Second Laryngeal Cancers in Previously Treated Larynges

Objectives: To review the management and outcome of patients with new second primary cases of laryngeal cancer occurring more than 3 years after the initial cancer was treated. Study Design: Retrospective review of 855 patients with newly diagnosed and treated laryngeal cancers. Methods: Charts were...

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Bibliographic Details
Published in:The Laryngoscope 1999-09, Vol.109 (9), p.1406-1408
Main Authors: McGuirt, W. Frederick, Ray, Mark
Format: Article
Language:English
Subjects:
Biological and medical sciences
Cancer
Carcinoma, Squamous Cell - epidemiology
Carcinoma, Squamous Cell - therapy
Combined Modality Therapy
Follow-Up Studies
Humans
Laryngeal Neoplasms - epidemiology
Laryngeal Neoplasms - therapy
Laryngectomy
larynx
Medical sciences
Neoplasms, Second Primary - epidemiology
Neoplasms, Second Primary - therapy
Otorhinolaryngology. Stomatology
radiotherapy
recurrence
Registries - statistics & numerical data
Retrospective Studies
Risk Factors
Smoking - epidemiology
surgery
Time Factors
Tumors
Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology
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Summary:Objectives: To review the management and outcome of patients with new second primary cases of laryngeal cancer occurring more than 3 years after the initial cancer was treated. Study Design: Retrospective review of 855 patients with newly diagnosed and treated laryngeal cancers. Methods: Charts were reviewed and tabulated for occurrence of second primary laryngeal tumors, method of treatment for the index and second primary laryngeal tumors, and effect of smoking status or cessation of smoking. Results: Of the 855 patients, 532 patients retained their larynx; of these 377 lived more than 3 years and thus were at risk for a second new primary cancer. Of these 377 patients at risk, 19 or 5.1% developed second primary tumors. The rate of second primary disease was lower in patients whose index laryngeal cancer was treated by irradiation (4.3%) compared with those treated surgically (9.2%). However, surgical treatment of second primary laryngeal tumors resulted in far higher rates of laryngeal voicing (82%) compared with irradiation (33%). Conclusion: When possible, management of the index primary tumor by endoscopic resection has resulted in the highest future retention of laryngeal speech, leaving all treatment options available should a second laryngeal cancer occur. Lifelong follow‐up of patients with laryngeal cancer for secondary primary tumors is important. Second primary tumors were equally distributed between patients who continued to smoke and ceased to smoke after their index primary lesion was diagnosed.
ISSN:0023-852X
1531-4995
DOI:10.1097/00005537-199909000-00008