[Early diagnosis of bronchial carcinoma after head and neck cancer]

Abstract

Background: Patients with a previous history of cancer of the upper respiratory and digestive tracts (URDT) frequently develop a bronchial carcinoma (synchronous or metachronous) that may affect their survival.

Objective: To determine the prevalence of bronchial carcinoma at an early stage in a population of patients treated for cancer of the URDT.

Materials and methods: This was a single centre prospective study (2002-2006). Patients in remission following treatment of cancers of the buccal cavity, pharynx (stages I -II) and larynx (stages I - III), were examined by a spiral CT scan and fibreoptic bronchoscopy (white light and autofluorescence), with biopsies, and cytology of the bronchial aspirate.

Results: 60 patients (55 men) were included. Two peripheral bronchial carcinomas were detected by scanning and two more (proximal) by endoscopy. All 4 bronchial tumours were squamous carcinomas (stage IA). Three patients had surgery, the fourth declined intervention.

Conclusion: Our study confirms the high prevalence (6.7%) of bronchial carcinoma in patients with a past history of cancer of the URDT. It emphasises the complimentary roles of spiral scanning and bronchoscopy in early diagnosis. It is still too early to evaluate the impact of these investigations on the survival of the patients.