頭頸部扁平上皮癌における重複癌の検討

DOI Web Site 被引用文献1件 参考文献13件
  • 十名 理紗
    神戸市立医療センター中央市民病院耳鼻咽喉科・頭頸部外科 公益財団法人先端医療振興財団先端医療センター耳鼻咽喉科
  • 篠原 尚吾
    神戸市立医療センター中央市民病院耳鼻咽喉科・頭頸部外科
  • 菊地 正弘
    神戸市立医療センター中央市民病院耳鼻咽喉科・頭頸部外科
  • 藤原 敬三
    神戸市立医療センター中央市民病院耳鼻咽喉科・頭頸部外科
  • 山崎 博司
    神戸市立医療センター中央市民病院耳鼻咽喉科・頭頸部外科
  • 岸本 逸平
    神戸市立医療センター中央市民病院耳鼻咽喉科・頭頸部外科
  • 原田 博之
    神戸市立医療センター中央市民病院耳鼻咽喉科・頭頸部外科
  • 内藤 泰
    神戸市立医療センター中央市民病院耳鼻咽喉科・頭頸部外科 公益財団法人先端医療振興財団先端医療センター耳鼻咽喉科

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タイトル別名
  • Synchronous Multiple Malignancies in Patients with Head and Neck Squamous Cell Carcinoma
  • リンショウ アタマ ケイブ ヘンペイ ジョウヒガン ニ オケル チョウフクガン ノ ケントウ

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In the period from April, 2004 to March, 2010, we retrospectively reviewed 286 patients who were newly-diagnosed as squamous cell carcinoma of the head and neck (HNSCC), in order to investigate the incidence of multiple primary malignancies and the overall survival rate of such patients, and the therapeutic strategy to deal with them.<br> In 83 patients (29%) other primary malignancies were revealed, 35 patients (12%) synchronously and 48 patients (17%) metachronously. The 5-year overall survival rates shown with the Kaplan-Meier method were 74% for single primary malignancy, and 49% and 70% for synchronous and metachronous multiple malignancies, respectively. The overall survival of patients with synchronous multiple malignancies was significantly worse than those with single primary malignancy, while the difference between single and metachronous cases was not significant. The therapeutic strategies for synchronous multiple malignancies were decided according to the following policies. 1) Treatment of more advanced cancer went ahead when simultaneous treatments of both malignancies were difficult. 2) As simultaneous operation for both lesions was considered if safely possible. 3) An endoscopic resection for the other gastrointestinal tract malignancy could be performed at a convenient time for HNSCC treatment. 4) The choice of synchronous or metachronous radiation for multiple lesions depended on the total range of radiation fields and the purpose of treatment. Upper gastrointestinal endoscopy and FDG-PET are recommended in patients with untreated HNSCC, because the ratio of synchronous primary malignancy was as high as 12%. Although synchronous multiple malignancies including HNSCC should be considered according to the stage and the location of each lesion, we discuss the relevant therapeutic strategies.<br>

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