Classificatory updates in verrucous and cuniculatum carcinomas:Insights from the 5^(th) edition of WHO-IARC head and neck tumor classification

The International Agency for Research on Cancer(IARC)and World Health Organization(WHO)collaboratively produce the'WHO Blue Books'essential tools standardizing the diagnostic process for human cancers.Regular updates in this classification accommodate emerging molecular discoveries,advances in immunohistochemical techniques,and evolving clinical insights.The 5th edition of the WHO/IARC classification of head and neck tumors refines the'Oral Cavity and Mobile Tongue'chapter,including sections for non-neoplastic lesions,epithelial tumors,and tumors of uncertain histogenesis.Notably,the epithelial tumors section is rearranged by tumor behavior,starting with benign squamous papillomas and progressing through potentially malignant oral disorders to oral squamous cell carcinoma(OSCC).The section on OSCC reflects recent information on epidemiology,pathogenesis,and histological prognostic factors.Noteworthy is the specific categorization of verrucous carcinoma(VC)and carcinoma cuniculatum(CC),both associated with the oral cavity and distinct in clinical and histologic characteristics.This classification adjustment emphasizes the oral cavity as their predominant site in the head and neck.Designating specific sections for VC and CC aims to provide comprehensive insights into these unique subtypes,elucidating their clinical features,distinct histological characteristics,prevalence,significance,and clinical relevance.By categorizing these subtypes into specific sections,the 5th edition of the WHO classification aims to provide a more nuanced and detailed account,enhancing our understanding of these specific variants within the broader spectrum of head and neck tumors.

Reconstruction surgery in head and neck cancer patients amidst the COVID-19 pandemic:Current practice and lessons for the future

The coronavirus disease 2019(COVID-19)pandemic has imposed a radical change in daily life and work routine.In this context,health systems have suffered important and serious repercussions in all fields.Among the changes brought about by the state of global health emergency,adjustments to guidelines,priorities,structures,professional teams,and epidemiological data stand out.In light of this,the oncological field has witnessed several changes in the approach to cancer,whether due to delay in diagnosis,screening deficit,personnel shortage or the psychological impact that the pandemic has had on cancer patients.This article focuses on the management of oral carcinoma and the surgical approaches that oral and maxillofacial specialists have had at their disposal during the health emergency.In this period,the oral and maxillofacial surgeons have faced many obstacles.The proximity of maxillofacial structures to the airways,the need of elective and punctual procedures in cancerous lesions,the aggressiveness of head and neck tumors,and the need for important healthcare costs to support such delicate surgeries are examples of some of the challenges imposed for this field.One of the possible surgical'solutions'to the difficulties in managing surgical cases of oral carcinoma during the pandemic is locoregional flaps,which in the pre-COVID-19 era were less used than free flaps.However,during the health emergency,its use has been widely reassessed.This setback may represent a precedent for opening up new reflections.In the course of a long-term pandemic,a reassessment of the validity of different medical and surgical therapeutic approaches should be considered.Finally,given that the pandemic has highlighted vulnerabilities and shortcomings in a number of ways,including the issues of essential resource shortages,underinvestment in public health services,lack of coordination and versatility among politicians,policymakers and health leaders,resulting in overloaded health systems,rapid case development,and high mortality,a more careful analysis of the changes needed in different health systems to satisfactorily face future emergencies is essential to be carried out.This should be directed especially towards improving the management of health systems,their coordination as well as reviewing related practices,even in the surgical field.

