[Incidence, latency, and prognosis of local and regional recurrences in patients with upper aerodigestive tract cancer treated by laser microsurgery: influence of initial tumor parameters].
BACKGROUND
The aim of the present study is to identify clinical factors that influence the incidence and the prognosis of local and regional recurrences.


METHODS
The data of 1,426 patients with newly diagnosed squamous cell carcinoma of the upper aerodigestive tract who were treated by curative laser microsurgery between August 1986 and December 2002 were reviewed.


RESULTS
In 381 patients (27%), tumor recurrences were detected during follow-up. The frequency of local as well as regional recurrences significantly correlated with the initial stage of tumors. Recurrences of advanced carcinomas occurred considerably sooner than those of stage II and I cancer. During the 4th year of follow-up, patients with early stage disease had a recurrence rate twice as high as those with advanced carcinomas. Survival with recurrence was adversely affected by adjuvant radiotherapy as part of initial treatment, simultaneous local and regional manifestation of recurrence, male sex, advanced stage of initial disease, and by oral or hypopharyngeal site of the primary tumor.


CONCLUSIONS
Early carcinomas of the upper aerodigestive tract recur at a lower rate than advanced stage diseases, but after a longer mean latency period. As a consequence, these patients should receive close follow-up also during the 3rd and 4th years after treatment, particularly as the prognosis of their recurrences is most often favorable.
Universitäts-HNO-Klinik, Essen. martin.jaeckel@surfeu.de
M C
MC
Jäckel
A
A
Martin
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Steiner
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000601:surgery*; D015897:Comorbidity; D018572:Disease-Free Survival; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D053685:Laser Therapy / Q000706:statistics & numerical data; D008297:Male; D008866:Microsurgery / Q000706:statistics & numerical data; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology* / Q000517:prevention & control*; D010039:Otorhinolaryngologic Neoplasms / Q000453:epidemiology* / Q000601:surgery*; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome