title: A role for panendoscopy? Second primary tumour in early stage squamous cell carcinoma of the oral tongue.
abstract: BACKGROUND
  Panendoscopy is routinely used for the identification of occult second primary tumours in head and neck squamous cell carcinoma. However, its role in low risk subgroups, particularly non-smoking, non-drinking patients and patients presenting with early stage oral cavity lesions, is debatable.
  
  
  METHODS
  The records of 112 patients with T₁ or T₂ oral tongue squamous cell carcinoma were retrospectively reviewed. Demographic, disease characteristics and survival data were collected.
  
  
  RESULTS
  Average follow-up duration was 71.7 months (range, 3.6-238.3 months). Thirty-five patients died within this period. Thirteen second primary events were identified in 11 patients, with all but 2 tumours in the oral cavity or oropharynx. There was a single synchronous primary - a lung adenocarcinoma; all other events were metachronous. No non-smoking, non-drinking patients re-presented with a second primary tumour; tobacco and alcohol use are clearly risk factors for development of a second primary tumour.
  
  
  CONCLUSIONS
  The role of panendoscopy for identifying synchronous primary tumours in patients with early stage oral tongue squamous cell carcinoma should be re-evaluated, particularly in non-smoking, non-drinking patients who are at low risk of second primary development. Close follow up with regular clinical examination including flexible fibre-optic endoscopy may be sufficient in this subgroup.
authors: Department of Surgery,The University of Melbourne,The Royal Melbourne Hospital,Parkville,Victoria,Australia.
authors: K
authors: K
authors: Koo
authors: Department of Otolaryngology,Royal Devon and Exeter Hospital,UK.
authors: R
authors: R
authors: Harris
authors: Department of Surgery,The University of Melbourne,The Royal Melbourne Hospital,Parkville,Victoria,Australia.
authors: D
authors: D
authors: Wiesenfeld
authors: Department of Surgery,The University of Melbourne,The Royal Melbourne Hospital,Parkville,Victoria,Australia.
authors: T A
authors: TA
authors: Iseli
mesh_terms: D000368:Aged; D000428:Alcohol Drinking / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000473:pathology; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000175:diagnosis* / Q000473:pathology; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary / Q000175:diagnosis* / Q000473:pathology; D015995:Prevalence; D012189:Retrospective Studies; D012907:Smoking / Q000473:pathology; D000077195:Squamous Cell Carcinoma of Head and Neck; D014062:Tongue Neoplasms / Q000175:diagnosis* / Q000473:pathology
keywords: Drinking