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Acta Endoscopica

, Volume 21, Issue 5, pp 599–606 | Cite as

Apport de la panendoscopie lors du bilan pré-théapeutique des cancers bucco-pharyngo-laryngés

  • E. Brossard
  • Ph. Monnier
Article

Résumé

L’existence de cancers multiples des voies aéro-digestives supérieures est bien connue. Cette étude a pour but d’évaluer l’apport de 100 panendoscopies successives effectuées au stade pré-thérapeutique chez des patients hospitalisés entre Janvier 1989 et mai 1990 pour un carcinome épidermoïde de la cavité’ buccale, du pharynx ou du larynx. La rentabilité du dépistage panendoscopique (examen ORL, bronchoscopie, œsophagoscopie) est démontrée par le taux élevé de polylocalisations simultanées (24 %), correspondant à 32 % de localisations additionnelles. 20 secondes localisations réparties chez 14 patients n’étaient pas visibles lors de l’examen ORL habituel ni à la radiographic de thorax et ont été exclusivement découvertes lors de la broncho-œsophagoscopie. 85 % des secondes localisations découvertes lors de la broncho-ésophagoscopie correspondaient à des lésions tumorales « pr6coces » (Stade TNM : Tis et Tl). La découverte de secondes localisations simultanées chez 24 patjents a conduit à une modification du programme thérapeutique initial dans 23 cas. L’investigation panendoscopique nous paraît par conséquent déterminante pour la prise en charge oncologique des porteurs de carcinomes bucco-pharyngo-laryngés.

Mots-clés

panendoscopie cancers multiples cancers ORL 

The contribution of panendoscopy in the pre-therapeutic screening of bucco-pharyngeal-laryngeal cancers

Summary

It is well-known that multiple cancers exist in the upper digestive tract. The aim of this study is to pre-evaluate the results of 100 successive panendoscopies carried out at the pre-therapeútic stage in patients hospitalised betwen January 1989 and May 1990. These patients were suffering from squamous cell cancer of the buccal cavity, of the larynx or of the pharynx. The value of panendoscopic detection (ENT examination, bronchoscopy, esophagoscopy) is shown by the high level of simultaneous polylocalisations (24 %) corresponding to 32 % of additional localisations. In 14 patients, 20 secondary localisations were not visible at the time of the ENT examination nor during the X-ray of the thorax and were only discovered during the broncho-œsophagoscopy. 85 % of the secondary localisations corresponded to «early » tumorous lesions (TNM Stage: Tis and Tl). The discovery of simultaneous secondary localisations in 24 patients lead to changes in the initial therapeutic programme in 23 cases. Consequently, the panendoscopic investigation seems to determine the oncological treatment of patients with the above cancers.

Key-words

panendoscopy neoplasm multiple primaries ENT cancers 

Aporte de la panendoscopia en el estudio preterapéutico de los cánceres buco-farinco-laríngeos

Resumen

La existencia de cánceres mútiples de las vías aerodigestivas superiores es bien conocida. Este estudio tiene por fin evaluar la ayuda de 100 panendoscopias sucesivas preterapéuticas efectuadas en pacientes hospitalizados entre Enero de 1989 y Mayo de 1990 por un carcinoma epidermoide de la cavidad bucal, de la faringe o de la laringe. La rentabilidad de la investigaciãn panendoscópica (examen ORL, broncoscopia, esofagoscopia) está demostrada por la tasa elevada de poli-localizaciones simultáneas (24 %), correspondientes a 32 % de localizaciones adicionales. 20 segundas localizaciones repartidas en 14 pacientes no fueron visibles con el examen ORL habitual ni a la radiografía de tórax y han sido descubiertas exclusivamente con la bronco-esofagoscopia. 85 % de las segundas localizaciones descubiertas con la bronco-esofagoscopia correspondieron a lesiones tumorales « precoces » (Estado TNM : Tis y TI). EI descubrimiento de segundas localizaciones simultáneas en 24 pacientes llevó a una modificación del programa terapéutico inicial en 23 casos. La investigación panendoseópica nos parece por tanto, determinante para el manejo oncológico de los portadores de carcinomas buco-faringo-laríngeos.

Palabras claves

panendoscopia cánceves múltiples carcinomas buco-faringo-laríngeos 

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Copyright information

© Springer-Verlag 1991

Authors and Affiliations

  • E. Brossard
    • 1
  • Ph. Monnier
  1. 1.clinique ORL, CHUVLausanneSuisse

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