Clinical Analysis of Multiple Primary Cancer in Patients with Head and Neck Carcinomas

Abstract

The incidence of multiple primary cancers in the head and neck has increased a long with the progress made in the diagnosis of these cancers.
In 537 patients with head and neck cancer treated in Kagawa Medical University from October, 1983 to March, 1998, 51 cases (9.5%) had multiple primary cancers. The mean age of 51 patients was 66.2 years and the male to female ratio was 4:1. The highest incidence of multiple primary cancers was found in hypopharyngeal cancers (31.0%). Fourteen of 51 cases (27.5%) exhibited as second primary cancers synchronously within 6 months, and 37 cases (72.5%) metachronously. About 70% of the additional cancers were in the “multicentric zone”, the stomach, lung, esophagus, head, and neck.
The 5-year survival rate for all patients was 35.6%. There was a significant difference in the survival rate between ‘synchronous’ multiple primary cancers (15.6%) and `metachronous' ones (41.6%).
In treating synchronous multiple primary cancers, the patient's prognosis, the selection of the optimum treatment, quality of life and the location and extent of cancers are important factors to consider. To improve the prognosis in patients with metachronous multiple primary cancers, more sensitive and convenient examinations should be performed for the early detection of the second cancer.