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Impact of Second Primary Tumors on Survival in Head and Neck Cancer: An Analysis of 2,063 Cases
Author(s) -
Rennemo Erlend,
Zätterström Ulf,
Boysen Morten
Publication year - 2008
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/mlg.0b013e318172ef9a
Subject(s) - medicine , primary tumor , larynx , head and neck cancer , stage (stratigraphy) , cancer , basal cell , surgery , carcinoma , oncology , metastasis , paleontology , biology
Abstract Objective/Hypothesis: To investigate the impact of second primary tumors on prognosis for patients with head and neck squamous cell carcinoma (HNSCC). Study Design: Prospectively recorded data on HNSCC patients treated at an academic tertiary referral center. Methods: An analysis of 2,063 patients treated over a 15 year period for tumors of the upper aerodigestive tract, with a minimum follow‐up of 10 years. Results: A total of 351 (17%) patients developed a second primary, mean time to diagnosis of the second tumor being more than 4 years from the date of the initial tumor. Median overall survival from the date of the first tumor among patients who later developed a second primary was 6 years versus 3 years among all other patients ( P < .05). During the first 6 years after treatment of the initial tumor, cancer specific survival was better in the second primary group. After diagnosis of a second primary tumor, median survival was 12 months. A positive correlation was found between second primaries and stage I/II primary disease, low patient age, and initial tumors of the larynx and oral cavity. Conclusions: The group of patients with the highest risk of a second primary tumor was younger patients with limited initial tumors. A high proportion of patients who later developed a second primary were complete responders after treatment of the first tumor. However, prognosis was poor after the actual diagnosis of the second primary tumor.