Factors influencing comfort level in head and neck neoplasm patients receiving radiotherapy

Objective:To determine factors that influence comfort in head and neck neoplasm patients receiving radiotherapy.Methods:In total,200 head and neck neoplasm patients receiving radiotherapy were recruited from three tertiary first class hospitals.They were assessed by Radiotherapy Comfort Questionnaire for patients with head and neck neoplasm,Social Support Scale,and Medical Coping Modes Questionnaire.Results:The total score of comfort was 60.54±8.32.Multiple linear regression analysis indicated that number of radiation treatments,family accompaniment,educational level,resignation coping mode,complications due to diabetes,accompanying chemotherapy,and the utilization of social support significantly influenced comfort level(p<0.05).Among these,number of radiation treatments,complications due to diabetes,accompanying chemotherapy,and resignation coping were negative factors.Conclusion:Encouraging utilization of social support systems and a positive coping mode is important for increasing comfort level in head and neck neoplasm patients during radiotherapy.Nurses should pay particular attention to those patients during later stages of radiotherapy or chemotherapy,with diabetes,without family accompaniment,and with lower education level.

Evaluation of Quality of Life and Oral Changes of Patients in Head and Neck Radiotherapy: Observational Study

Radiotherapy (RT) in the head and neck, despite coming from technological evolution, is challenged by the acute and late side effects of local irradiation, including permanent loss of saliva, osteoradionecrosis, dental caries induced by radiation and necrosis of the oral cavity, mucositis, xerostomia and secondary infections like candidiasis. Since these manifestations are limiting and the integrity of the vital organs contemplates the patient’s general health status, the oral health-related quality of life (OHRQoL) can be significantly affected by the treatment of head and neck cancer (HNC), since cancer can cause important changes in vital functions related to communication, food and social contact, causing disturbances in the patient’s life. An observational and longitudinal study was carried out with 16 cancer patients submitted to RT in the head and neck, between the years 2019-2020 with the objectives of collecting clinical and epidemiological data on the main oral changes caused by RT in the head and neck and correlating them with the impact on OHRQoL. To analyze the OHRQoL, the University of Washington’s Quality of Life Assessment questionnaire (UW-QOL) was applied once a week for 4 weeks and to observe oral manifestations, a dental clinic file standardized by the researchers was applied. The main oral manifestations clinically observed were hyposalivation, trismus and oral mucositis. The UW-QOL presented pain, chewing and taste as the main complaints reported by patients, however, appearance, salivation and chewing showed statistically significant differences over the weeks. The main manifestations observed were hyposalivation, trismus and oral mucositis, the physical limitations resulting from these manifestations impact the OHRQoL of cancer patients in terms of appearance, salivation and chewing.

Targeting head and neck tumoral stem cells： From biologicalaspects to therapeutic perspectives

Head and neck squamous cell cancer(HNSCC) is the sixth most common cancer in the world. Effective therapeutic modalities such as surgery, radiation, chemotherapy and combinations of each are used in the management of the disease. In most cases, treatment fails to obtain total cancer cure. In recent years, it appears that one of the key determinants of treatment failure may be the presence of cancer stem cells(CSCs) that escape currently available therapies. CSCs form a small portion of the total tumor burden but may play a disproportionately important role in determining outcomes. CSCs have stem features such as self-renewal, high migration capacity, drug resistance, high proliferation abilities. A large body of evidence points to the fact that CSCs are particularly resistant to radiotherapy and chemotherapy. In HNSCC, CSCs have been increasingly shown to have an integral role in tumor initiation, disease progression, metastasis and treatment resistance. In the light of such observations, the present review summarizes biological characteristics of CSCs in HNSCC, outlines targeted strategies for the successful eradication of CSCs in HNSCC including targeting the self-renewal controlling pathways, blocking epithelial mesenchymal transition, niche targeting, immunotherapy approaches and highlights the need to better understand CSCs biology for new treatments modalities.

Restricting carbohydrates to fight head and neck cancer——is this realistic?

