[Impact of diagnosis and treatment of early stage secondary tumors on outcome for the oncologic ORL patient].

Objective: To study the incidence, location and stage of second primary tumours in patients with head and neck cancer and analyse the survival and outcome of patients with early-stage second primary tumours.

Methods: Retrospective chart review of patients treated for head and neck cancer from 1989 to 1993. Survival analyses and statistical comparisons with the Kaplan-Meier method and log-rank test.

Results: 99 of the 311 patients had second primary tumours. 45 patients had synchronous second primary tumours and 54 metachronous second primary tumours, diagnosed at an early stage (stage 0 or I) in 78 and 63% of cases respectively. Patients with second primary tumours had a significantly (p = 0.03) lower survival rate than patients with single tumour. However, for patients with early stage second primary tumours survival was not significantly decreased (p = 0.3).

Discussion: This study confirms the high incidence of second primary tumours and their negative impact on the outcome of patients with head and neck cancer. Early diagnosis and treatment of second primary tumours results in a survival rate very similar to that of patients with a single head and neck cancer. This provides indirect evidence that in patients with curable initial head and neck cancer intensive screening for second primary tumours may result in an improved overall outcome.