Table 4.
Tumor board review of H&N cancer patients with modified treatment strategy after IEE screening
| No. | H&N cancer / TNM stage | Location / size (cm) / pathology (TNM stage) of esophagus | Treatment strategy without IEE screening | Treatment strategy with IEE screening |
|---|---|---|---|---|
| 1 |
Oropharynx / II |
Lower third / 0.3 / LGIN |
Tumor excision |
Tumor excision + EMR of esophageal lesion |
| 2 |
Hypopharynx / I |
Middle third / 0.5 / LGIN |
Tumor excision |
Tumor excision + EMR of esophageal lesion |
| 3 |
Oropharynx / III |
Lower third / 0.5 / LGIN |
Tumor excision + LN dissection + Adjuvant CCRT |
Tumor excision + EMR of esophageal lesion + Adjuvant CCRT |
| 4 |
Hypopharynx / III |
Middle third / 6.0 / SCC (IIA) |
Tumor excision + LN dissection + Adjuvant CCRT |
Tumor excision + Adjuvant CCRT with RT field involving esophagus |
| 5 |
Larynx / I |
Middle / 1.5 / HGIN |
Laryngectomy |
Laryngectomy + ESD of esophageal lesion |
| 6 |
Larynx / I |
Upper / 6.0 / SCC (IB) |
Laryngectomy |
Laryngectomy + Esophagectomy + Adjuvant CCRT |
| 7 |
Oropharynx / IVA |
Upper / 0.6 / SCC (IA) |
Neoadjuvant CCRT + Tumor excision + LN dissection |
Neoadjuvant CCRT + Tumor excision + Esophagectomy |
| 8 |
Oropharynx / II |
Middle / 4.0 / SCC (IA) |
Tumor excision + Adjuvant CCRT |
Tumor excision + Esophagectomy + Adjuvant CCRT |
| 9 |
Hypopharynx/IVA |
Middle / 2.0 / HGIN |
Tumor excision + LN dissection + Adjuvant CCRT |
Tumor excision + LN dissection + RFA of esophageal lesion + Adjuvant CCRT |
| 10 |
Hypopharynx / IVB |
Upper / 1.5 / SCC(IB) |
Definitive CCRT |
Definitive CCRT with RT field involving the esophagus |
| 11 |
Hypopharynx/III |
Middle / 5.0 / SCC (IIIA) |
Tumor excision + LN dissection + Adjuvant CCRT |
Neoadjuvant CCRT + Tumor excision + LN dissection + Esophagectomy |
| 12 |
Hypopharynx / IVB |
Middle / 1.5 / SCC (IIIA) |
Definitive CCRT |
Definitive CCRT with RT filed involving the esophagus |
| 13 |
Oral cavity / II |
Lower / 0.2 / LGIN |
Tumor excision |
Tumor excision + EMR of esophageal lesion |
| 14 |
Hypopharynx / III |
Middle / 0.8 / HGIN |
Tumor excision + LN dissection + Adjuvant CCRT |
Tumor excision + LN dissection + ESD of esophageal lesion + Adjuvant CCRT |
| 15 |
Oral cavity / I |
Upper / 2.0 / SCC ( IB) |
Tumor excision |
Tumor excision + Esophagectomy |
| 16 |
Oral cavity / II |
Middle / 1.0 / SCC (IA) |
Tumor excision |
Tumor excision + EMR of esophageal lesion |
| 17 |
Oral cavity / IVB |
Middle / 2.0 / SCC (IIIA) |
Definitive CCRT |
Definitive CCRT with RT field involving esophagus |
| 18 |
Hypopharynx / IVA |
Upper / 2.0 / SCC (IB) |
Tumor excision + LN dissection + Adjuvant CCRT |
Tumor excision + LN dissection + Adjuvant CCRT with RT field involving esophagus |
| 19 |
Hypopharynx / IVA |
Middle / 0.8 / HGIN |
Tumor excision + LN dissection + Adjuvant CCRT |
Tumor excision + LN dissection + EMR + Adjuvant CCRT |
| 20 | Larynx / IVA | Middle / 6.0 / SCC (IB) | Laryngectomy + Adjuvant CCRT | Laryngectomy + Esophagectomy + Adjuvant CCRT |
Abbreviation: CCRT concurrent chemoradiotherapy, EMR endoscopic mucosal resection, ESD endoscopic submucosal dissection, H&N head and neck, HGIN high-grade intraepithelial neoplasia, IEE image-enhanced endoscopy, LN lymph node, LGIN low-grade intraepithelial neoplasia, RFA radiofrequency ablation, SCC squamous cell carcinoma.