Prevalence of Liver Fibrosis and Cirrhosis in Patients With Squamous Cell Carcinoma of the Head and Neck
Prevalence of Liver Fibrosis and Cirrhosis in Patients With Squamous Cell Carcinoma of the Head and Neck
Tobacco and alcohol are the two major risk factors for upper respiratory tract cancer (VADS).
Tobacco and alcohol are the two major risk factors for upper respiratory tract cancer (VADS).
 Among patients with VADS cancer, more than 60% reported daily alcohol consumption of more
 than 20 g / d. Such poisoning can be harmful, causing histological lesions of alcoholic liver
 disease, such as steatosis, alcoholic hepatitis, liver fibrosis and cirrhosis. In a
 population consuming more than 50 g of alcohol per day for 5 years, the prevalence of severe
 hepatic fibrosis is between 30% and 40%. In the therapeutic management of a cancer of VADS,
 the presence of cirrhosis is a prognostic element, increasing the postoperative risk of
 haemorrhage, surgical site infection and acute renal failure. The search for cirrhosis in the
 pre-therapeutic assessment is therefore important. The diagnosis of cirrhosis is not a
 problem when clinical, biological, radiological or endoscopic signs of hepatic insufficiency
 or portal hypertension are present. Asymptomatic cirrhosis is more difficult to diagnose
 without liver biopsy. Noninvasive hepatic exploration techniques have recently been developed
 and validated for the evaluation of liver fibrosis in the context of alcoholic liver disease.
 Fibroscan® (Echosens, Paris, France) is an imaging device for measuring the liver hardness
 (hepatic elasticity expressed in kPa), with a strong correlation with the presence of
 histological fibrosis of the liver. At the threshold of 19.5 kPa, Fibroscan can be used to
 diagnose cirrhosis with good diagnostic performance (Se 80%, Sp 90%, VPP 93%, VPN 70%) and
 good inter- and intra-observer reproducibility. Elastometry is a simple, reliable and
 non-invasive tool to systematically evaluate hepatic fibrosis in patients with VADS cancer.
 The examination can be performed during a routine care consultation. The post-therapeutic
 morbidity induced by cirrhosis in the cancers of VADS is not well known and there is no
 recommendation in France about the hepatic explorations to be carried out during the initial
 assessment of these neoplasias. It is essential to be able to specify this morbidity in order
 to adapt if necessary the therapeutic strategy of cancers of VADS.

 The objective of this study is to systematically determine the presence of cirrhosis and / or
 liver fibrosis in patients with VADS cancer, in order to investigate their impact on the
 morbidity after treatment of squamous cell carcinomas of the head and neck.
Inclusion Criteria:

 -  Patient over 18 years of age

 -  Supported in the department of Orl & CCF or Maxillo-Faciale surgery of the CHU
 d'Amiens

 -  Histological diagnosis of epidermoid carcinoma:

 -  From the oral cavity

 -  From the oropharynx

 -  Hypopharynx

 -  Larynx

 -  Any stage of cancer

 -  Affiliation to a social security scheme

 Exclusion Criteria:

 -  Patient already treated previously for a cancer of the VADS

 -  Patient referred to in Articles L. 1121-5 to L. 1121-8 and L. 1122-1-2 of the Public
 Health Code