Second neoplasm in patients with head and neck cancer

TLDR

Improved locoregional control of head and neck cancers has not increased overall survival because distant metastases and second neoplasms remain common. The study aimed to determine the incidence and characteristics of second neoplasms in head and neck cancer patients. A retrospective analysis of 1,845 head and neck cancer patients treated between 1984 and 1995 identified 302 (16%) who developed a second neoplasm. Second neoplasms occurred at a constant rate of 4 % per year, predominantly as carcinomas of the head and neck (40 %), lungs (31 %), or esophagus (9 %), with 20 % arising outside the aerodigestive tract, and their appearance significantly reduced survival.

Abstract

The improvement in locoregional control of head and neck carcinomas over the last decades does not appear to modify the final survival of these patients, mainly due to the appearance of distant metastases and second neoplasms. We ran a study to evaluate the incidence of second neoplasms and their characteristics in patients with head and neck carcinoma treated in our hospital.A retrospective study was undertaken to analyze the appearance of second neoplasm, its characteristics, and repercussion on the survival in 1845 patients with carcinoma of the oral cavity, oropharynx, hypopharynx, and larynx diagnosed and treated in our department between 1984 and 1995.A group of 302 patients (16%) developed a second neoplasm. The incidence of second neoplasms was 4% per year and was constant during the follow-up period. Second neoplasms were mainly carcinomas located in head and neck (40%), lungs (31%), or esophagus (9%). Twenty percent of second neoplasms were tumors located outside the aerodigestive tract. The appearance of a second neoplasm significantly worsened the survival.Four percent per year of patients with carcinoma of the oral cavity, oropharynx, hypopharynx, and larynx develop a second neoplasm, most frequently a carcinoma of the aerodigestive tract. This leads to a significant worsening of survival.