Head and neck cancers(HNCs) are aggressive tumors that typically demonstrate a high glycolytic rate, which results in resistance to cytotoxic therapy and poor prognosis. Due to their location these tumors specifically impair food intake and quality of life, so that prevention of weight loss through nutrition support becomes an important treatment goal. Dietary restriction of carbohydrates(CHOs) and their replacement with fat, mostly in form of a ketogenic diet(KD), have been suggested to accommodate for both the altered tumor cell metabolism and cancer-associated weight loss. In this review, I present three specific rationales for CHO restriction and nutritional ketosis as supportive treatment options for the HNC patient. These are(1) targeting the origin and specific aspects of tumor glycolysis;(2) protecting normal tissue from but sensitizing tumor tissue to radiation- and chemotherapy induced cell kill;(3) supporting body and muscle mass maintenance. While most of these benefits of CHO restriction apply to cancer in general, specific aspects of implementation are discussed in relation to HNC patients. While CHO restriction seems feasible in HNC patients the available evidence indicates that its role may extend beyond fighting malnutrition to fighting HNC itself.

Rupture of carotid artery pseudoaneurysm in the modern era of definitive chemoradiation for head and neck cancer:Two case reports

BACKGROUND Carotid blowout syndrome(CBS)is a rupture of the carotid artery and is mainly caused by radiation and resection of head and neck cancers or direct tumor invasion of the carotid artery wall.It is a life-threatening clinical situation.There is no established and effective mode of management of CBS.Furthermore,there is no established preceding sign or symptom;therefore,preventive efforts are not clinically meaningful.CASE SUMMARY We described two cases of CBS that occurred in patients with head and neck cancer after definitive chemoradiotherapy(CRT)using three-dimensional conformal intensity-modulated radiation therapy.Two men aged 61 and 56 years with locally advanced head and neck cancer were treated with definitive CRT.After completing CRT,both of them achieved complete remission.Subsequently,they had persistent severe pain in the oropharyngeal mucosal region and the irradiated neck despite the use of opioid analgesics and rehabilitation for relief of contracted skin.However,continuous follow-up imaging studies showed no evidence of cancer recurrence.Eleven to twelve months after completing CRT,the patients visited the emergency room complaining about massive oronasal bleeding.Angiograms showed rupture of carotid artery pseudoaneurysms on the irradiated side.Despite attempting to secure hemostasis with carotid arterial stent insertion and coil embolization,both patients died because of repeated bleeding from the pseudoaneurysms.CONCLUSION In patients with persistent pain in irradiated sites,clinicians should be suspicious of progressing or impending CBS,even in the three-dimensional conformal intensity-modulated radiation therapy era.

38例头颈部髓外浆细胞瘤临床分析

目的探讨头颈部髓外浆细胞瘤(head and neck extramedullary plasmacytoma,HNEMP)的临床特征、危险因素、治疗及预后。方法回顾性分析2008年9月~2022年1月间北京同仁医院收治的38例新诊断且未治疗的HNEMP患者的临床资料,分析影响生存的因素及其预后。结果38例患者中,病变呈现鼻颅眶沟通性者5例(13.2%),肿瘤最大直径≥5 cm者8例(21.1%)。仅接受单纯手术切除的患者17例(44.7%),术后给予放疗者13例(34.2%),化疗者8例(21.1%),接受放化疗联合治疗者5例(13.2%)。治疗后评价疗效,完全缓解32例,部分缓解3例,疾病稳定1例,疾病进展2例。中位随访86个月,5年的无进展生存率和总生存率分别92.1%和94.7%。其中,颅鼻眶沟通病变患者中位无进展生存期仅13个月,5年的无进展生存率和总生存率为40%和60%,而其余组均为100%。此外,病变范围≥5 cm和累及鼻颅眶沟通是影响患者无进展生存率和总生存率的不良预后因素。结论HNEMP发病率低,治疗上以手术联合放疗为主,预后相对较好,颅鼻眶沟通病变及高肿瘤负荷为不良预后因素。

