[Multiple primary tumors in patients with laryngeal carcinoma: incidence and prognostic factors]

An a series of 1.053 treated surgically for laryngeal cancer, a noteworthy incidence of secondary tumors (S.T.) was observed. This occurrence was correlated to various oncological parameters of primitive laryngeal tumors in order to reveal any eventual predictive factors. A S.T. occurred in 80 patients (7.6%): in 22 cases (27.5%) in the upper aero-digestive tract; in 23 (28,8%) in the lungs; in 15 (18.7%) in the gastro-intestinal tract (stomach, intestines, liver, esophagus); in 9 (11.2%) in the genitourinary tract (bladder, prostate); in 4 (5%) on the skin; in 3 (3.8%) in the thyroid; in 2 (2.5%) in the skeletal system; in one case each in the nervous system and in the mediastinum (1.2% respectively). On slightly more than one half of the cases (56.3%) diagnosis was made in the first 5 years following laryngeal surgery; in 26.2% in the following 6-10 years; in 26.2% in the 17.5% after 10 years. Only in two cases (stomach and thyroid) a S.T. appear within 6 months (simultaneous S.T.). No predictive correlation was revealed with regard to site or laryngeal tumor extension; to the presence of lymph node metastases or capsular rupture. However, in patients that had undergone functional surgery, S.T. incidence was double that of those who had been treated with total laryngectomy. Furthermore, in comparing the incidence of pulmonary metastases with that of a pulmonary S.T., it appeared that these is a higher probability of occurrence of the former in cases of supraglottic carcinomas, of laterocervical lymph node metastases or of capsular rupture. This findings clearly demonstrate that during pre-operative staging and post-operative follow-up an extremely accurate clinical and instrumental examination, aimed furthermore at revealing any eventual second neoplasms which, on the basis of our observations, may strike anywhere in the body, is absolutely indispensable.