Diagnosis of second head and neck tumors in primary laryngeal SCC is an indicator of overall survival and not associated with poorer overall survival: a single centre study in 987 patients.
OBJECTIVE
Second primary tumors (SPTs) have been implicated in poor overall survival (OS) of head and neck squamous cell carcinomas (HNSCCs). Confusion remains regarding their actual incidence and prognostic impact. This study assessed the incidence of SPTs; the SPT diagnostic time lag; the impact on OS; and the mean annual risk.


METHODS
Nine hundred eighty seven consecutive patients treated for primary larynx SCC (1967-2004) were analyzed in this study. 96.3% and 91.4% of patients reached a minimum follow-up period of 3 and 5 years.


RESULTS
Two hundred eight (21.1%) patients were diagnosed with SPTs. One hundred forty three (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 esophageal-SPTs. Survival analysis demonstrated clear superior OS rates for the UAD-SPT (P < 0.008) and HNSCC-SPT (P < 0.001) groups. A comparison of survival of subgroups showed lung/esophagus to have a poorer survival when compared to all other subgroups. OS after diagnosis of an SPT was poorer when compared with no-SPT group (P < 0.001). The mean annual risk of developing UAD-SPTs was 2.4%.


CONCLUSIONS
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 behavior and prognosis.
Department of Plastic Surgery, St Vincent's Hospital, Melbourne, Australia. rostam74@yahoo.com.au
Ross Darius
RD
Farhadieh
Arash
A
Salardini
Jia Lin
JL
Yang
Pamela
P
Russell
Robert
R
Smee
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000401:mortality*; D005260:Female; D006258:Head and Neck Neoplasms / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D007822:Laryngeal Neoplasms / Q000150:complications / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000453:epidemiology* / Q000209:etiology