恶性肿瘤同步放化疗患者的营养状况及其影响因素

目的调查恶性肿瘤同步放化疗患者营养状况并分析其影响因素。方法以自设问卷方式收集2019年3-5月于北京大学肿瘤医院行同步放化疗恶性肿瘤患者的相关临床资料。采用患者参与主观整体评估量表(PG-SGA)评估患者的营养状况,并分析其影响因素。结果共收回有效问卷150份。150例患者的PG-SGA评分中位数为6.0(3.0,11.0)分。56例(37.3%)患者重度营养不良,49例(32.7%)患者中度营养不良。单因素分析显示,老年、食管癌或头颈部肿瘤、Ⅳ期、放疗次数>15次、化疗次数>4次、紫杉醇+铂或铂类单药治疗方案是患者营养不良的影响因素(Z=-3.839~-2.087,P<0.05)。二元logistic回归分析显示,老年、食管癌或头颈部肿瘤、放疗次数>15次是患者重度营养不良的独立危险因素(P<0.05)。结论恶性肿瘤同步放化疗患者营养不良比例高,尤其是老年、食管癌或头颈部肿瘤、同步放化疗后期患者。医务人员应动态评估、监测患者营养状况,并及时干预。

头颈癌患者身体意象研究的范围综述

目的 对国内外头颈癌患者身体意象相关研究进行范围综述。方法 检索PubMed、Web of Science、Embase、The Cochrane Library、CINAHL、中国知网、万方数据库、维普中文科技期刊数据库的相关文献,检索时限为建库至2023年4月10日,并对纳入文献进行讨论分析。结果 共纳入33篇文献。结果显示,头颈癌患者身体意象的影响因素包括社会人口学特征、疾病治疗因素、心理和行为因素、其他因素。身体意象评估工具主要从身体意象相关的情感认知、生理功能、社会活动来进行评估。研究中头颈癌患者的干预措施主要包括美容修复技术、皮肤伪装计划、运动疗法、认知行为干预、表达性写作、积极心理干预。结论 身体意象的影响因素还需进一步探讨,未来研究应选择科学的评估工具,并在此基础上开展干预性研究,改善头颈癌患者身体意象水平。

头颈部肿瘤患者放射性皮炎预防及管理的最佳证据总结

目的 系统检索、评价和总结头颈部肿瘤患者放射性皮炎预防及管理的最新最佳证据,为临床制定个性化的皮肤管理方案提供循证依据。方法 计算机检索各指南及专业协会网站、Cochrane图书馆、JBI循证护理数据库、PubMed、CINAHL、Web of Science Core Collection、Embase、中国知网、维普数据库、万方数据库、中国生物医学文献数据库中所有关于头颈部肿瘤放射性皮炎预防及管理的文献,包括指南、专家共识、系统评价、最佳实践信息册等。检索时间为建库至2023年8月23日。结果 共纳入22篇文献,包括1篇指南、4篇专家共识、17篇系统评价或meta分析。从头颈部肿瘤患者放射性皮炎的发病率、危险因素、临床表现、评估监测、健康教育、日常护理、预防及治疗措施、感染控制、管理策略9个方面总结出43条证据。结论 头颈部肿瘤患者放射性皮炎预防及管理的最佳证据为医疗保健人员制定个性化皮肤管理方案提供循证依据,临床实践过程中需结合具体情境和患者个人意愿选择证据。

头颈部肿瘤患者家庭抗逆力的潜在剖面分析及其影响因素

目的 了解头颈部肿瘤患者家庭抗逆力特征的分类,并分析不同类别的影响因素。方法 采用便利抽样,选取2021年12月-2022年12月上海质子重离子医院接受治疗的316例头颈部肿瘤患者为研究对象,采用自编一般资料调查问卷和家庭弹性评定量表中文简化版(FRAS-C)分别收集患者一般资料和家庭抗逆力资料。采用潜在剖面分析识别家庭抗逆力特征得类别,采用多元logistic回归分析不同类别的影响因素。结果 头颈部肿瘤患者家庭抗逆力特征分为3个类别:低家庭抗逆力型(10.8%)、高抗逆力-低资源利用型(24.0%)和中等家庭抗逆力型(65.2%)。文化程度、家庭年收入、是否与照顾者同住、子女个数和病程是头颈部肿瘤患者家庭抗逆力不同类别的影响因素(P<0.05)。结论 头颈部肿瘤患者家庭抗逆力特征存在异质性,医护人员可在了解患者社会人口学和疾病特征基础上预判家庭抗逆力特征,针对患者需求提供相应的护理服务,帮助成功应对肿瘤疾病。

