected in 1 patient (0.3%) in group A, and in 12 (3.9%) in group B (P = 0.008). During the follow up period, metachronous HNSCC were detected in 10 patients (3.9%) in group A and in 30 patients (9.8%) in group B (P = 0.008). All metachronous lesions in group B were early stage, and 26 patients underwent local resection, however, 6 of 10 patients (60%) in group A lost their laryngeal function and died with metachronous HNSCC.
CONCLUSION
Surveillance for the HN region by using NBI endoscopy increase the detection rate of early HNSCC in patients with ESCC, and led to decrease serious events related to advanced metachronous HNSCC.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Carcinoma, Squamous Cell/diagnostic imaging
- Carcinoma, Squamous Cell/mortality
- Carcinoma, Squamous Cell/pathology
- Carcinoma, Squamous Cell/therapy
- Chemoradiotherapy
- Early Detection of Cancer/methods
- Endoscopic Mucosal Resection
- Esophageal Neoplasms/diagnostic imaging
- Esophageal Neoplasms/mortality
- Esophageal Neoplasms/pathology
- Esophageal Neoplasms/therapy
- Esophageal Squamous Cell Carcinoma
- Female
- Follow-Up Studies
- Head and Neck Neoplasms/diagnostic imaging
- Head and Neck Neoplasms/mortality
- Head and Neck Neoplasms/pathology
- Head and Neck Neoplasms/therapy
- Humans
- Male
- Middle Aged
- Narrow Band Imaging
- Neoplasm Staging
- Neoplasms, Multiple Primary/diagnostic imaging
- Neoplasms, Multiple Primary/mortality
- Neoplasms, Multiple Primary/pathology
- Neoplasms, Multiple Primary/therapy
- Neoplasms, Second Primary/diagnostic imaging
- Neoplasms, Second Primary/mortality
- Neoplasms, Second Primary/pathology
- Neoplasms, Second Primary/therapy
- Retrospective Studies
- Squamous Cell Carcinoma of Head and Neck
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19
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Yamasaki Y, Ishihara R, Hanaoka N, Matsuura N, Kanesaka T, Akasaka T, Kato M, Hamada K, Tonai Y, Yamamoto S, Takeuchi Y, Higashino K, Uedo N, Ito Y, Yano M, Iishi H. Pethidine hydrochloride is a better sedation method for pharyngeal observation by transoral endoscopy compared with no sedation and midazolam. Dig Endosc 2017; 29:39-48. [PMID: 27696551 DOI: 10.1111/den.12746] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 09/26/2016] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIM Standard surveillance methods for pharyngeal cancer have not been established. We conducted a randomized controlled trial to investigate the best sedation method for pharyngeal observation using transoral endoscopy. METHODS In total, 120 patients who underwent surveillance or diagnostic examinations for esophageal cancer were enrolled and divided equally into three groups (no sedation, midazolam, or pethidine hydrochloride). In the midazolam group, midazolam was given i.v. maintaining a Ramsay score of 3. In the pethidine group, pethidine hydrochloride (35 mg) given i.v. Seven sites in five pharyngeal regions were observed on insertion of the endoscope, and graded (0 = poor, 1 = good). After examination, the five pharyngeal regions were scored using a seven-point scale. Primary endpoint was the total score from the five pharyngeal regions. Secondary endpoints were the proportion of the perfect score using the seven-point scale, discomfort score, and adverse events. RESULTS Mean total scores for the no sedation group, the midazolam group and the pethidine group were 5.7, 5.5, and 6.8, respectively (P < 0.0001). Proportion of patients with a perfect score for the no sedation group, the midazolam group and the pethidine group were 53%, 35%, and 89%, respectively (P < 0.0001). The pethidine group had better results than the other two groups. Discomfort score and adverse events were low in the pethidine group. CONCLUSION Pethidine hydrochloride is a feasible and safe sedation method, and was superior to no sedation and midazolam regarding pharyngeal observation of esophageal cancer patients.
