Incidence of second metachronous head and neck cancers: Population‐based outcomes over 25 years. (30th May 2014)

• Record Type: Journal Article
• Authors: Tiwana, Manpreet S.; Hay, John; Wu, Jonn; Wong, Frances; Cheung, Winson; Olson, Robert A.
• Is Part Of: Laryngoscope. Volume 124:Number 10(2014:Oct.)
• Page Start: 2287
• Page End: 2291
• Publication Date: 2014-05-30
• Subjects: Otolaryngology -- Periodicals; 617.51005
• DOI: 10.1002/lary.24719
• Languages: English
• ISSNs: 0023-852X

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="lary24719-sec-0001" sec-type="section"> <title>Objectives/Hypothesis</title> <p>The primary objective was to determine the incidence of second metachronous head and neck cancers (HNC) following an index HNC and estimate their overall survival.</p> </sec> <sec id="lary24719-sec-0002" sec-type="section"> <title>Study Design</title> <p>Retrospective cohort study.</p> </sec> <sec id="lary24719-sec-0003" sec-type="section"> <title>Methods</title> <p>A total of 1, 658 consecutive primary HNC patients diagnosed in 1986 to 1990 were identified through the prospectively maintained provincial BC Cancer Registry database. They were followed up for a period of 25 years. Survival analysis and second cancer estimates were performed with standard Kaplan‐Meier & Cox regression analysis.</p> </sec> <sec id="lary24719-sec-0004" sec-type="section"> <title>Results</title> <p>Out of a total of 443 (27%) second cancers, 89 (5%) second HNC occurred in 1, 658 HNC patients, with an actuarial metachronous HNC incidence rate at 5, 10, 15, 20, and 25 years that was 3.9%, 8.1%, 10.4%, 13.2%, and 14.5%, respectively. Second primary cancer (SPC) in lung and esophagus occurred in 155 (9%) and 32 (2%) patients, respectively. The median follow‐up time for all patients and alive patients was 4.05 years (range, 0.2–25.0 years) and 23.2 years (range, 20.76–25.0 years), respectively. Of second HNC, 83 (93%) were metachronous. Oral cavity (<italic>P</italic> < 0.001) and oropharyngeal (<italic>P</italic> < 0.002) index cancers were more likely to develop a metachronous HNC. The overall survival rate for the metachronous HNC patients at 5 years is 15%. SPCs in esophagus and lung had lower overall survival compared to second HNC (<italic>P</italic> < 0.001).</p> </sec> <sec id="lary24719-sec-0005" sec-type="section"> <title>Conclusion</title> <p>Oral cavity and oropharyngeal cancers carry the highest risk of a subsequent metachronous HNC. Given the incidence and prognosis of second HNC, future research should address the frequency and duration of screening the head and neck region for a second cancer.</p> </sec> <sec id="lary24719-sec-0006" sec-type="section"> <title>Level of Evidence</title> <p>2b. <italic>Laryngoscope</italic> 124:2287–2291, 2014</p> </sec> </abstract>