[Early detection of multiple tumors in primary diagnosis of oral carcinomas using panendoscopy]

Early diagnosis of additional carcinomas in the diagnosis of primary oral squamous epithelial carcinomas is important for prognosis and provides helpful pointers for planning therapy. In a prospective study from 1993 to 1998, 83 patients with histologically confirmed primary squamous epithelial carcinomas of the oral cavity, the oropharynx and the lip underwent panendoscopy staging to check whether early diagnosis of simultaneous, additional carcinomas of the upper aerodigestive tract is possible with this method. Panendoscopy commenced with rigid tracheobronchoscopy followed by rigid esophagoscopy. Afterwards, the nasopharynx, oropharynx and hypopharynx were examined endoscopically. Finally, microlaryngoscopy was performed. Biopsy and microbiological smears were taken from suspect areas. The incidence of simultaneous, additional carcinomas was 8.4%. All tumors were located in the upper aerodigestive tract with the exception of the esophagus, trachea and bronchial system. A simultaneous laryngeal carcinoma was also diagnosed on the vocal cord in a patient with lip carcinoma. Precancerous conditions could also be diagnosed by means of panendoscopy. This study and two retrospective studies from 1988 to 1994 from the Clinic of Oromaxillofacial Surgery and from the Regensburg Tumor Center (1993 to 1997) confirm the high proportion of additional carcinomas in a primary cancer in the "head and neck region." The financial costs and instrumental requirements of the method appear to be justified in view of the high proportion of simultaneous, additional tumors. Expierience so far and the uncomplicated course indicate that this investigation does not entail any additional risk for the patient, which is why panendoscopy can be recommended without reservations for staging in tumors in the head and neck region.