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Affiliation(s)
- Yasushi Yamasaki
- Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Ryu Ishihara
- Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Noboru Hanaoka
- Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Noriko Matsuura
- Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Takashi Kanesaka
- Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Tomofumi Akasaka
- Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Minoru Kato
- Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Kenta Hamada
- Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Yusuke Tonai
- Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Sachiko Yamamoto
- Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Yoji Takeuchi
- Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Koji Higashino
- Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Noriya Uedo
- Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Yuri Ito
- Center for Cancer Control and Statistics, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Masahiko Yano
- Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Hiroyasu Iishi
- Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
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20
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Mizushima T, Ohnishi S, Shimizu Y, Hatanaka Y, Hatanaka KC, Hosono H, Kubota Y, Natsuizaka M, Kamiya M, Ono S, Homma A, Kato M, Sakamoto N, Urano Y. Fluorescent imaging of superficial head and neck squamous cell carcinoma using a γ-glutamyltranspeptidase-activated targeting agent: a pilot study. BMC Cancer 2016; 16:411. [PMID: 27387955 PMCID: PMC4936014 DOI: 10.1186/s12885-016-2421-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2015] [Accepted: 06/16/2016] [Indexed: 01/11/2023] Open
Abstract
Background Detecting superficial head and neck squamous cell carcinoma (HNSCC) by endoscopy is challenging because of limited morphological hallmarks, and iodine cannot be applied to head and neck lesions due to severe mucosal irritation. γ-glutamyltranspeptidase (GGT), a cell surface enzyme, is overexpressed in several cancers, and it has been reported that γ-glutamyl hydroxymethyl rhodamine green (gGlu-HMRG), a fluorescent targeting agent which can be enzymatically activated and becomes fluorescent after cleavage of a GGT-specific sequence, can be activated within a few minutes after application to animal models. We investigated whether early HNSCC can be detected by applying gGlu-HMRG to clinical samples. Methods gGlu-HMRG was applied to four HNSCC cell lines, and fluorescence was observed by fluorescence microscopy and flow cytometry. Immunohistological examination was performed in three recent cases of endoscopic submucosal dissection (ESD) to investigate GGT expression. Fluorescence imaging with gGlu-HMRG in eight clinical samples resected by ESD or surgery was performed, and fluorescence intensity of tumor and normal mucosa regions of interest (ROI) was prospectively measured. Results All four gGlu-HMRG-applied cell lines emitted green fluorescence. Immunohistological examination demonstrated that GGT was highly expressed in HNSCC of the recent three ESD cases but barely in the normal mucosa. Fluorescence imaging showed that iodine-voiding lesions became fluorescent within a few minutes after application of gGlu-HMRG in all eight resected tumors. Tumor ROI fluorescence intensity was significantly higher than in the normal mucosa five minutes after gGlu-HMRG application. Conclusions Fluorescence imaging with gGlu-HMRG would be useful for early detection of HNSCC.
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Affiliation(s)
- Takeshi Mizushima
- Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, 060-8638, Japan
| | - Shunsuke Ohnishi
- Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, 060-8638, Japan.
| | - Yuichi Shimizu
- Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, 060-8638, Japan
| | - Yutaka Hatanaka
- Department of Surgical Pathology, Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo, 060-8648, Japan
| | - Kanako C Hatanaka
- Department of Surgical Pathology, Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo, 060-8648, Japan
| | - Hidetaka Hosono
- Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, 060-8638, Japan
| | - Yoshimasa Kubota
- Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, 060-8638, Japan
| | - Mitsuteru Natsuizaka
- Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, 060-8638, Japan
| | - Mako Kamiya
- Laboratory of Chemical Biology and Molecular Imaging, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Shouko Ono
- Division of Endoscopy, Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo, 060-8648, Japan
| | - Akihiro Homma
- Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, 060-8638, Japan
| | - Mototsugu Kato
- Division of Endoscopy, Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo, 060-8648, Japan
| | - Naoya Sakamoto
- Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, 060-8638, Japan
| | - Yasuteru Urano
- Laboratory of Chemical Biology and Molecular Imaging, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.,Japan Agency for Medical Research and Development (AMED)-CREST, 7-1 Ootemachi-1, Chiyoda-ku, Tokyo, 100-0004, Japan
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21
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Zwakenberg MA, Dikkers FG, Wedman J, Halmos GB, van der Laan BFAM, Plaat BEC. Narrow band imaging improves observer reliability in evaluation of upper aerodigestive tract lesions. Laryngoscope 2016; 126:2276-81. [PMID: 27074877 DOI: 10.1002/lary.26008] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 02/23/2016] [Accepted: 03/07/2016] [Indexed: 01/18/2023]
Abstract
OBJECTIVES/HYPOTHESIS Visualization by endoscopy is essential in the diagnosis of upper aerodigestive tract lesions. Recent studies showed that narrow band imaging (NBI) increases the diagnostic potential of conventional white light imaging (WLI) by highlighting the superficial vessels. The objective of this study was to evaluate whether the use of NBI would influence inter- and intraobserver agreement while making diagnostic decisions using rigid endoscopy of the upper aerodigestive tract. STUDY DESIGN Retrospective study. METHODS One hundred routinely collected pictures of laryngeal, hypopharyngeal, and oropharyngeal lesions were used. Rigid endoscopies and patient data collection were performed according to standard protocol. Twelve observers, grouped in different levels of experience, assessed all lesions twice with a 2 to 4 week interval. Fleiss and Cohen's kappa (κ) values were calculated to assess inter- and intraobserver agreement. RESULTS Overall interobserver agreement increased from κ = 0.34 to κ = 0.40 by adding NBI to WLI (WLI and WLI + NBI, respectively). In experienced observers, an improvement from κ = 0.39 to κ = 0.43 was observed; in less-experienced observers an improvement from κ = 0.30 to κ = 0.37 was observed. Overall intraobserver agreement increased from moderate (κ = 0.54) to substantial (κ = 0.63) with addition of NBI. Intraobserver agreement for less-experienced observers improved remarkably when WLI was combined with NBI (κ = 0.51 vs. κ = 0.67). CONCLUSIONS Addition of NBI during rigid endoscopies of the upper aerodigestive tract led to improvement of both inter- and intraobserver agreement. LEVEL OF EVIDENCE 4 Laryngoscope, 126:2276-2281, 2016.
