Different patterns of second primary malignancy in patients with squamous cell carcinoma of larynx and hypopharynx.
OBJECTIVE
The aim of the present study was to compare the incidence, patterns, and survival of second primary malignancy (SPM) in patients with squamous cell carcinoma of the larynx (LSCC) and hypopharynx (HPSCC).


METHODS
We retrospectively review the medical record of 581 previously untreated patients with LSCC (392 cases) and HPSCC (189 cases) who received primary surgery with or without postoperative radiotherapy from 1990 to 2000. Data including age, sex, risk factors, subsites and TNM stage of primary tumor, treatment, site and incidence of SPM, and prognosis were collected from medical charts.


RESULTS
Groups with HPSCC had a higher incidence (4.2% vs 2.9% annual rate) and shorter median time (30 vs 59 months) developing SPM rather than LSCC. Fifty-five percent of the SPM occurred in the respiratory axis in LSCC, and 66% developed in the digestive axis in HPSCC. The factors influencing the appearance of SPM included early T stage, tobacco use, and less tumor recurrence. Long-term survival was poorer in those with than without SPM (38% vs 49% at 10 years).


CONCLUSIONS
There is a tendency for SPM to occur in the respiratory axis (lung and larynx) in LSCC and in the digestive axis (oral cavity, pharynx, and esophagus) in HPSCC. This information is important for posttreatment follow-up.
Chu
Pen-Yuan
PY
Department of Otolaryngology, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan. pychu@vghtpe.gov.tw
Chang
Shyue-Yih
SY
Huang
Jui-Lin
JL
Tai
Shyh-Kuan
SK
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000453:epidemiology / Q000601:surgery*; D015994:Incidence; D007822:Laryngeal Neoplasms / Q000453:epidemiology / Q000601:surgery*; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000453:epidemiology / Q000601:surgery*; D010611:Pharyngectomy; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome