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HEAD AND NECK SECOND PRIMARY TUMORS IN LARYNGEAL SCC ARE NOT ASSOCIATED WITH POORER OVERALL SURVIVAL: A SINGLE CENTER STUDY IN 987 PATIENTS
Author(s) -
Farhadieh R. D.,
Rees C. G.,
Salardini A.,
Lin J.,
Russell P. J.,
Smee R.
Publication year - 2009
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2009.04919_3.x
Subject(s) - medicine , larynx , incidence (geometry) , head and neck cancer , head and neck , single center , oncology , survival analysis , overall survival , gastroenterology , surgery , cancer , physics , optics
Objectives: Second Primary Tumours (SPTs) have been implicated in poor Overall Survival (OS) of Head and Neck Squamous Cell Carcinomas (HNSCCs). The incidence of SPTs; the SPT diagnostic time lag; the impact on OS; and the mean annual risk was assessed. Methods: 987 consecutive patients treated for primary larynx SCC (1967–2004) were analysed in this study. 96.3% and 91.4% of patients reached a minimum follow up period of 3 and 5 years. Results: 208 (21.1%) patients were diagnosed with SPTs. 143 (14.5%) patients developed upper aero‐digestive tract UAD‐SPTs, 83 (8.4%) were HNSCCs, 56 (5.7%) were lung, and 4 (0.41%) were oesophageal SPTs. Survival analysis demonstrated unexpected but clear superior OS rates for the UAD‐SPT (p < 0.008) and HNSCC‐SPTs (p < 0.001). Patients with synchronous SPTs had a poorer overall survival (p < 0.001). The mean annual risk of developing UAD‐SPTs was 2.4%. Conclusion: These results suggest that HNSCC‐SPT should not be viewed as an adverse prognostic factor. Reclassifications of UAD‐SPTs into HNSCC‐SPT and non HNSCC‐SPT better reflects their clinical behaviour and prognosis.