Second Primary Tumors in head and neck cancer patients: the importance of a “tailored” surveillance

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Oral Dis. 2020 Oct 14. doi: 10.1111/odi.13681. Online ahead of print.


OBJECTIVE: Head and neck cancer survivors have increased risk of developing second primary tumors compared to overall population. Because second primary represent a major cause of morbidity and mortality in this population, early detection is fundamental.

MATERIALS AND METHODS: In this 10-years single-institution study we investigated: incidence, clinical-pathological risk factors and survival of patients with second primary tumor. We included all patients with diagnosis of squamous cell carcinoma of the head and neck seen at the Modena University Hospital from 2008 to 2018.

RESULTS: Among 1177 patients included, 222 (18.9%) developed second primary tumor; its survival probability at 5 years was 40.6%. Alcohol consumption (p=0.0055) and index cancer in oropharynx (p=0.0029), supraglottic larynx (p=0.0000), glottic larynx (p=0.0222) were associated with higher risk of second primary. The most common second primary sites were head and neck district and lung (70, 31.5% and 67, 30.2%, respectively). Head and neck district were more common in oral cavity (18, 43%) and oropharynx index cancer (20, 31%); lung second primary in hypopharynx (4, 40%), supraglottic larynx (17, 43%) and glottic larynx index cancer (23, 35%).

CONCLUSION: Head and neck cancer survivors developing a second primary tumor have dismal prognosis. Tailored surveillance is recommended.

PMID:33051941 | DOI:10.1111/odi.13681