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Affiliation(s)
- Manon A Zwakenberg
- Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - Frederik G Dikkers
- Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jan Wedman
- Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Gyorgy B Halmos
- Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Bernard F A M van der Laan
- Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Boudewijn E C Plaat
- Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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22
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Cosway B, Drinnan M, Paleri V. Narrow band imaging for the diagnosis of head and neck squamous cell carcinoma: A systematic review. Head Neck 2016; 38 Suppl 1:E2358-67. [DOI: 10.1002/hed.24300] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 09/19/2015] [Indexed: 12/17/2022] Open
Affiliation(s)
- Benjamin Cosway
- Department of Otolaryngology - Head and Neck Surgery; Freeman Hospital; Newcastle United Kingdom
| | - Michael Drinnan
- Department of Clinical Engineering; Freeman Hospital; Newcastle United Kingdom
| | - Vinidh Paleri
- Department of Otolaryngology - Head and Neck Surgery; Freeman Hospital; Newcastle United Kingdom
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23
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Vu A, Farah CS. Narrow band imaging: clinical applications in oral and oropharyngeal cancer. Oral Dis 2016; 22:383-90. [PMID: 26713751 DOI: 10.1111/odi.12430] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 12/21/2015] [Indexed: 01/19/2023]
Abstract
Narrow Band Imaging (NBI) is an endoscopic optical imaging enhancement technology that improves the contrast of mucosal surface texture, and enhances visualisation of mucosal and submucosal vasculature. White light is filtered to emit two 30-nm narrow bands of blue (415 nm) and green light (540 nm) light simultaneously, the former corresponding to the main peak absorption spectrum of haemoglobin, and the latter allowing visualisation of blood vessels in the deeper mucosal and submucosal layers. NBI has been used to better assess oral potentially malignant disorders (OPMD), identify oral and oropharyngeal squamous cell carcinoma (SCC), and to define surgical margins of head and neck malignancies. NBI shows great potential in improving detection rates of OPMD, facilitating better assessment of oral and oropharyngeal SCC, and reducing the risk of recurrence for oral SCC. Although further research is required to better understand and define intrapapillary capillary loop (IPCL) patterns and to relate these with clinical, histopathological and molecular parameters especially for early mucosal changes, there is building evidence to recommend its use as the new gold standard for endoscopic assessment in head and neck oncology.
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Affiliation(s)
- A Vu
- The Australian Centre for Oral Oncology Research & Education, School of Dentistry, University of Western Australia, Nedlands, Australia
| | - C S Farah
- The Australian Centre for Oral Oncology Research & Education, School of Dentistry, University of Western Australia, Nedlands, Australia
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24
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Otowa Y, Nakamura T, Takiguchi G, Yamamoto M, Kanaji S, Imanishi T, Oshikiri T, Suzuki S, Tanaka K, Kakeji Y. Safety and benefit of curative surgical resection for esophageal squamous cell cancer associated with multiple primary cancers. Eur J Surg Oncol 2015; 42:407-11. [PMID: 26733367 DOI: 10.1016/j.ejso.2015.11.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 10/05/2015] [Accepted: 11/20/2015] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Enhancements in surgical techniques have led to improved outcomes for esophageal cancer. Recent findings have showed that esophageal cancer is frequently associated with multiple primary cancers, and surgical resection is usually complicated in such cases. The aim of this study was to clarify the clinical significance of surgery for patients with esophageal squamous cell cancer associated with multiple primary cancers. METHODS The clinical outcomes of surgical resection for esophageal cancer were compared among 79 patients with antecedent and/or synchronous cancers (Multiple cancer group) and 194 patients without antecedent and/or synchronous cancers (Single cancer group). RESULTS The most common site of multiple primary cancers was the pharynx (36 patients; 29.7%), followed by the stomach (24 patients; 19.8%). The reconstruction method was more complicated in the Multiple cancer group as a result of the prolonged surgery time and increased blood loss. However, postoperative morbidity and overall survival (OS) did not differ between the two groups. After esophagectomy, metachronous cancers were observed in 26 patients, with 30 regions in total, and 93.1% were found to be curable. Sex was the only independent risk factors for developing metachronous cancer after esophagectomy. CONCLUSIONS The presence of antecedent and synchronous cancers complicates the surgical resection of esophageal cancer; however, no differences were found in the OS and postoperative morbidity between the two groups. Therefore, surgical intervention should be selected as a first-line treatment. Because second primary cancers are often observed in esophageal cancer, we recommend a close follow-up using esophagogastroduodenoscopy and contrast-enhanced computed tomography.
