Presentation of second primary cancers in young laryngeal carcinoma patients

Abstract

Background: Laryngeal squamous cell carcinoma (LSCC) is rare in the young. Objectives: We characterized the clinical behavior of LSCC and assessed the presentation of second primary tumors (SPCs) in this patient population. Materials and methods: Data from the Finnish Cancer Registry (FCR) were used to identify an epidemiological series of LSCC patients diagnosed at the age of 40 years or under, during 1953-2012 in Finland. Data regarding primary treatment, survival and SPCs were available. To further characterize the comorbidity and lifestyle factors of young patients with LSCC, institutional data was collected of patients treated at the Helsinki University Hospital during 1967-2012. Results: We identified 151 patients, with a mean follow-up of 252 months. The 10year overall survival (OS) was 75% and the disease-specific survival was 84%. SPCs were diagnosed in 26% (n=39), with a median delay of 28 years. Of the 35 patients in the institutional series from Helsinki, 22 (63 %) were current or former smokers. LSCC recurred in 28% of patients. Conclusions and Significance: The delay to SPCs in young patients was significantly longer compared with the general LSCC population. As factors underlying this phenomenon cannot be identified by this retrospective study, further studies are warranted.

The risk of second primary tumors in head and neck cancer: A systematic review

“…Our search criteria identified, 5540 papers and after removal of duplicates, 61 papers were selected for data review and are summarized in Table . Most of the studies were retrospective.…”

The risk of second primary cancer after nasopharyngeal cancer: a systematic review

“…Moreover, some studies proposed that common genetic factors may play a role in SPC risk in younger patients. Interestingly, regarding laryngeal carcinoma, a study by Silén et al [ 38 ] reported that SPCs in younger patients occurred at approximately the same age as in laryngeal carcinoma patients in general. However, the reason behind this remained unknown.…”

Laryngeal cancers in paediatric and young adult patients: epidemiology, biology and treatment

“…Early stages usually require single modality treatment, while advanced cancers involve a combination of modalities. In recent studies conducted since 2000, some authors reported preferences for radiation [14,[62][63][64] (Table 2), while others reported a higher proportion of patients treated with surgery [15]. Accordingly, the significant heterogeneity between studies of clinical staging of young patients may cause enormous downstream variability and bias in the choice of therapeutic modalities.…”

“…Depending on the cohort features, the 5-year OS of young adults with LSCC significantly varies across studies, ranging from 55 to 87.5% (Table 2) [8,15,62,[65][66][67]. Glottic SCC seems to entail better survival outcomes than supraglottic SCC in young adults [62], but the proportion of anatomical location of tumour varies between studies (Table 2). As for clinical staging, there is an important heterogeneity between studies in the prognosis of laryngeal cancer in young versus old patients.…”

“…Disease-free survival was investigated in two studies in 1996 [65] and 2011 [63] and was similar between young and older patients. Regarding recurrence rates, Benninger et al [69] reported 62% of recurrence in young adults (average follow-up: 50.4 months), while Silen et al [62] found 28% of recurrence 10 years after the initial treatment. None of these studies compared recurrence rates between various age groups.…”