title: Second primary malignancies in head and neck cancer patients: high prevalence of curable-stage disease.
abstract: OBJECTIVE
  Patients treated for squamous cell carcinoma of the head and neck (HNSCC) carry a high risk of second primary malignancies (SPM). Recently, computed tomography (CT) of the chest was shown to significantly decrease the risk of death due to bronchial carcinoma (BC) in a cohort of smokers whose risk of BC is increased but might be lower than that of patients previously treated for HNSCC. Thus, the present study evaluated the potential benefit of CT and other examinations in the detection of SPM in HNSCC patients.
  
  
  METHODS
  Between July 2008 and November 2011, 118 participants underwent a prospective, systematic examination for SPM (13 women, 105 men, median age 62 years). All patients had been previously treated for HNSCC and showed no recurrence or distant metastases at the time of the study start. CT scans, ear-nose-throat endoscopy, and endoscopy of the esophagus and stomach were performed.
  
  
  RESULTS
  Overall, 33 suspicious findings were clarified by additional investigations. In all, 26 SPM were confirmed in 21 of 118 patients (18%; 10 lung, 7 HNSCC, 3 gastrointestinal, 1 renal). Eighteen of these 21 patients (86%) underwent therapy with curative intent.
  
  
  CONCLUSIONS
  The examinations revealed a high prevalence of curable stage SPM in HNSCC patients. Adapting a surveillance scheme including a chest CT is recommended.
authors.affiliation: Department of Radiotherapy and Radiooncology, Universitätsmedizin Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany, hendrik.wolff@med.uni-goettingen.de.
authors.forename: H A
authors.initials: HA
authors.lastname: Wolff
authors.forename: C R M
authors.initials: CR
authors.lastname: Wolff
authors.forename: C F
authors.initials: CF
authors.lastname: Hess
authors.forename: K
authors.initials: K
authors.lastname: Jung
authors.forename: S
authors.initials: S
authors.lastname: Sennhenn-Kirchner
authors.forename: M
authors.initials: M
authors.lastname: Hinterthaner
authors.forename: A
authors.initials: A
authors.lastname: Müller-Dornieden
authors.forename: W
authors.initials: W
authors.lastname: Körber
authors.forename: K
authors.initials: K
authors.lastname: Marten-Engelke
authors.forename: R
authors.initials: R
authors.lastname: Roedel
authors.forename: H
authors.initials: H
authors.lastname: Christiansen
authors.forename: C
authors.initials: C
authors.lastname: Engelke
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000532:radiotherapy*; D005858:Germany / Q000453:epidemiology; D006258:Head and Neck Neoplasms / Q000401:mortality* / Q000532:radiotherapy*; D006801:Humans; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000401:mortality* / Q000532:radiotherapy*; D015995:Prevalence; D020266:Radiotherapy, Conformal / Q000401:mortality*; D018570:Risk Assessment; D000077195:Squamous Cell Carcinoma of Head and Neck; D015996:Survival Rate; D016896:Treatment Outcome