Outcomes for patients with second primary malignancy after primary surgical treatment for early‐stage squamous cell carcinoma of the oral cavity

Abstract

Background The purpose of our article was to describe a tertiary center's experience with patients with primarily surgically treated early‐stage intraoral cancer with a second primary malignancy confirmed during follow‐up. Methods A total of 183 patients were primarily surgically treated for oral cancer between 2000 and 2004. Among these, 24 patients (13.1% (24/183)) met inclusion criteria. Results There were 22 men (91.7%) and 2 women (8.3%) with a median age of 59.5 years. Patients with head and neck cancer with a second primary malignancy had significantly higher survival compared to nonhead and neck cancer with a second primary malignancy. Patients with head and neck cancer with second primary malignancy were diagnosed during the period of 14 to 45 months (median 29 months), whereas nonhead and neck cancer with second primary malignancy occurred in a period of 7 to 46 months (median 19 months). Conclusion This study highlights the importance of optimizing screening strategies for second primary malignancies. In order to improve the survival of patients with head and neck squamous cell carcinoma (HNSCC), effective programs of screening and/or chemoprevention of second primary malignancies are essential.

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

“…Early detection of a SP is a key factor in reducing further treatment burden, dysfunction and optimising disease specific survival. 6 Patients should be reassured by the evidence that if a SP is detected early most are treatable with primary closure, laser, or resection and free tissue reconstruction. With increasing time intervals between follow-up appointments at hospital or and ultimately discharge, 18 patients should have an easy mechanism to allow rapid assessment back into clinic if new symptoms of concern are raised.…”

“…Following treatment for oral cancer there is a risk of developing a second primary (SP). The rate is varies in published papers, 3% to 7% 1 , 7% 2 , 9% 3 11% 4,5 , 13% 6 and as high as 18.4%. 7 Of the head and neck sites, oral cavity and oropharynx are more likely to develop a SP.…”

Pathogenesis and Therapy of Oral Carcinogenesis

“…In addition, 15% of patients are no longer in follow-up care after surgery, about 35% continue to consume tobacco products, and 16.7% consume alcohol [ 8 , 9 ]. Chronic alcohol and tobacco consumption is responsible for the occurrence of other primary tumors (head and neck, lung, colon, liver, pancreas) in 17.8% of patients in the early stages of the disease [ 10 ]. Worryingly, the incidence of OSCC is increasing in the younger population, particularly in white women under the age of 40 who do not smoke or drink alcohol.…”