Value of panendoscopy in the evaluation of upper aerodigestive tract cancer

pThe concept of multiple squamous cell carcinoma in the region of the upper aerodigestive tract was first described over 100 years ago by Billroth. Th e aim of our study was to assess the incidence of synchronous and metachron ous second primary rumours and refine the role of panendoscopy in diagnosin g them. The charts of 358 patients presenting for initial treatment of primary squa mous cell carcinoma of the upper aerodigestive tract between January 1990 a nd December 1995 were reviewed. The incidence of second primary tumours was 16.2%, 6.4% being synchronous and 9.8% metachronous. In only 3.1% of all p atients was a synchronous tumour clinically silent and only revealed by pan endoscopy. Synchronous tumours were most likely to be located in the oral c avity, pharynx or larynx (61%), whereas metachronous second primary tumours were most likely to be located in the lung (57%). Though the incidence of synchronous second primary rumours revealed by routine panendoscopy is low (3%), we still recommend this investigation because it is often necessary f or exact assessment of the first primary tumour. Further, it is ideal for t raining in the use of rigid endoscopy. In our opinion panendos-copy involve s minimal time, cost and morbidity.