Abstract
BACKGROUND/AIM: The oropharynx, hypopharynx, and esophagus share similar epithelial characteristics, rendering them highly susceptible to the development of synchronous or metachronous multiple primary cancers. As endoscopic technologies, including Narrow Band Imaging (NBI) and high-resolution imaging systems, have advanced, early-stage pharyngeal cancers are increasingly detected during routine endoscopic evaluations or follow-up examinations for other head and neck or esophageal malignancies. This study aimed to retrospectively evaluate the clinical features, treatment modalities, occurrence of synchronous/metachronous multiple primary cancers, and prognoses in patients with early-stage (Tis, T1, T2/N0) oropharyngeal and hypopharyngeal squamous cell carcinoma who underwent initial treatment between January 2016 and December 2021. PATIENTS AND METHODS: Seventy-six patients with early-stage oropharyngeal or hypopharyngeal squamous cell carcinoma were included in the analysis. Parameters evaluated included patient demographics, tumor classification and localization, detection methods, therapeutic interventions, presence and type of multiple primary cancers, and clinical outcomes. RESULTS: While the disease-specific survival (DSS) rates were generally favorable across T stages, overall survival (OS) rates were comparatively lower, with many deaths attributable to the progression of multiple primary cancers, especially those involving the upper gastrointestinal tract. Detection of Tis and T1 lesions often occurred incidentally during gastrointestinal endoscopy performed for other indications. In contrast, T2 lesions were predominantly detected following the onset of pharyngeal symptoms and ENT examination. Multiple primary cancers were highly prevalent, particularly esophageal and gastric carcinomas. CONCLUSION: Despite favorable DSS outcomes in early-stage oropharyngeal and hypopharyngeal cancers, OS remains compromised due to secondary malignancies. These findings underscore the critical need for early, isolated detection of pharyngeal carcinoma through interdepartmental collaboration, particularly with gastroenterologists and screening physicians, to enhance comprehensive cancer control and improve patient survival.