The incidence of head and neck cancer is increasing. A significant problem is the high incidence of second primary tumours (SPTs) of head and neck area, which has the greatest impact on survival rates. However, there is nothing to distinguish between patients with high and low risk of developing a SPT. We evaluated the incidence and pattern of STP of head and neck area, the impact of SPT on survival, treatments and prognostic factors.
We conducted a retrospective study in a series of 394 patients at the Hospital La Fe in whom a diagnosis of head and neck cancer was made between January 2005 and February 2015.
Of 394 patients, a total of 35 patients (8.9%) developed a STP. Of them 10 were synchronous neoplasia (SN), 25 metachronous neoplasia (MN)) and 1 patient developed a third MN. The median follow-up was 149 months (25-297). The characteristics of the first primary tumour (FPT) are in the table. Recurrent disease of FPT developed in 3 patients (1 locally and 2 loco-regional). The median time for recurrence was 10.6 months (4.8-31). The characteristics of the SPT are listed in the table. The treatment intention was radical in 27 patients with complete response in 17 patients (48.6%) and palliative in 9 (25.7%). Of all patients with SPT, 10 of them (28%) presented a recurrence of it. The median time from initial diagnosis of the SPT was 62 months (0-168), including SN. The median overall survival was 149 months (84-214). The log-rank test, when comparing the groups of SN or MN of SPT, showed a significant difference for OS (p
SPT represents the leading long-term cause of mortality in these patients. SN or MN of SPT was the only independent predictor of lower OS in our study. If we identified features that prelude a higher risk for the appearance of SPT, follow-up could be optimized for patients with higher risk.
Clinical trial identification
Legal entity responsible for the study
Hospital Universitario La Fe
All authors have declared no conflicts of interest.