Detection of synchronous lung tumors in patients presenting with squamous cell carcinoma of the head and neck

Authors

  • Samit K. Ghosh FRCS (ORL-HNS),

    1. Department of Otolaryngology/Head and Neck Surgery, Aintree University Hospital NHS Foundation Trust, Longmoor Lane, Liverpool L9 7AL, United Kingdom
    2. School of Cancer Studies, University of Liverpool, Liverpool L69 3GA, United Kingdom
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  • Nicholas J. Roland FRCS (ORL-HNS), MD,

    1. Department of Otolaryngology/Head and Neck Surgery, Aintree University Hospital NHS Foundation Trust, Longmoor Lane, Liverpool L9 7AL, United Kingdom
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  • Aman Kumar MRCS,

    1. Department of Otolaryngology/Head and Neck Surgery, Aintree University Hospital NHS Foundation Trust, Longmoor Lane, Liverpool L9 7AL, United Kingdom
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  • Sankalap Tandon FRCS (ORL-HNS),

    1. Department of Otolaryngology/Head and Neck Surgery, Aintree University Hospital NHS Foundation Trust, Longmoor Lane, Liverpool L9 7AL, United Kingdom
    2. School of Cancer Studies, University of Liverpool, Liverpool L69 3GA, United Kingdom
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  • Jeffrey L. Lancaster FRCS (ORL-HNS),

    1. Department of Otolaryngology/Head and Neck Surgery, Aintree University Hospital NHS Foundation Trust, Longmoor Lane, Liverpool L9 7AL, United Kingdom
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  • Shaun R. Jackson FRCS (ORL-HNS),

    1. Department of Otolaryngology/Head and Neck Surgery, Aintree University Hospital NHS Foundation Trust, Longmoor Lane, Liverpool L9 7AL, United Kingdom
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  • Andrew Jones MD, FRCS,

    1. School of Cancer Studies, University of Liverpool, Liverpool L69 3GA, United Kingdom
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  • Huw Lewis Jones FRCR,

    1. Department of Radiology, Aintree University Hospital NHS Trust, Longmoor Lane, Liverpool L9 7AL, United Kingdom
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  • Rebecca Hanlon FRCR,

    1. Department of Radiology, Aintree University Hospital NHS Trust, Longmoor Lane, Liverpool L9 7AL, United Kingdom
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  • Terry M. Jones FRCS (ORL-HNS), MD

    Corresponding author
    1. Department of Otolaryngology/Head and Neck Surgery, Aintree University Hospital NHS Foundation Trust, Longmoor Lane, Liverpool L9 7AL, United Kingdom
    2. School of Cancer Studies, University of Liverpool, Liverpool L69 3GA, United Kingdom
    • Department of Otolaryngology/Head and Neck Surgery, Aintree University Hospital NHS Foundation Trust, Longmoor Lane, Liverpool L9 7AL, United Kingdom
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  • This paper was presented at the American Head and Neck Society, 7th International Conference on Head and Neck Cancer, San Francisco, July 2008 and at the Otolaryngology Research Society, Coventry, UK, March 2008.

Abstract

Background.

Screening for synchronous pulmonary tumors in patients presenting with squamous cell carcinoma of the head and neck (SCCHN) is important, because detection may alter subsequent management.

Methods.

We conducted a retrospective review, comparing effectiveness of pulmonary screening using thoracic CT or chest X-ray, in 1882 patients presenting with SCCHN.

Results.

The overall rate of synchronous pulmonary tumors was 4.3%. The number needed to scan, ie, the number of thoracic CTs required to detect 1 pulmonary tumor, is reported for recurrent primary tumors, primary disease load (T and N classification), and individual primary sites. The incidence of pulmonary metastases is related to locoregional disease load while the incidence of bronchogenic carcinoma is sporadic.

Conclusion.

Although it is possible to propose a pragmatic screening protocol for pulmonary metastases, this is not possible for bronchogenic carcinomas. Therefore, we recommend that thoracic CT is used in all cases to screen for coexistent pulmonary pathology. © 2009 Wiley Periodicals, Inc. Head Neck, 2009

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