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[Multiple primary carcinomas in patients with head and neck malignancies]
E Di Martino1, M Rieger, H A Hassan
1Klinik für Hals-, Nasen- und Ohren-Heilkunde und Plastische Kopf- und Halschirurgie der Medizinischen Fakultät der RWTH Aachen. edimartino@post.klinikum.rwth-aachen.de
Laryngo- Rhino- Otologie
|February 24, 2001
Summary
Patients with head and neck tumors frequently develop multiple primary cancers. Synchronous tumors significantly reduce survival, while metachronous tumors, especially those appearing after five years, require prolonged follow-up for better outcomes.
Area of Science:
- Oncology
- Otorhinolaryngology
- Epidemiology
Context:
- Multiple primary tumors present significant diagnostic and therapeutic challenges.
- Head and neck cancers are prone to developing secondary primary malignancies.
- Understanding the patterns of multiple primary tumors is crucial for patient management.
Purpose:
- To investigate the frequency, localization, diagnostic, chronological, and therapeutic aspects of multiple primary carcinomas in patients with head and neck tumors.
- To analyze the survival rates associated with synchronous and metachronous secondary primary tumors.
- To determine the optimal follow-up strategies for patients diagnosed with head and neck malignancies.
Summary:
- A retrospective study of 843 patients revealed that 7.71% developed multiple primary tumors, with the larynx and oropharynx being common initial sites.
- Synchronous tumors, occurring in 24.6% of cases, significantly decreased survival rates (3-year survival: 15%) compared to metachronous tumors (3-year survival: 81%).
- Lung, oral cavity, and larynx were preferential sites for second tumors, with 28.57% of metachronous cases appearing after five years, often detected via clinical complaints and confirmed by panendoscopy.
Impact:
- This study highlights the high incidence of multiple primary malignomas in head and neck cancer patients, emphasizing the need for tailored diagnostic and therapeutic approaches.
- Surgical interventions offer the highest survival rates.
- The findings underscore the necessity of extended follow-up periods due to the significant occurrence of metachronous carcinomas beyond five years post-initial diagnosis.