Compliments on Castillo-Ledesma et al., in their study about head and neck screening in patients eligible for liver transplantation

Machado, André; Silva, Ana; Sousa, Cecília Almeida e

doi:10.1016/j.otoeng.2020.09.001

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This letter is to expose a point of view of pathophysiology shared by the two entities: liver disease and head and neck cancer.According to the literature, the albumin levels in hepatic disease are decreased due to the loss of function of the liver,<a class="elsevierStyleCrossRef" href="#bib0035">2</a> and there is also evidence of poorer overall survival in patients with head and neck cancer associated with lower values of serum albumin.<a class="elsevierStyleCrossRef" href="#bib0040">3</a>In authors’ opinion, albumin serum measurements with different cut-offs should be taken into account as a screening and prognostic tool in these patients, combined with ENT assessment with pharyngo-laryngeal fibroscopy and cervical palpation. These different cut-offs should be taken into account the etiology of liver disease, because of the different patterns of albumin and liver function tests levels that characterize each one of them.<a class="elsevierStyleCrossRef" href="#bib0045">4</a>By sharing the same the risk factors, such as alcohol consumption and tobacco use, the authors consider of major importance the screening of the two types of malignancies – in line of the statements of Castillo-Ledesma et al.<a class="elsevierStyleCrossRef" href="#bib0030">1</a>The authors also consider that the ENT screening should not be only directed toward those who have tobacco and alcohol consumption, and that is reinforced by the literature that documented and increased incidence of head and neck cancer in liver transplant recipients,<a class="elsevierStyleCrossRef" href="#bib0050">5</a> which reinforces the intensive screening of these patients.FundingNo funding was provided.Conflict of interestThe authors have no funding, financial relationship of conflict of interest to disclose." 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