[The effectiveness of follow-up care in tumour patients in the early detection of metachronous second primary tumours after curative treatment of carcinoma of the upper aerodigestive tract].
The effectiveness of screening for metachronous second primary tumours by routine follow-up after curative treatment of carcinoma of the upper aerodigestive tract (UADT) was investigated. Data relating to epidemiology, treatment, follow-up (8,014 consultations), and survival from 819 previously untreated patients were analysed to identify risk factors for second primary tumours and to evaluate their impact on survival. During the follow-up period (median 45.2 months), 10.7% of the patients developed a second carcinoma. The annual incidence, which depended on the localisation of the index tumour, was 1.6% for glottic, 3.0% for oropharyngeal, 3.4% for oral cavity, 3.6% for supraglottic, and 4.6% for hypopharyngeal carcinoma. Male sex and the site of the index tumour were identified as relevant prognostic factors for the time to occurrence of a second carcinoma. Radiotherapy as part of initial treatment was associated with a decreased risk for second tumour. Second primary tumour-specific survival was influenced by age, treatment of the index carcinoma, site and stage of the second carcinoma. Patients with curatively treated UADT cancer should have a long-term follow-up with an annual otolaryngologic examination to screen for second primary tumours. More intensive follow-up strategies do not appear to be beneficial.
HNO-Klinik der Universität Göttingen, jetzt: Klinik für Hals-, Nasen-, Ohrenheilkunde, Kopf- und Halschirurgie des Universitätsklinikum Schleswig-Holstein, Campus Kiel. ambrosch@hno.uni-kiel.de
Petra
P
Ambrosch
Stefan
S
Veltmaat
Martina
M
Kron
D004067:Digestive System Neoplasms / Q000473:pathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D016609:Neoplasms, Second Primary / Q000453:epidemiology / Q000401:mortality / Q000532:radiotherapy / Q000628:therapy*; D011379:Prognosis; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors