Is there a role for triple endoscopy in the staging of head and neck cancer?

Abstract

Triple endoscopy had been a traditional investigation utilized in detecting synchronous and/or metachronous tumors along the upper aerodigestive tract in patients with head and neck squamous cell carcinomas, but the routine use of it had been debatable. The rate of synchronous esophageal tumors ranged from 0% to 30.4% in all literature. There was a trend towards a lower rate of occurrence in the Western literature in recent years while most Asian studies still reported a substantial rate of occurrence, especially in patients with hypopharyngeal cancer and among alcoholics. Esophagoscopy is therefore still recommended widely as a staging tool especially in Asian studies. In comparison, there was a lower rate of synchronous lung cancers in the literature, ranging from 0% to at most 1.5%. Most studies didn’t suggest routine use of bronchoscopy as it can be potentially replaced by imaging modalities such as computed tomography scan.