医务人员对老年头颈癌患者实施术前预立医疗照护计划的观点:Q方法

目的调查头颈外科医务人员对老年头颈癌手术患者术前实施预立医疗照护计划的观点。方法采用Q方法,结合量性和质性方法探索和分析参与者的态度。参与者对半结构式访谈和文献综述产生的35个Q陈述进行排序,并在后续的半结构式访谈中解释排序原因,分析数据形成因子序列以说明参与者的观点。结果共有15名医务人员参与本研究,包括8名医生和7名护士。医务人员对术前实施预立医疗照护计划的观点各不相同,分为3类:维护患者的自主权,患者的知识和传统文化背景影响术前实施预立医疗照护计划,缺乏实施术前预立医疗照护计划的信心。结论尽管本研究中头颈外科医护人员能够认识到术前讨论预立医疗照护计划的益处,但患者认知水平的限制、传统文化价值观、医护人员能力不足及相关法律和政策不健全等因素导致这些医护人员对术前咨询和与患者讨论预立医疗照护计划存有疑虑。未来的研究应探讨克服术前预立医疗照护计划讨论障碍的策略。

同步放化疗期间头颈癌病人症状群与生活质量的相关性研究

目的:调查头颈癌病人同步放化疗期间症状群及生活质量,并分析两者之间的相关性。方法:采用一般资料调查表、安德森症状评估量表-头颈部模块、头颈癌生活质量量表,对安徽省某三甲医院134例同步放化疗期间头颈癌病人进行调查。结果:通过因子分析提炼出头颈放疗特异性症状群、进食障碍症状群、病感行为症状群、心理情绪症状群、胃肠道症状群5组症状群,累积方差贡献率达72.21%,其中头颈放疗特异性症状群尤为严重;病人生活质量总分为(82.95±9.01)分,处于较低水平;5组症状群与生活质量总分均呈负相关关系(P<0.05~P<0.01);回归分析显示,除胃肠道症状群外,其余4组症状群均为生活质量的负向预测因素(P<0.05~P<0.01)。结论:头颈癌病人同步放化疗期间存在多个影响生活质量的症状群,医护人员应及时准确识别并干预,尤其是头颈放疗特异性症状群,从而提高病人的生活质量。

Symptom distress and interference among cancer patients with osteoradionecrosis of jaw: A cross-sectional study

Objective:Osteoradionecrosis of the jaws(ORNJ)is among the most serious oral complications of head and neck cancer treatment with radiation therapy.This study aimed to examine the level of symptom distress and interference of ORNJ in head and neck cancer patients in China.Methods:A cross-sectional study was conducted to profile patient reported symptom severity.Ninetyfive hospitalized ORNJ patients were recruited.Participants completed the MD Anderson Symptom Inventory-Head and Neck Module-Chinese version.Results:The percentage of participants who reported that they experienced at least one type of symptom was 97.9%,and 85.2%patients reported interference.The 10 most severe symptoms were as follows:limited mouth opening,problem with teeth/gums,difficulty swallowing/chewing,dry mouth,oral malodor,difficulty with voice/speech,dental ulcer,tinnitus/ear obstruction,skin pain/burning/rash,and difficulty hearing.The problem of limited mouth opening was more severe in patients with longer time to onset of ORNJ after radiotherapy.The interference of patients positively correlated with core symptoms(r=0.612),head and neck symptoms(r=0.709),and ORNJ symptoms(r=0.440)(P<0.01).The longer time to the onset of ORNJ after radiotherapy was positively and significantly correlated with symptom distress(r=0.479,P<0.001),and mouth opening correlated negatively with symptom distress(r=-0.298,P=0.003).Conclusions:ORNJ patients suffered mainly from limited mouth opening and other maxillofacial symptoms.The problem of limited mouth opening was more severe in patients with longer time to onset of ORNJ after radiotherapy.ORNJ patients commonly had symptom distress,which influenced their quality of life.

