European Archives of Oto-Rhino-Laryngology

, Volume 269, Issue 5, pp 1503–1507 | Cite as

Diagnostic sensitivity of 18fluorodeoxyglucose positron emission tomography for detecting synchronous multiple primary cancers in head and neck cancer patients

Head and Neck

Abstract

We assessed the sensitivity of positron emission tomography (PET) for detecting synchronous multiple primary cancers, particularly synchronous esophageal cancers in head and neck cancer patients. We retrospectively reviewed 230 head and neck cancer patients. All the patients routinely underwent the following examinations: urinalysis, occult blood, tumor marker detection [squamous cell carcinoma (SCC), cytokeratin fragment (CYFRA), and carcinoembryonic antigen (CEA)], esophagogastroduodenoscopy, colonoscopy (when CEA was high or occult blood was positive), abdominal ultrasonography, plain chest computed tomography (CT), and PET. Bronchoscopy was performed when CT revealed lung shadow of central region. Synchronous multiple primary cancers were detected in 42 (18.2%) patients. The diagnostic sensitivity of PET for synchronous primary cancers was as follows: esophagus, 7.6% (1/13); stomach, 25.0% (2/8); lung, 66.7% (4/6); head and neck, 75.0% (3/4); colon, 0% (0/1); kidney, 0% (0/1); and subcutaneous, 100% (1/1). The sensitivity of PET for detecting synchronous esophageal cancers is low because these are early-stage cancers (almost stage 0–I). Therefore, it is necessary to perform esophagogastroduodenoscopy for detecting synchronous esophageal cancers. PET is an important additional tool for detecting synchronous multiple primary cancers because the diagnostic sensitivity of PET in synchronous head and neck cancer and lung cancer is high. But PET has the limitation of sensitivity for synchronous multiple primary cancers because the diagnostic sensitivity of PET in synchronous esophageal cancer is very low.

Keywords

Synchronous multiple primary cancers PET Sensitivity Head and neck cancer Esophageal cancer 

Notes

Conflict of interest

The authors have no conflict of interest.

References

  1. 1.
    Shons AR, McQuarrie DG (1985) Multiple primary epidermoid carcinomas of the upper aerodigestive tract. Arch Surg 120:1007–1009PubMedCrossRefGoogle Scholar
  2. 2.
    Yamamoto E, Shibuya H, Yoshimura R, Miura M (2002) Site specific dependency of second primary cancer in early stage head and neck squamous cell carcinoma. Cancer 94:2007–2014PubMedCrossRefGoogle Scholar
  3. 3.
    Jones AS, Morar P, Phillips DE, Field JK, Husband D, Helliwell TR (1995) Second primary tumors in patients with head and neck squamous cell carcinoma. Cancer 75:1343–1353PubMedCrossRefGoogle Scholar
  4. 4.
    Schoder H, Yeung HW, Gonen M, Kraus D, Larson SM (2004) Head and neck cancer: clinical usefulness and accuracy of PET/CT image fusion. Radiology 231:65–72PubMedCrossRefGoogle Scholar
  5. 5.
    Andrade RS, Heron DE, Degirmenci B et al (2006) Posttreatment assessment of response using FDG-PET/CT for patients treated with definitive radiation therapy for head and neck cancers. Int J Radiat Oncol Biol Phys 65:1315–1322PubMedCrossRefGoogle Scholar
  6. 6.
    Warren S, Gates O (1932) Multiple malignant tumors: a survey of literature and statistical study. Am J Cancer 51:1358–1414Google Scholar
  7. 7.
    Billroth T (1882) Die allgemeine chirurgische pathologie und therapie. Ihr 51 vorlesungen: ein handbuch fur studierende und aerzte. Berlin G Riemer, pp 980Google Scholar
  8. 8.
    McGarry GW, Mackenzie K, Periasamy P, McGurk F, Gatehouse S (1992) Multiple primary malignant tumours in patients with head and neck cancer: the implications for follow-up. Clin Otolaryngol Allied Sci 17:558–562PubMedCrossRefGoogle Scholar
  9. 9.
    Stokkel MP, Moons KG, ten Broek FW, van Rijk PP, Hordijk GJ (1999) 18F-fluorodeoxyglucose dual-head positron emission tomography as a procedure for detecting simultaneous primary tumors in cases of head and neck cancer. Cancer 86:2370–2377PubMedCrossRefGoogle Scholar
  10. 10.
    Bold B, Piao Y, Murata Y, Kishino M, Shibuya H (2008) Usefulness of PET/CT for detecting a second primary cancer after treatment for squamous cell carcinoma of the head and neck. Clin Nucl Med 33:831–833PubMedCrossRefGoogle Scholar
  11. 11.
    Panosetti E, Luboinski B, Mamelle G, Richard JM (1989) Multiple synchronous and metachronous cancers of the upper aerodigestive tract: a nine-year study. Laryngoscope 99:1267–1273PubMedCrossRefGoogle Scholar
  12. 12.
    Haughey BH, Gates GA, Arfken CL, Harvey J (1992) Meta-analysis of second malignant tumors in head and neck cancer: the case for an endoscopic screening protocol. Ann Otol Rhinol Laryngol 101:105–112PubMedGoogle Scholar
  13. 13.
    Dhooge IJ, de Vos M, van Cauwenberge PB (1998) Multiple primary malignant tumors in patients with head and neck cancer: results of a prospective study and future perspectives. Laryngoscope 108:250–256PubMedCrossRefGoogle Scholar
  14. 14.
    Jovanovic A, van der Tol IG, Kostense PJ et al (1994) Second respiratory and upper digestive tract cancer following oral squamous cell carcinoma. Eur J Cancer B Oral Oncol 30B:225–229PubMedCrossRefGoogle Scholar
  15. 15.
    Hurt HH, Borders AC (1932–1933) Multiple primary malignant neoplasms. J Lab Clin Med 18:765–777Google Scholar
  16. 16.
    Slaughter DP, Southwick HW, Smejkal W (1953) Field cancerization in oral stratified squamous epithelium; clinical implications of multicentric origin. Cancer 6:963–968PubMedCrossRefGoogle Scholar
  17. 17.
    Cohn AM, Peppard SB (1980) Multiple primary malignant tumors of the head and neck. Am J Otolaryngol 1:411–417PubMedCrossRefGoogle Scholar
  18. 18.
    Yoon YC, Lee KS, Shim YM, Kim BT, Kim K, Kim TS (2003) Metastasis to regional lymph nodes in patients with esophageal squamous cell carcinoma: CT versus FDG PET for presurgical detection prospective study. Radiology 227:764–770PubMedCrossRefGoogle Scholar
  19. 19.
    van Westreenen HL, Heeren PA, Jager PL, van Dullemen HM, Groen H, Plukker JT (2003) Pitfalls of positive findings in staging esophageal cancer with F-18-fluorodeoxyglucose positron emission tomography. Ann Surg Oncol 10:1100–1105PubMedCrossRefGoogle Scholar
  20. 20.
    Himeno S, Yasuda S, Shimada H, Tajima T, Makuuchi H (2002) Evaluation of esophageal cancer by positron emission tomography. Jpn J Clin Oncol 32:340–346PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  1. 1.Department of Biology and Function in the Head and NeckYokohama City University Graduate School of MedicineYokohamaJapan

Personalised recommendations