Incidence, timing, presentation, treatment, and outcomes of second primary head and neck squamous cell carcinoma after oral cancer

Abstract

Patients following their initial presentation of oral squamous cell carcinoma (SCC) have a lifelong risk of another new head and neck SCC. The present study aimed to establish the rates of second primary (SP), baseline characteristics (site, clinical or pathological stage, smoking and alcohol history), timing, presentation, treatment and outcomes. From the regional unit, records of patients treated with curative intent for their first oral cancer between 2002 and 2007 inclusive were analysed. Patients had at least 10 years of follow-up either to death or to the end of 2017. Of 347 patients treated with curative intent 29 had a SP at a median (IQR) of 52 (30-79) months after index surgery. All patients had at least 10 years of follow-up and the incidence of developing a second primary tumour within 2 years was 1.7% (95% CI: 0.7-3.7%), within 5 years was 4.9% (95% CI: 2.9-7.7% and within 10 years was 7.8% (95% CI: 5.1-11.1%). Early stage of first cancer was the only statistically significant factor (P=0.001) for SP within 10 years reflecting survivorship. SP were mainly (21 patients) staged as early and by visual inspection. Most (20) were located within the oral cavity with one of these overlapping the oropharynx, oropharynx (8) and larynx (1). The majority (22) were treated by surgery with curative intent and 3 were palliative. Patients need to be aware of the risk of SP and as most are in the mouth or oropharynx there is a role for surveillance by primary dental care. Manuscript with title (excluding any author details including names and affiliations) Click here to view linked References

The role of NBI with flexible video-endoscope in the follow-up of head and neck cancer patients: a prospective study

“…This was particularly evident in the oral cavity. A recurrence in the oral cavity after an oral index tumor has been previously reported also by Rogers et al [31], and could be explained with a strong local effect of carcinogens in this area.…”

Second primary tumors in head and neck cancer patients: The importance of a “tailored” surveillance

“…This may be due to the different risk factors between HPV‐related and HPV‐unrelated cancer; HPV‐related HNSCCs are not associated to alcohol abuse and smoking history, the most important risk factors for the development of SPT (Boakye et al., 2018). Several studies reported that early stage of the index cancer (i.e., absence of nodal involvement) was a risk factor associated with the development of SPT, reflecting survivorship (Lee et al., 2013; Rogers et al., 2019). We collected data about stage, nodal involvement, and grading and of primary tumor, but we did not find significant correlation with development of SPT.…”

High‐dose‐rate remote brachytherapy for metachronous second primary carcinoma of soft palate by iridium 192 isotope in an afterload surface mold

“…HDR has the advantage of high dose radiation at the target area sparing the remaining tissues, thereby minimizing post radiation sequelae and enhancing the quality of life. [1][2][3][4][5]12,13 Since the radiation implant was placed after the accurate seating of the mold at each radiotherapy session, it was an afterload brachytherapy mold. 13 This minimized the risk of radiation exposure to the patient and to the personnel handling the mold.…”

“…Metachronous second primary carcinoma (MCSPC) are tumors occurring in areas close to the region of primary carcinoma, which have been detected 6 months or more after the index carcinoma is treated. [1][2][3][4][5] High dose rate (HDR) brachytherapy is preferred for local tumor control and to conserve form and function in treatment of MCSPC. [6][7][8][9] A brachytherapy mold is used to carry the radioisotope as radiation source.…”