Identifying pain-related concerns in routine follow-up clinics following oral and oropharyngeal cancer

AIM:To describe clinical characteristics of head and neck cancer(HNC)patients with pain and those wishing to discuss pain concerns during consultation.METHODS:Cross-sectional,questionnaire study using University of Washington Quality of Life,version 4(UWQOL)and the Patients Concerns Inventory(PCI)in disease-free,post-treatment HNC cohort.Significant pain on UW-QOL and indicating"Pain in head and neck"and"Pain elsewhere"on PCI.RESULTS:One hundred and seventy-seven patientscompleted UW-QOL and PCI.The prevalence of selfreported pain issues was 38%(67/177)comprising25%(44/177)with significant problems despite medications and 13%(23/177)with lesser or no problems but wishing to discuss pain.Patients aged under 65years and patients having treatment involving radiotherapy were more likely to have pain issues.Just over half,55%(24/44)of patients with significant pain did not express a need to discuss this.Those with significant pain or others wanting to discuss pain in clinic had greater problems in physical and social-emotional functioning,reported suboptimal QOL,and also had more additional PCI items to discuss in clinic compared to those without significant pain and not wishing to discuss pain.CONCLUSION:Significant HNC-related pain is prevalent in the disease-free,posttreatment cohort.Onward referral to a specialist pain team may be beneficial.The UW-QOL and PCI package is a valuable tool that may routinely screen for significant pain in outpatient clinics.

Cutaneous ciliated cyst on the anterior neck in young women: A case report

BACKGROUND A cutaneous ciliated cyst(CCC)is a rare,benign tumor in young female adults,which is usually found on the lower extremities.CASE SUMMARY We found an uncommon location of CCC in the anterolateral cervical area and reviewed the literature.A 20-year-old female complained of a well-defined,painless,palpable mass that started several years ago.The mass was tense and movable and located at the anterolateral aspect of the neck.Imaging showed a non-enhancing round mass.Surgical excision biopsy was performed,and the cystic mass was revealed to be a CCC.CONCLUSION The rare location of CCC can be found in anterior neck area,which should be another diagnostic option for mass on anterior neck.

The Comparison of Diagnostic Significance of Narrow Band Imaging in Contrast of White Light Endoscopy in the Assessment of Nasopharyngeal Cancer

Background: Narrow band imaging (NBI) is reported to improve the diagnostic importance of nasopharyngeal cancer. The purpose of this review was to evaluate the diagnostic significance of NBI in the literature and compare it to the conventional white light endoscopy. The use of narrow band imaging (NBI) and further technological achievements concerning the resolution and magnification of endoscopic images have in the past 15 years. With the use of NBI, superficial mucosal lesions, which may be missed by standard WLI endoscopy, can be identified easily by their neoangiogenic pattern. Objective:?To assess diagnostic value of the narrow band imaging and white light endoscopy in nasopharyngeal carcinoma and compare diagnostic values (sensitivity, specificity, positive predictive value and negative predictive value) with white light endoscopy. Search Methods: From 2010 to 2020, data was searched from electronic databases such as PubMed, web of science. We used narrow band imaging as a key word accordance with diagnostic modalities such as sensitivity, specificity, PPV and NPV and data were collected. Results: We have found mainly 6 studies have discussed about diagnostic value of endoscopy in nasopharyngeal carcinoma in the total of 2746 suspected patients. Among them, 5 studies have compared diagnostic values such as sensitivity, specificity, positive predictive value and negative predictive value between NBI and WLE. Among 5 studies, 4 studies have found higher sensitivity in NBI, 2 studies found higher 1 equal to WLE specificity in NBI. 3 studies have compared PPV and NPV between NBI and WLE. Among them, all the studies found higher PPV and NPV in NBI than WLE. Conclusion: Recently?developed narrow band imaging has a great significance in the diagnosis of nasopharyngeal carcinoma. Although NBI has also encountered some problem such as contact bleeding and darker image. So, further evaluation should be done.

