{"title":"Differences in Clinical Characteristics Between Missed and Detected Laryngopharyngeal Cancers.","authors":"Yusuke Kumazawa, Yohei Ikenoyama, Manabu Takamatsu, Koyo Kido, Ken Namikawa, Yoshitaka Tokai, Shoichi Yoshimizu, Yusuke Horiuchi, Akiyoshi Ishiyama, Toshiyuki Yoshio, Toshiaki Hirasawa, Akira Seto, Takashi Toshiyasu, Shunji Takahashi, Junko Fujisaki","doi":"10.1111/jgh.17023","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and aim: </strong>Laryngopharyngeal cancers are often overlooked during endoscopy because of their anatomical complexity and the gag reflex. However, the characteristics of these cancers remain poorly understood. We studied the differences in clinical characteristics and endoscopic procedures between missed and detected cancers.</p><p><strong>Methods: </strong>Newly diagnosed laryngopharyngeal squamous cell carcinomas identified during esophagogastroduodenoscopy at our hospital between January 2016 and December 2020 were analyzed. A total of 179 lesions were categorized into two groups: missed (n = 74) and detected (n = 105). Missed cancer was defined as a lesion identified within 18 months of preceding esophagogastroduodenoscopy at our hospital, while detected cancer was defined as a lesion not included in the missed group.</p><p><strong>Results: </strong>The miss rate of laryngopharyngeal cancers on esophagogastroduodenoscopy was 41.3%. Multivariate analysis showed that the non-use rate of pethidine hydrochloride (odds ratio 4.1, 95% confidence interval 2.0-8.6, p < 0.01), ratio of white-light imaging ≥ narrow-band imaging through observation of laryngopharynx (odds ratio 31.8, 95% confidence interval 3.9-258.0, p < 0.01), and number of \"comprehensiveness of laryngopharyngeal observation\" negatives (odds ratio 2.6, 95% confidence interval 1.3-5.4, p = 0.01) were significantly larger in the missed group. Univariate analysis showed that the number of tumors located on the epiglottis (p = 0.02) was significantly larger in the missed group.</p><p><strong>Conclusions: </strong>This study highlights the importance of precisely observing the laryngopharynx, facilitated by the use of pethidine hydrochloride and narrow-band imaging. In addition, epiglottic lesions are frequently missed. Comprehensive observation of the laryngopharynx using narrow-band imaging and premedication may reduce the frequency of missed cancers.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7000,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Gastroenterology and Hepatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/jgh.17023","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background and aim: Laryngopharyngeal cancers are often overlooked during endoscopy because of their anatomical complexity and the gag reflex. However, the characteristics of these cancers remain poorly understood. We studied the differences in clinical characteristics and endoscopic procedures between missed and detected cancers.
Methods: Newly diagnosed laryngopharyngeal squamous cell carcinomas identified during esophagogastroduodenoscopy at our hospital between January 2016 and December 2020 were analyzed. A total of 179 lesions were categorized into two groups: missed (n = 74) and detected (n = 105). Missed cancer was defined as a lesion identified within 18 months of preceding esophagogastroduodenoscopy at our hospital, while detected cancer was defined as a lesion not included in the missed group.
Results: The miss rate of laryngopharyngeal cancers on esophagogastroduodenoscopy was 41.3%. Multivariate analysis showed that the non-use rate of pethidine hydrochloride (odds ratio 4.1, 95% confidence interval 2.0-8.6, p < 0.01), ratio of white-light imaging ≥ narrow-band imaging through observation of laryngopharynx (odds ratio 31.8, 95% confidence interval 3.9-258.0, p < 0.01), and number of "comprehensiveness of laryngopharyngeal observation" negatives (odds ratio 2.6, 95% confidence interval 1.3-5.4, p = 0.01) were significantly larger in the missed group. Univariate analysis showed that the number of tumors located on the epiglottis (p = 0.02) was significantly larger in the missed group.
Conclusions: This study highlights the importance of precisely observing the laryngopharynx, facilitated by the use of pethidine hydrochloride and narrow-band imaging. In addition, epiglottic lesions are frequently missed. Comprehensive observation of the laryngopharynx using narrow-band imaging and premedication may reduce the frequency of missed cancers.
期刊介绍:
Journal of Gastroenterology and Hepatology is produced 12 times per year and publishes peer-reviewed original papers, reviews and editorials concerned with clinical practice and research in the fields of hepatology, gastroenterology and endoscopy. Papers cover the medical, radiological, pathological, biochemical, physiological and historical aspects of the subject areas. All submitted papers are reviewed by at least two referees expert in the field of the submitted paper.