[Pretherapeutical evaluation of cancers of upper respiratory and digestive tracts]

Pretreatment work-up in cancer of the upper aerodigestive tract should follow precise guidelines and chronology. In addition to assessment of the tumoural area, attention should be directed to the general condition of the patient and to any associated pathology. Clinical assessment of the region involved will define the localisation and extension of the tumour, its functional impact and its extension to the cervical lymph nodes. This work-up should immediately be followed by imaging study, today mainly CT scan and magnetic resonance imaging or echography. Only after these examinations are completed should panendoscopy be initiated. Its performance is essential. Routine use of this examination has led to the demonstration of the high number (up to 20% of cases) of second tumours which are underestimated in the first examination. Appropriate therapeutic indications and, in large part, the future health of the patient, depend on the proper performance of this initial work-up.