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Vol. 71. Issue 4.
Pages 249-252 (July - August 2020)
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Vol. 71. Issue 4.
Pages 249-252 (July - August 2020)
Brief communication
DOI: 10.1016/j.otoeng.2020.02.003
Head and neck cancer screening in patients eligible for liver transplantation
Cribado de cáncer de cabeza y cuello en pacientes candidatos a trasplante hepático
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Nathalia Castillo-Ledesmaa,
Corresponding author
, Patricia Corriols-Novala, Eugenia López-Simóna, Aiara Viana-Coraa, Fernando Casafont-Morencosb, Iranzu Ezcurra-Acedob, Carmelo Morales-Anguloa
a Servicio de Otorrinolaringología, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, IDIVAL, Santander, Spain
b Servicio de Digestivo, Hospital Universitario Marqués de Valdecilla, Santander, Spain
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Abstract
Introduction

Liver transplantation is the only alternative treatment in patients in end-stage liver function. In many cases the need for liver transplantation is a consequence of the toxic effects of alcohol.

The aim of our study was to determine if patients who are candidates for a liver transplant require a systematic exploration of the head and neck to rule out malignant lesions in this area.

Patients and methods

All the candidates for a liver transplant, between 2011 and 2017, were included in our study. All of them underwent a systematic exploration of the head and neck by an otolaryngologist to rule out malignancy of the head and neck.

Results

A total of 141 patients were included in our study. In two of them (1.3%) a carcinoma of the head and neck was detected (one of the oropharynx and the other of the larynx). Both patients were asymptomatic from an ENT point of view. They were treated with chemoradiotherapy. One of them died during follow-up due to the appearance of a metachronous lung tumour. The other is free of disease 2 years after diagnosis but without having been transplanted. Both patients had a history of smoking and high alcohol intake.

Conclusions

In patients who are candidates for a liver transplant who have a history of smoking and / or high alcohol intake, a pretransplant head and neck study including pharyngo-laryngeal fibroscopy is indicated.

Keywords:
Liver transplant
Head and neck cancer
Screening
Resumen
Introducción

El trasplante hepático constituye la única alternativa de tratamiento en pacientes con hepatopatías crónicas avanzadas. La etiología más frecuente en nuestro medio es la viral y la alcohólica.

El objetivo de nuestro estudio fue determinar si los pacientes que son candidatos a un trasplante hepático precisan una exploración de cabeza y cuello de forma sistemática para descartar neoplasias de dicha área.

Pacientes y métodos

Todos los pacientes candidatos a la realización de un trasplante hepático entre los años 2011 y 2017, fueron incluidos en nuestro estudio. A todos ellos se les realizó de forma sistemática una exploración de cabeza y cuello por un otorrinolaringólogo para descartar neoplasias de cabeza y cuello.

Resultados

Un total de 141 pacientes fueron incluidos en nuestro estudio. En dos de ellos (1,3%) se detectó un carcinoma de cabeza y cuello (uno de orofaringe y otro de laringe), estando ambos pacientes asintomáticos. Fueron tratados con quimiorradioterapia, falleciendo uno de ellos durante el seguimiento por la aparición de un tumor metacrónico pulmonar. El otro paciente está libre de enfermedad 2 años después del diagnóstico, pero no ha recibido trasplante hepático hasta la fecha. Ambos pacientes tenían antecedentes de tabaquismo y alta ingesta de alcohol.

Conclusiones

En pacientes que son candidatos a un trasplante hepático, y que presentan antecedentes de tabaquismo y/o alta ingesta alcohólica recomendamos la realización de un estudio de cabeza y cuello pretrasplante que incluya exploración nasofibroscópica de las regiones faringo-laríngeas para despistaje de tumores sincrónicos.

Palabras clave:
Trasplante hepático
Cáncer de cabeza y cuello
Cribado

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