Association of Laryngeal and Pulmonary Malignancies: A Continuing Challenge

Abstract

Over a 10-year period, 790 patients with squamous cell carcinoma of the head and neck were treated at The Medical College of Wisconsin Affiliated Hospitals and were followed for a minimum of 7 years. Of the 218 patients with index primary laryngeal tumors, 43 (19.7%) developed additional malignancies in the head and neck, esophagus, or lung. Secondary lung tumors were the most common, occurring in 23 patients (10.6%). Of the 218 patients with index primary laryngeal carcinoma, 113 were treated successfully and never developed a recurrence of the original tumor. Twenty-one second primary lung malignancies developed in this group of successfully treated laryngeal tumor patients. The occurrence of these pulmonary malignancies was distributed fairly evenly over time. Three patients developed second primary lung tumors more than 7 years after initial treatment. The appearance of a secondary malignancy in the lung had a devastating effect upon survival. None of our patients survived more than 2 years after detection of the lung lesion. The relatively high incidence and delayed onset of second primary lung tumors in this group call into question the concept of 5-year "cures." Our challenge for the future should be the prevention and early detection of these second primary lung tumors.

Second primary cancer of the larynx in patients with lung cancer

“…This high incidence (10 per cent) can perhaps be attributable to pathological findings that were too early for overt clinical manifestation. Yet, a similarly high incidence of 10.6 per cent of associated laryngeal and lung cancers was reported by Strigenz et al (1987) in a group of 790 squamous cell HNCP. McGuirt (1982) found 16 per cent of simultaneous second primary malignancies in 100 consecutive HNCP although only two lung cancers were found.…”

Second Malignant Neoplasms in Patients with Head and Neck Squamous Cell Carcinomas

“…6). Somewhat paradoxically this is of particular importance to patients with early stage tumors who most likely survive the index tumor (7,9,15). If some type of screening for or preventive measures of SMN should be recommended, it is for this group of patients.…”

FDG pet evaluation of head and neck cancer: Value of imaging the thorax

“…A high incidence of second primary tumors of the lung and upper aerodigestive tract has been well documented for many years in patients with primary tumors of the head and neck. [1][2][3][4][5][6][7][8] This has been noted particularly with squamous cell carcinomas arising below the level of the nasopharynx. Schwartz et al 9 found the probability of developing a second, metachronous cancer within 5 years of undergoing treatment for an initial squamous cell carcinoma of the head and neck to be 22%.…”