Multiple Primary Malignancies in the Head and Neck: A Clinical Review of 70 Patients

Bai, Chang Hoon; Chen, Seung Min; Lee, Seok Choon; Jung, Eun Chae; Baek, Eun Hoi; Choi, Sung Won; Choi, Yun Seok; Kim, Yong Dae; Song, Si Youn

Abstract

BACKGROUND AND OBJECTIVES: Recent advances in medical management, along with increased life span, have contributed to the increased opportunity for detecting multiple primary malignancy (MPM). The purpose of this study was to evaluate the incidence and clinical characteristics of MPM in the head and neck region.
SUBJECTS AND METHOD
We reviewed retrospectively the medical records of 984 patients with malignant tumors of head and neck who had been diagnosed histopathologically and treated between August 1985 to July 2005.
RESULTS
Seventy patients (7.11%) were diagnosed as having MPM (double, n=66 ; triple, n=4). This group consisted of 67 men and 3 women (p<0.01). Twenty-five patients (36%) had synchronous double primary malignancy (SDPM) and 45 patients (64%) had metachronous double primary malignancy (MDPM). The hypopharynx was the most frequently involved site of the index tumor. The most common index tumors were squamous cell carcinoma histopathologically. Second primary malignancies were found in esophagus, stomach and lung. Fifty-five patients were found with first primary malignancy in head and neck, and 25 were with second primary malignancy. The patients with first and second primary malignancy in head and neck were 10 cases. The prognosis of SDPM (average of survival 11.1 months) was very poor. Patients with MPM have high cigarettes smoking and alcohol drinking habit.
CONCLUSION
Patients with head and neck malignancies will require careful follow up for prevention, early detection, and the treatment of second primary malignancy.