Results of Esophagogastroduodenoscopy in Patients With Oral Squamous Cell Carcinoma—Value of Endoscopic Screening: 10-Year Experience

Purpose

Oral squamous cell carcinoma (OSCC) represents more than 90% of oral malignancies. Risk factors such as smoking and alcohol abuse can result in additional diseases, particularly of the upper gastrointestinal tract. The aim of the present study was to assess the synchronous pathologic changes of the upper gastrointestinal tract using endoscopy at the diagnosis of OSCC using a retrospective cohort study design.

Patients and Methods

The clinical records of 806 patients with OSCC from 1997 to 2007 were reviewed. Of the 806 patients, 570 (188 females and 382 males) with primary OSCC were identified. All patients underwent esophagogastroduodenoscopy at the initial tumor staging. The tumor stage was defined according to the International Union Against Cancer classification for head and neck malignancies. The clinical and histologic data were analyzed for probability using univariate and multivariate analyses.

Results

Of the 570 patients, 289 had limited and 281 advanced disease. A statistically significant association was found between the advanced and limited tumor stage for Barrett's esophagus with an odds ratio of 4.986 (95% confidence interval 1.370 to 27.360, P = .0061). Pathologic findings were observed in 169 patients. Additional risk factors for the development of secondary upper aerodigestive tract cancers were found in 103 patients.

Conclusions

Esophagogastroduodenoscopy provides the opportunity to identify second malignancies, precancerous lesions, and risk factors and to obtain biopsies using one procedure. The results can be immediately integrated into the therapeutic concept of the primary disease. Although new imaging techniques have been available, esophagogastroduodenoscopy still plays a decisive role in the routine staging of OSCC.

⁎ Associate Professor, Department of Oral and Maxillofacial Surgery, Klinikum Rechts Der Isar, Technische Universität München, München, Germany; and Department of Oral and Maxillofacial Plastic Surgery, Knappschaftskrankenhaus Bochum-Langendreer, Ruhr-Universität Bochum, Bochum, Germany

† Doctor, Department of Otorhinolaryngology, Klinikum Rechts Der Isar, Technische Universität München, München, Germany

‡ Medical Student, Department of Oral and Maxillofacial Surgery, Klinikum Rechts Der Isar, Technische Universität München, München, Germany; and Department of Oral and Maxillofacial Plastic Surgery, Knappschaftskrankenhaus Bochum-Langendreer, Ruhr-Universität Bochum, Bochum, Germany

§ Professor, Department of Plastic Surgery, Burn Unit, BG-Universitätsklinikum “Bergmannsheil,” Ruhr-Universität Bochum, Bochum, Germany

¶ Medical Student, Department of Oral and Maxillofacial Surgery, Klinikum Rechts Der Isar, Technische Universität München, München, Germany

∥ Doctor, Institute for Medical Statistics and Epidemiology, Klinikum Rechts Der Isar, Technische Universität München, München, Germany

# Professor, Head of Department, Department of Oral and Maxillofacial Surgery, Klinikum Rechts Der Isar, Technische Universität München, München, Germany; and Department of Oral and Maxillofacial Plastic Surgery, Knappschaftskrankenhaus Bochum-Langendreer, Ruhr-Universität Bochum, Bochum, Germany

⁎⁎ Doctor, Department of Oral and Maxillofacial Surgery, Klinikum Rechts Der Isar, Technische Universität München, München, Germany; and Department of Oral and Maxillofacial Plastic Surgery, Knappschaftskrankenhaus Bochum-Langendreer, Ruhr-Universität Bochum, Bochum, Germany

†† Doctor, Department of Oral and Maxillofacial Surgery, Klinikum Rechts Der Isar, Technische Universität München, München, Germany; and Department of Oral and Maxillofacial Plastic Surgery, Knappschaftskrankenhaus Bochum-Langendreer, Ruhr-Universität Bochum, Bochum, Germany

Address correspondence and reprint requests to Dr Kesting: Department of Oral and Maxillofacial Surgery, Klinikum Rechts der Isar der Technischen Universität München, Ismaninger Strasse 22, München 81675 Germany

PII: S0278-2391(09)00561-8

doi:10.1016/j.joms.2009.04.061

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