Second primary tumors and field cancerization in oral and oropharyngeal cancer: Molecular techniques provide new insights and definitionsCarl H. Synderman, MD, Section Editor

Proteomic analysis reveals successive aberrations in protein expression from healthy mucosa to invasive head and neck cancer

“…These early p53 alterations have been more frequently observed in patients suffering from multiple cancers compared to those with only one tumor (Waridel et al, 1997;Homann et al, 2001), in agreement with the field model . In cytogenetic studies, allelic imbalances/loss of heterozygosity (LOH) and chromosomal aneuploidy have been detected in tumors and mucosal biopsies of tumor patients (Soder et al, 1995;Bedi et al, 1996;Califano et al, 1996;Ai et al, 1999;Partridge et al, 2000;Braakhuis et al, 2002;Tabor et al, 2004). Chromosomal aneuploidy appears to precede malignant transformation as indicated by findings of monosomy and trisomy in histologically normal squamous mucosa (Ai et al, 2001;Wolf et al, 2004).…”

“…For instance, such fields may persist after resection of the primary tumor and may result in either local recurrency (minimal residual disease) or, if located at distance to the primary tumor, in second primary cancer (Braakhuis et al, 2002). Accordingly, diagnosis, treatment and clinical monitoring should focus on the presence of genetically altered fields.…”