[Second primary lung cancer in laryngeal cancer patients: report on 36 cases]

To discuss the development, treatment and prognosis of a second primary lung cancer in laryngeal carcinoma patients.

A total of 36 patients with a second primary lung cancer was discovered in 2,182 laryngeal cancer patients. For comparison, a group of 15,541 lung cancers was also reviewed for the presence of a second primary laryngeal cancer. All patients have been followed for over five years.

From 1958 to 1999, out of 2,182 laryngeal carcinoma patients, 36 synchronous (3) or metachronous (33) second primary malignancies of the lung were found. This represented 1.65% of all largngeal cancers observed or 45.0% of all the second primary cancers developed. Their pathology was: squamous cell carcinoma (32-88.9%), adenocarcinoma(2-5.6%), small cell carcinoma(1-2.8%) and large cell carcinoma (1-2.8%). The c-TNM stages were: stage I (7-19.4%), stage II (12-33.3%), stage III (9-25.0%) and stage IV (8-22.2%). The 2- and 5-year survival rates were 41.7% and 8.3%, with an average survival of 23 months. The interval from the treatment of the initial laryngeal carcinoma to the development of the new second primary carcinoma of lung ranged from 1 to 14 years, with an average of 44 months.

Synchronous or metachronous second malignancies of the lung are sometimes encountered in laryngeal cancer patients while the occurrence of a laryngeal second primary following a lung cancer is not observed. The development of the second primary lung cancer is not related to the treatment of the initial laryngeal malignancies. Surgery plus external radiotherapy provides better results than surgery or radiotherapy alone.