Background: Early detection of esophageal secondary primary tumors (SPTs) in head and neck squamous cell carcinoma (HNSCC) patients could increase patient survival. The purpose of this study was to determine the diagnostic yield of esophageal SPTs using Lugol chromoendoscopy. Methods: A systematic review of all available databases was performed to find all Lugol chromoendoscopy screening studies. Results: Fifteen studies with a total of 3386 patients were included. The average yield of esophageal-SPTs in patients with HNSCC was 15%. The prevalence was the highest for patients with an index hypopharyngeal (28%) or oropharyngeal (14%) tumor. The esophageal-SPTs were classified as high-grade dysplasia in 49% of the cases and as invasive carcinoma's in 51%. Conclusion: Our results show that 15% of the patients with HNSCC that underwent Lugol chromoendoscopy were diagnosed with an esophageal-SPT. Based on these results there is enough evidence to perform Lugol chromoendoscopy, especially in an Asian patient population.

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Keywords early detection, esophageal cancer, head and neck cancer, Lugol chromoendoscopy, second primary tumor
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Journal Head & Neck: journal for the sciences and specialities of the head and neck
Bugter, O, van de Ven, S.E.M, Hardillo, J.A.U, Bruno, M.J, Koch, A.D, & Baatenburg de Jong, R.J. (2018). Early detection of esophageal second primary tumors using Lugol chromoendoscopy in patients with head and neck cancer: A systematic review and meta-analysis. Head & Neck: journal for the sciences and specialities of the head and neck, 41(4), 1122–1130. doi:10.1002/hed.25548