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Affiliation(s)
- Y Otowa
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Hyogo, Japan.
| | - T Nakamura
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - G Takiguchi
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - M Yamamoto
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - S Kanaji
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - T Imanishi
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Hyogo, Japan; Department of Gastroenterological Surgery, Hyogo Cancer Center, Hyogo, Japan
| | - T Oshikiri
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - S Suzuki
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - K Tanaka
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Hyogo, Japan; Department of Surgery, Saiseikai Osaka Nakatsu Hospital, Osaka, Japan
| | - Y Kakeji
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Hyogo, Japan
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25
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Chung CS, Lo WC, Lee YC, Wu MS, Wang HP, Liao LJ. Image-enhanced endoscopy for detection of second primary neoplasm in patients with esophageal and head and neck cancer: A systematic review and meta-analysis. Head Neck 2015; 38 Suppl 1:E2343-9. [DOI: 10.1002/hed.24277] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Revised: 05/13/2015] [Accepted: 09/12/2015] [Indexed: 12/16/2022] Open
Affiliation(s)
- Chen-Shuan Chung
- Department of Internal Medicine; Far Eastern Memorial Hospital; Banciao District New Taipei City Taiwan
- College of Medicine; Fu Jen Catholic University; New Taipei City Taiwan
| | - Wu-Chia Lo
- Department of Otolaryngology; Far Eastern Memorial Hospital; Banciao District New Taipei City Taiwan
| | - Yi-Chia Lee
- Department of Internal Medicine; National Taiwan University Hospital; Taipei Taiwan
| | - Ming-Shiang Wu
- Department of Internal Medicine; National Taiwan University Hospital; Taipei Taiwan
| | - Hsiu-Po Wang
- Department of Internal Medicine; National Taiwan University Hospital; Taipei Taiwan
| | - Li-Jen Liao
- Department of Otolaryngology; Far Eastern Memorial Hospital; Banciao District New Taipei City Taiwan
- Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health; National Taiwan University; Taipei Taiwan
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26
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He Y, Zhao Y, Fu K, Du Y, Yu J, Wang J, Jin P, Zhao X, Li N, Guo H, Li J, Zhao F, Sheng J. Propofol sedation versus no sedation in detection of pharyngeal and upper gastrointestinal superficial squamous cell carcinoma using endoscopic narrow band imaging: a multicenter prospective trial. Int J Clin Exp Med 2015. [PMID: 26770478 DOI: 10.1103/physrevd.67.105020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Intravenous propofol can provide a superior quality of sedation compared to standard sedation for upper gastrointestinal endoscopy. However, the utility of propofol sedation for the endoscopic early detection of superficial pharyngeal and esophageal squamous cell carcinoma has not been investigated. In a multicenter, prospective trial, 255 patients with esophageal squamous cell carcinomas (ESCCs) were assigned to receive propofol sedation or no sedation according to their own willingness. The primary aim was to compare the detection rates of superficial cancer in the pharyngeal region and the esophagus between two groups. The secondary aim was to evaluate factors associated with technical adequacy. The detection rate was higher in the propofol sedation vs. no sedation group for H&N region (6.06% vs. 2.40%), but not significantly (P=0.22). However, the small lesion (less than 10 mm in diameter) detection rate was higher in sedation vs. no sedation group for H&N region (88.89% vs. 33.33%; P=0.048). The median time for pharyngeal observation in the sedation group was faster than in the no sedation group (20.6 s vs. 44.3 s; P<0.001). Ninety-five percent of H&N region evaluations were totally complete in sedation compared with sixty percent in the no sedation group (P<0.001). The overall p value indicated that only smoking habit was associated with incomplete pharyngeal observation (P<0.05), and it was more difficult to accomplish a complete pharyngeal observation in patients who smoked more than 10 packs per day. Intravenous propofol sedation compared to no intravenous sedation during conventional upper gastrointestinal endoscopy can facilitate a more complete pharyngeal examination and increase the detection rate of superficial H&N squamous cell carcinoma in high risk patients.