COMPASS系统在头颈部肿瘤调强放疗计划验证中的应用

目的探讨COMPASS三维剂量验证系统在头颈部肿瘤调强放疗计划剂量验证中的应用。方法选取我院8例头颈部肿瘤患者的调强放疗计划,采用COMPASS系统进行三维剂量验证。对比分析计划系统剂量和COMPASS系统基于测量的重构剂量的三维Gamma通过率和剂量体积直方图。结果肿瘤靶区的计划剂量和COMPASS实测剂量间Gamma通过率平均值均在95%以上。各靶区的计划系统剂量和重构剂量在D_(99)、D_(mean)和D_1的差异平均值均<3%。脊髓和脑干的Gamma通过率平均值均在95%以上。脊髓和脑干的剂量差异平均值均<10%。结论 COMPASS三维剂量验证系统能在患者CT图像上重建剂量分布,反映感兴趣区域的真实剂量分布,是安全可靠的剂量验证工具。

Clinical impact of gastrointestinal endoscopy on the early detection of pharyngeal squamous cell carcinoma: A retrospective cohort study

BACKGROUND In recent years,with the growing availability of image-enhanced gastrointestinal endoscopy,gastroenterologists have contributed to the early detection of pharyngeal squamous cell carcinomas(SCC).AIM To clarify the clinical characteristics of pharyngeal SCCs detected by gastrointestinal endoscopy.METHODS This is a retrospective cohort study conducted in a single-center,a university hospital in Japan.We retrospectively assessed the clinical records of 522 consecutive patients with oropharyngeal or hypopharyngeal SCC who were examined in our hospital between 2011 and 2018.The lesions were classified into two groups:Group GE(detected by gastrointestinal endoscopy)and Group non-GE(detected by means other than gastrointestinal endoscopy).The clinical characteristics were compared between the two groups.Continuous data were compared using the Mann–Whitney U test.Pearson’sχ2 test or Fisher's exact test was used to analyze the categorical data and compare proportions.The Kaplan–Meier method was used to estimate the cumulative patient survival rates.RESULTS In our study group,the median age was 65 years and 474 patients(90.8%)were male.One hundred and ninety-six cases(37.5%)involved the oropharynx and 326 cases(62.5%)involved the hypopharynx.Three hundred and ninety-five cases(75.7%)had some symptoms at the time of diagnosis.One hundred and forty-five(27.8%)cases had concurrent ESCC or a history of ESCC.One hundred and sixtyfour(31.4%)cases were detected by gastrointestinal endoscopy and classified as Group GE.The proportions of asymptomatic cases,cTis-1 cases and cases with no lymph node metastasis were significantly higher in Group GE than Group non-GE(61.6%vs 7.3%,P<0.001,32.9%vs 12.0%,P<0.001 and 69.5%vs 19.0%,P<0.001).Endoscopic laryngo-pharyngeal surgery or endoscopic submucosal dissection were performed in only 0.6%of the lesions in Group non-GE but in 21.3%of the lesions in Group GE(P<0.001).Overall survival was significantly longer in Group GE than in Group non-GE(P=0.018).The 2-year and 4-year survival rates were 82.5%and 70.7%in Group GE,and 71.5%and 59.0%in Group non-GE,respectively.CONCLUSION Gastrointestinal endoscopy plays an important role in the early detection and improving the prognosis of pharyngeal SCCs.