[Multiple primary carcinomas in patients with head and neck malignancies].
BACKGROUND
Multiple primary tumors can lead to diagnostic and therapeutical problems. In this study we surveyed frequency, localisation, diagnostic, chronologic and therapeutic aspects of multiple primary carcinomas in patients with head and neck tumors.


METHODS
The data of 843 patients from the tumor registry of the ENT-clinic Aachen were retrospectively studied.


RESULTS
Larynx (41.87%) and oropharynx (12.57%) were the main localisation of the first primary neoplasma. In 65 patients (7.71%) multiple primary tumors were observed. 24.6% of these tumors occurred synchronously. Preferential localisation of a second tumor were lung (20%), oral cavity (15.3%) and larynx (13.8%). 28.57% of the metachronous tumors were observed after more than five years. In 46.15% clinical complaints led to the suspicion of a second tumor. Panendoscopy was the most reliable diagnostic procedure. The survival rate and time was significantly reduced in patients with synchronous tumors. 3-year survival rate was 15% compared to 81% in patients with metachronous tumor appearance (p < 0.0001).


CONCLUSIONS
Patients with head and neck tumors have a high incidence of multiple primary malignomas varying from the region of the first presentation of a malignant tumor. Concepts comprising surgery provide the highest survival rates. Because of the high incidence of metachronous carcinomas after five years found in this study, the authors regard a prolonged follow-up period as necessary.
Di Martino
E
E
Klinik für Hals-, Nasen- und Ohren-Heilkunde und Plastische Kopf- und Halschirurgie der Medizinischen Fakultät der RWTH Aachen. edimartino@post.klinikum.rwth-aachen.de
Rieger
M
M
Hassan
H A
HA
Hausmann
R
R
Reinecke
T
T
Lohmann
M
M
Westhofen
M
M
D003131:Combined Modality Therapy; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery; D016609:Neoplasms, Second Primary / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality / Q000601:surgery; D010039:Otorhinolaryngologic Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery; D015996:Survival Rate
Zur Problematik multipler primärer Karzinome bei Patienten mit Kopf-Hals-Malignomen.