Is There a Role for Triple Endoscopy in the Staging of Head and Neck Cancer?

  • Thomas S. Y. Ho
  • Raymond K. Y. TsangEmail author
Part of the Difficult Decisions in Surgery: An Evidence-Based Approach book series (DDSURGERY)


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.


Triple endoscopy Head and neck squamous cell carcinomas Second primary cancers Synchronous cancer Upper aerodigestive tract Field cancerization 


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Authors and Affiliations

  1. 1.Division of Otorhinolaryngology, Department of SurgeryThe University of Hong Kong, Queen Mary HospitalHong KongHong Kong

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