Second primary malignancies in patients with cancer of the head and neck

Abstract

OBJECTIVE: Clinical study of second primary malignancies (SPM) in patients with cancer of the head and neck (HNC). STUDY DESIGN AND SETTING: Retrospective study over 48 patients with SPMs culled from 636 with HNC seen in 122 months. The minimum follow-up was 18 months, and the setting for the study was the institutional referral center. RESULTS: There was association between the sites of first and second tumor. The SPMs were diagnosed with a constant rate throughout the period of study. Five year-survival rate was 29%. SPM in an advanced stage either outside of the head and neck or synchronous had poor survival. CONCLUSION: The SPMs are a growing problem with better survival after treatment of the first malignancy. SIGNIFICANCE: Regular follow-up is necessary in HNC patients to improve their survival, giving special attention to the development of SPM.

Outcomes following transoral robotic surgery: Supraglottic laryngectomy

“…In other words, early staged (II) supraglottic SCCA can receive identical CRT treatment as advanced staged (IV) tumors. Additionally, with a significant majority of early staged supraglottic SCCA surviving beyond 5 years,3 the risk of development of second aerodigestive primary tumors25 should factor into primary treatment decisions. If radiation is used early in treatment for resectable tumors, this modality will not be available when second tumors arise in a substantial percentage of these patients, as has been demonstrated in the endoscopic laser supraglottic laryngectomy experience 11…”

Survival outcomes for second primary head and neck cancer: A matched analysis

“…Typically, approximately two thirds of these reported SPM occur within the head and neck. 4 For primaries occurring outside of the head and neck, pharyngeal primary HNSCCA is most closely linked with subsequent development of esophageal carcinoma (digestive axis), whereas first primary laryngeal carcinoma is most commonly associated with subsequent second pri- mary lung carcinoma (respiratory axis). 17 Importantly, the risk for second primary malignancy continues at a relatively steady rate for even decades after the diagnosis of the initial primary.…”

“…Most commonly, these SPM figures include second primary malignancies developing at all sites, not only those within the head and neck. Typically, approximately two thirds of these reported SPM occur within the head and neck 4 . For primaries occurring outside of the head and neck, pharyngeal primary HNSCCA is most closely linked with subsequent development of esophageal carcinoma (digestive axis), whereas first primary laryngeal carcinoma is most commonly associated with subsequent second primary lung carcinoma (respiratory axis) 17 .…”

“…One factor that may significantly affect survival for patients with head and neck squamous cell carcinoma (HNSCCA) is the development of a second primary squamous cell carcinoma within the head and neck thought to approximate 2% per patient‐year of follow‐up. This risk may translate to a lifetime incidence of second primary affecting 30% or more of patients who survive their initial HNSCCA 4 …”

“…This risk may translate to a lifetime incidence of second primary affecting 30% or more of patients who survive their initial HNSCCA. 4 Because of this relatively high incidence of second primary development, concerted efforts have been aimed at reducing the risk of second primary development. Smoking cessation and curtailment of alcohol intake, which may be difficult in patients diagnosed with HNSCCA, are obvious interventions that require specific attention in the follow-up period.…”