1993 Volume 1993 Issue Supplement61 Pages 169-177
A statistical study was made of the incidence, gender, age distribution, site of development, histological type, interval of occurrence, risk factors and prognosis in 25 patients with multiple malignant tumors of the head and neck who were admitted to this department for treatment between January,1982 and December,1991. Literature on the pathogenesis of multiple cancer and suggested therapeutic measures was reviewed. The incidence of multiple tumors was about 6.2% and that of triple malignant tumors was about 0.7%. By gender, males accounted for the majority with 23 males and 2 females. By age distribution, the proportion of those aged 60 to 70 years was high, the average age being 67.7 years. By site of development, the number of laryngeal cancer plus lung cancer or laryngeal cancer plus esophageal cancer was large with 3 cases of the former and 2 cases of the latter. By site of multiplicity, the head and neck region was reported most frequently with 8 cases. By histological type, the combination of adenocarcinoma and squamous cell carcinoma was the most common with 8 cases. By interval of occurrence, synchronous occurrence (not more than 1 year) was found in 10 patients and metachronous occurrence (not less than 1 year) in 15 patients. By environmental factors, the influence of smoking and drinking was suggested. Smoking history and drinking history over a long period of time were noted in 2 out of 3 cases of triple malignant tumors. By prognosis, the prognosis of metachronous cases was poor compared with synchronous cases, with 9 deaths (60%) in the metachronous occurrence. As pathogenic factors for multiple cancer,1) accidental nature,2) internal factor,3) external factor and 4) field carcinogenesis were mentioned and discussed.
It is necessary to draw up an appropriate examination plan and therapeutic policy for each case using statistical results as a guide line.