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Affiliation(s)
- Yuqi He
- Department of Gastroenterology, Beijing Military General Hospital Beijing 100700, China
| | - Yuqing Zhao
- Department of VIP, Beijing Military General Hospital Beijing 100700, China
| | - Kuangi Fu
- Department of Gastroenterology, Beijing Military General Hospital Beijing 100700, China
| | - Yongqiang Du
- Department of Science, Tianjin University of Commerce Tianjin 300134, China
| | - Jin Yu
- Department of Gastroenterology, Xinqiao Hospital, Third Military Medical University Chongqing 400038, China
| | - Jianxun Wang
- Institute for Translational Medicine, College of Medicine, Qingdao University Qingdao 266021, China
| | - Peng Jin
- Department of Gastroenterology, Beijing Military General Hospital Beijing 100700, China
| | - Xiaojun Zhao
- Department of Gastroenterology, Beijing Military General Hospital Beijing 100700, China
| | - Na Li
- Department of Gastroenterology, Beijing Military General Hospital Beijing 100700, China
| | - Hua Guo
- Department of Gastroenterology, Beijing Military General Hospital Beijing 100700, China
| | - Jiandong Li
- Department of Gastroenterology, 285 Hospital of PLA Handan, Hebei 056001, China
| | - Fayun Zhao
- Department of Gastroenterology, 285 Hospital of PLA Handan, Hebei 056001, China
| | - Jianqiu Sheng
- Department of Gastroenterology, Beijing Military General Hospital Beijing 100700, China
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27
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OTOWA YASUNORI, NAKAMURA TETSU, TAKIGUCHI GOSUKE, URAKAWA NAOKI, ISHIDA RYO, IMANISHI TATSUYA, SUZUKI SATOSHI, TANAKA KENICHI, KURODA DAISUKE, KAKEJI YOSHIHIRO. Successful treatment of quintuple primary cancer, including esophageal cancer: A case report. Oncol Lett 2015; 9:2583-2585. [PMID: 26137110 PMCID: PMC4473657 DOI: 10.3892/ol.2015.3082] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 02/11/2015] [Indexed: 11/05/2022] Open
Abstract
The present study reports the rare case of a patient with quintuple primary cancer that underwent systematic treatment, including surgical intervention. A 63-year-old male patient was initially diagnosed with primary esophageal cancer and hypopharyngeal cancer. The patient underwent total pharyngolaryngoesophagectomy using a thoracoscopic method and reconstruction using the free jejunal flap and gastric tube and was subsequently administered adjuvant chemotherapy (80 mg/m2 intravenously on day 1, cisplatin; 800 mg/m2 continuous intravenous administration on days 1-5, 5-fluorouracil). At 66 years old, the patient was diagnosed with left maxillary sinus cancer and underwent chemoradiotherapy (four 100 mg/m2 arterial cisplatin injections; 70 Gy/35 f radiotherapy, 2 Gy per day over 35 days). At 68 years old, the patient was diagnosed with gastric tube cancer and underwent gastric tube resection followed by pedicled jejunum flap reconstruction. At 69 years old, the patient was diagnosed with tongue cancer and underwent resection and reconstruction of the tongue by pectoralis major myocutaneous flap. Six years subsequent to the primary surgery, the patient remains alive, without metastasis of the lesions. To the best of our knowledge, the present study is the first report of a patient that underwent a curative procedure for the treatment of five primary multiple cancers in five organs, including esophageal cancer.
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Affiliation(s)
- YASUNORI OTOWA
- Department of Surgery, Division of Gastrointestinal Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - TETSU NAKAMURA
- Department of Surgery, Division of Gastrointestinal Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - GOSUKE TAKIGUCHI
- Department of Surgery, Division of Gastrointestinal Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - NAOKI URAKAWA
- Department of Surgery, Division of Gastrointestinal Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - RYO ISHIDA
- Department of Surgery, Division of Gastrointestinal Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - TATSUYA IMANISHI
- Department of Surgery, Division of Gastrointestinal Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - SATOSHI SUZUKI
- Department of Surgery, Division of Gastrointestinal Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - KENICHI TANAKA
- Department of Surgery, Division of Gastrointestinal Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - DAISUKE KURODA
- Department of Surgery, Kita-Harima Medical Center, Ono, Hyogo, Japan
| | - YOSHIHIRO KAKEJI
- Department of Surgery, Division of Gastrointestinal Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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Visual evaluation of the larynx and hypopharynx during esophagogastroduodenoscopy: a safety and feasibility study. Surg Endosc 2014; 29:1209-15. [PMID: 25303903 DOI: 10.1007/s00464-014-3796-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Accepted: 08/04/2014] [Indexed: 01/16/2023]
Abstract
BACKGROUND The larynx and hypopharynx are common sites for head and neck cancer, which shares many risk factors with upper digestive tract disease. Patient survival with malignancies depends on stage at the time of diagnosis. Endoscopic screening of the hypopharynx is neither routinely performed in clinical practice nor has it been evaluated in a formal study. METHODS This is a prospective pilot study of patients undergoing routine EGD. Demographic data were collected from patients prior to the procedure. All patients in the study underwent an EGD and prior to performing the standard portion of the EGD procedure, the endoscopist evaluated the larynx and hypopharynx with both white light endoscopy (WLE) and narrow band imaging (NBI). Details of the procedure, including ability to see all anatomic structures, time spent, complications, and findings, were recorded. RESULTS A total of 111 patients were included in the study. The exam of the laryngopharynx was completed in 87% of patients (97/111). Reasons for incomplete exam included intubated patients (2/14), inadequate sedation (9/14), and inability to see the entire hypopharynx (3/14). The mean time of the WLE was 20.2 s, while the NBI evaluation took 15.6 s for a mean and 35.8 s for the entire exam of the larynx and hypopharynx. Minor procedural complications occurred in 3/11 (2.7%) of the patients and included hypotension, tachycardia, and hypoxia. There were 6 patients who had hypopharyngeal abnormalities seen on both WLE and NBI (5.4%) and were subsequently referred to otolaryngology. Of the six referrals, one patient had a vocal cord biopsy showing leukoplakia, while the others were deemed normal anatomic variants. CONCLUSIONS Evaluation of the hypopharynx can be accomplished by gastrointestinal endoscopists at the time of EGD in the vast majority of patients in a safe manner while adding only about 35 s to the overall exam time.
