Second primary malignancies in squamous cell carcinomas of the tongue and larynx: an analysis of incidence, pattern, and outcome.
BACKGROUND
Head and neck cancer patients have a higher risk of developing a second primary malignancy (SPM) than the general population. This study was conducted to identify the characteristics of SPM and its impact on survival in patients with squamous cell carcinoma of the tongue (TSCC) and larynx (LSCC).


METHODS
A retrospective study was conducted of 538 patients who were treated by surgery primarily for TSCC (n = 146) and LSCC (n = 392) from 1990 to 2000. The incidence, site, and overall survival of SPMs were evaluated.


RESULTS
Seventy-seven patients developed SPM during the follow-up period (median, 73 months), including 18 (12%) with TSCC and 59 (15%) with LSCC. Fifty-six percent of SPMs of the TSCC group appeared in the oral cavity. Among the SPMs of LSCC patients, 54% developed in the lung (31%) and larynx (24%). The 5-year overall survival after the diagnosis of SPM in the head and neck was 39%, compared to 29% for SPM in other areas (p = 0.010).


CONCLUSIONS
SPMs after treatment of TSCC and LSCC are similar in incidence but distinct in pattern. SPMs within the head and neck are associated with a better prognosis than those outside this area.
Hsu
Yen-Bin
YB
Department of Otolaryngology, Taipei Veterans General Hospital, Taipei, ROC.
Chang
Shyue-Yih
SY
Lan
Ming-Chin
MC
Huang
Jui-Lin
JL
Tai
Shyh-Kuan
SK
Chu
Pen-Yuan
PY
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D006801:Humans; D015994:Incidence; D007822:Laryngeal Neoplasms / Q000453:epidemiology* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000453:epidemiology*; D013624:Taiwan / Q000453:epidemiology; D014062:Tongue Neoplasms / Q000453:epidemiology* / Q000401:mortality