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Tomizawa Y, Waxman I. Enhanced mucosal imaging and the esophagus--ready for prime time? Curr Gastroenterol Rep 2014; 16:389. [PMID: 24743954 DOI: 10.1007/s11894-014-0389-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Innovation of endoscopic technology has recently been introduced to improve real-time visualization of mucosal architecture and subepithelial vascular structures. Since the esophagus is easily accessible using endoscopy and the length of required observation is limited, many different types of new imaging modalities have been reported and showing promising data. Early detection of neoplastic changes in the esophagus is devoted to the treatment in early stage cancer and theoretically leads to better prognosis. This review will focus on the emerging endoscopic technologies for the management of esophageal cancer.
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Affiliation(s)
- Yutaka Tomizawa
- Section of Gastroenterology, Hepatology and Nutrition, The University of Chicago Medicine, 5841 S Maryland Ave. MC 4076, Room M421, Chicago, IL, 60637, USA,
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Goda K, Dobashi A, Tajiri H. Perspectives on narrow-band imaging endoscopy for superficial squamous neoplasms of the orohypopharynx and esophagus. Dig Endosc 2014; 26 Suppl 1:1-11. [PMID: 24372999 DOI: 10.1111/den.12220] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Accepted: 11/01/2013] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIM Narrow-band imaging (NBI) is widely available and over the last decade has been applied as a detection and characterization technique for superficial neoplasms of the aerodigestive tract. The aims of the present study were to systematically review clinical trials of NBI endoscopy and to investigate an upgraded NBI system using a novel endoscope for superficial squamous neoplasms in the orohypopharynx and esophagus. METHODS Studies on the diagnostic use of NBI endoscopy for superficial squamous neoplasms in the orohypopharynx and esophagus were retrieved from MEDLINE and PubMed and reviewed. An upgraded NBI system using a novel endoscope was investigated with our clinical cases. RESULTS In many clinical trials, NBI endoscopy with or without magnification had high diagnostic value for superficial squamousneoplasms in the orohypopharynx and esophagus. An upgraded NBI system can produce a significantly brighter endoscopic view than conventional endoscopes with high-quality magnified images that could be used to diagnose superficial squamous neoplasms. CONCLUSIONS NBI endoscopy with or without magnification has diagnostic utility for superficial squamous neoplasms in the orohypopharynx and esophagus. The upgraded NBI endoscopic system is expected to facilitate the use of NBI and magnifying endoscopic diagnosis.
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Affiliation(s)
- Kenichi Goda
- Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan
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Surgical strategies for esophageal cancer associated with head and neck cancer. Surg Today 2013; 44:1603-10. [PMID: 23989943 DOI: 10.1007/s00595-013-0713-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Accepted: 08/05/2013] [Indexed: 12/17/2022]
Abstract
Esophageal cancer is frequently associated with squamous cell carcinoma in the head and neck. Both cigarette smoking and alcohol consumption are risk factors for multiple cancers of the head and neck, as well as the esophagus. Routine screening and close follow-up for second cancers are important in patients with esophageal cancer or head and neck cancer. For this purpose, endoscopy with Lugol's staining, as well as narrow-band imaging combined with magnifying endoscopy, is a powerful tool for the early detection of esophageal cancer. Multimodal therapy is essential for patients with double cancers. When considering surgical treatment, the curability of both cancers must be carefully evaluated. If both tumors are potentially curable, each lesion should be treated individually. In patients with metachronous double cancers, the prior treatment of the first primary carcinoma often affects the treatment of the second cancer. Close cooperation among medical staff members is essential for complicated surgeries for double cancers. Techniques that are appropriate for each case must be adopted, such as careful dissection, staged operations, muscular flaps and microvascular anastomosis.
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Abstract
PURPOSE OF REVIEW Narrow band imaging (NBI) is a novel endoscopic technique using filtered wavelengths in order to enhance the microvascular abnormalities associated with the preneoplastic and neoplastic changes of the mucosal lining of the upper aerodigestive tract. The present review is focused on the use of NBI in the management of patients with laryngeal cancer. RECENT FINDINGS The larynx and hypopharynx represent an ideal site for NBI application because their thin, nonkeratinized, stratified squamous epithelium permits optimal visualization of the subtle neoangiogenic changes associated with precancerous and neoplastic diseases, including benign processes like recurrent respiratory papillomatosis. These abnormal vascular patterns have been recently described in great detail and demonstrated to be useful diagnostic tools in different settings of laryngeal cancer management: from preoperative diagnosis and staging to intraoperative evaluation of microsurgical margins and posttreatment follow-up. Particularly intriguing is the capacity of NBI to properly distinguish postactinic changes from persistent/recurrent disease. SUMMARY From different institutions in several countries, NBI continues to receive confirmations of its validity as an ancillary diagnostic tool for endoscopic evaluation of oncologic patients. This also holds true for laryngeal and hypopharyngeal neoplastic diseases.
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Kikuchi O, Ezoe Y, Morita S, Horimatsu T, Muto M. Narrow-band Imaging for the Head and Neck Region and the Upper Gastrointestinal Tract. Jpn J Clin Oncol 2013; 43:458-65. [DOI: 10.1093/jjco/hyt042] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
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Chromoendoscopy to detect early synchronous second primary esophageal carcinoma in patients with squamous cell carcinomas of the head and neck? Gastroenterol Res Pract 2013; 2013:236264. [PMID: 23573075 PMCID: PMC3616350 DOI: 10.1155/2013/236264] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2013] [Accepted: 02/25/2013] [Indexed: 02/07/2023] Open
Abstract
Objective. To evaluate the use of flexible esophagoscopy and chromoendoscopy with Lugol's solution in the detection of early esophageal carcinomas (second primary carcinomas) in patients with squamous cell carcinoma of the head and neck (HNSCC). Methods. All patients with newly diagnosed HNSCC underwent office-based Lugol's chromoendoscopy. After flexible esophagoscopy with white light, 3.0% Lugol's iodine solution was sprayed over the entire esophageal mucosa. Areas with less-intense staining (LVLs) were evaluated and biopsies taken. Results. 132 patients with HNSCC were enrolled in this study. The most frequent primary tumors were oropharyngeal (49/132), tumors of the oral cavity (36/132), and larynx (35/132). The majority of subjects (107/132 patients, 81.1%) had advanced HNSCC carcinomas (stages III and IV). Multiple LVLs were discovered in 24 subjects (18.2%) and no LVLs in 108 (81.8%) subjects. Fifty-five LVL biopsy specimens were obtained and assessed. Squamous cell carcinomas were detected in two patients, peptic esophagitis in 11 patients, gastric heterotopic mucosa in two patients, hyperplasia in two patients, and low- and high-grade dysplasia in three patients. Conclusion. Although only two patients with synchronous primary carcinomas were found among the patients, esophagoscopy should be recommended after detection of HNSCC to exclude secondary esophageal carcinoma or dysplasia.
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Kumamoto T, Sentani K, Oka S, Tanaka S, Yasui W. Clinicopathological features of minute pharyngeal lesions diagnosed by narrow-band imaging endoscopy and biopsy. World J Gastroenterol 2012; 18:6468-6474. [PMID: 23197893 PMCID: PMC3508642 DOI: 10.3748/wjg.v18.i44.6468] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the utility of magnified narrow-band imaging (NBI) endoscopy for diagnosing and treating minute pharyngeal neoplasia.
METHODS: Magnified NBI gastrointestinal examinations were performed by the first author. A magnification hood was attached to the tip of the endoscope for quick focusing. Most of the examinations were performed under sedation. Magnified NBI examinations were performed for all of the pharyngeal lesions that had noticeable brownish areas under unmagnified NBI observation, and an intrapapillary capillary loop (IPCL) classification was made. A total of 93 consecutive pharyngeal lesions were diagnosed as IPCL type IV and were suspected to represent dysplasia. Sixty-two lesions of approximately 1 mm in diameter were biopsied in the clinic, and 17 lesions with larger diameters were resected by endoscopic submucosal dissection (ESD) at the Hiroshima University Hospital. In addition to the histological diagnoses, the lesion diameters were microscopically measured in 45 of the 62 biopsies. Thirty-four of the 62 biopsied patients received endoscopic follow up.
RESULTS: Minute pharyngeal lesions were diagnosed in 93 of approximately 3000 patients receiving magnified NBI examinations at the clinic. Of the 93 patients with IPCL type IV lesions, 80 were men, and 13 were women. Fifty-six were drinkers, and 57 were smokers. Two had esophageal cancer. Twenty-one lesions were located on the posterior hypopharyngeal wall, and 72 lesions were located on the posterior oropharyngeal wall. All 93 lesions were flat and showed similar findings in the magnified and unmagnified NBI examinations. Although almost all of the IPCL type IV lesions showed faint redness when examined under white light, it was difficult to diagnose the lesions using only this technique because the contrast was weaker than that achieved in the NBI examinations. Of the 93 lesions, only 3 had diameters greater than 2.1 mm. Sixty-two lesions of approximately 1 mm were biopsied in the clinic, whereas 17 larger lesions were treated by ESD at the Hiroshima University Hospital. Of the 79 pharyngeal lesions that were biopsied or resected by ESD, 5 were histologically diagnosed as high-grade dysplasia, 39 were diagnosed as low-grade dysplasia, and 39 were determined to be non-dysplastic lesions. There were no cancerous lesions. Histologically, abnormal cell size variations and increased nuclear size were observed in all of the high-grade dysplasia lesions, while the incidence of these findings in the low-grade dysplasia lesions was low. Of the 62 biopsied lesions, 45 were microscopically measurable. The measured diameters ranged from 0.1 to 2.0 mm. The dysplasia ratios increased with the diameters. A follow-up endoscopic examination of the 34 biopsied patients found the rate of complete resection by biopsy to be 79%. The largest lesion in which complete resection was expected was a low-grade dysplasia of 1.9 mm in diameter.
CONCLUSION: Minute pharyngeal lesions suspected to be dysplasia that are identified by NBI magnifying endoscopy should be biopsied to determine the diagnosis and further treatment.
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Suzuki H, Saito Y, Oda I, Kikuchi T, Kiriyama S, Fukunaga S. Comparison of narrowband imaging with autofluorescence imaging for endoscopic visualization of superficial squamous cell carcinoma lesions of the esophagus. DIAGNOSTIC AND THERAPEUTIC ENDOSCOPY 2012; 2012:507597. [PMID: 23197931 PMCID: PMC3503267 DOI: 10.1155/2012/507597] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Revised: 09/02/2012] [Accepted: 09/25/2012] [Indexed: 12/26/2022]
Abstract
Aim. To compare narrowband imaging (NBI) and autofluorescence imaging (AFI) endoscopic visualization for identifying superficial esophageal squamous cell carcinoma (SCC). Methods. Twenty-four patients with superficial esophageal carcinomas diagnosed at previous hospitals were enrolled in this study. Lesions were initially detected using white-light endoscopy and then observed with both NBI and AFI. Endoscopic images documented each method, and three endoscopists experienced in esophageal imaging retrospectively reviewed respective images of histologically confirmed esophageal SCCs. Images were assessed for quality in identifying superficial SCCs and rated as excellent, fair, or poor by the three reviewers with interobserver agreement calculated using kappa (κ) statistics. Results. Thirty-one lesions histologically confirmed as superficial esophageal SCCs were detected in 24 patients. NBI images of 27 lesions (87%) were rated as excellent, three as fair, and one as poor compared to AFI images of 19 lesions (61%) rated as excellent, 10 as fair and two as poor (P < 0.05). Moderate interobserver agreement (κ = 0.42, 95% CI 0.24-0.60) resulted in NBI while fair agreement (κ = 0.35, 95% CI 0.18-0.51) was achieved using AFI. Conclusion. NBI may be more effective than AFI for visualization of esophageal SCC.
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Affiliation(s)
| | - Yutaka Saito
- Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
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Lin YC, Wang WH, Lee KF, Tsai WC, Weng HH. Value of narrow band imaging endoscopy in early mucosal head and neck cancer. Head Neck 2012; 34:1574-9. [DOI: 10.1002/hed.21964] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2011] [Revised: 07/28/2011] [Accepted: 09/06/2011] [Indexed: 01/16/2023] Open
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Ishii H, Masuyama K. Clinical Evaluation of Hypopharyngeal Cancer Associated with Multiple Primary Cancers. ACTA ACUST UNITED AC 2012. [DOI: 10.2468/jbes.63.443] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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‘Biologic endoscopy’: optimization of upper aerodigestive tract cancer evaluation. Curr Opin Otolaryngol Head Neck Surg 2011; 19:67-76. [DOI: 10.1097/moo.0b013e328344b3ed] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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