MULTIPLE PRIMARY MALIGNANT TUMORS IN PATIENTS WITH HEAD AND NECK SQUAMOUS CELL CARCINOMA: RESULTS OF MULTI-INSTITUTIONAL STATISTICAL ANALYSES

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  • 統計からみた頭頚部多重がんの実態
  • RESULTS OF MULTI-INSTITUTIONAL STATISTICAL ANALYSES

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Objective: To clarify various aspects of multiple primary malignant tumors (MPMTs) in patients treated for squamous cell carcinoma (SCC) of the head and neck in 1995.<br>Setting: Seven institutes, including universities and specialized cancer centers, prominent in head and neck cancer treatment in Japan.<br>Subjects: 565 patients treated in the 7 institutes for previously untreated SCC of the head and neck in 1995.<br>Methods: Clinical charts of the patients were retrospectively reviewed for MPMT development.<br>Results: (1) 94 MPMTs were observed in 82 patients (14.5%) during a mean follow-up period of 46.5 months. (2) The most common site for MPMT development was the esophagus (30 lesions), followed by the head and neck (22), stomach (18), and lung (7). These 4 sites comprised 81.9% of all MPMTs. (3) Among several head and neck primaries, MPMT development was most common in hypopharyngeal primary. (4) 37 synchronous MPMTs (39.4%) were observed. (5) The cumulative incidence rate of MPMTs was 4.1% at year zero and increased linearly by 2.6% per year. (6) Treatment results in patients with MPMTs were not significantly different from those in patients without MPMTs. Esophageal MPMTs treated by methods other than endoscopic mucosal resection and pulmonary MPMTs gave poor treatment results. (7) Significant risk factors in MPMT development included heavy smoking and a high alcohol intake.<br>Conclusions: These results will provide scientific evidence for our daily management of MPMTs, emphasizing the necessity of regular and repeated examinations of high-risk areas, i. e. the esophagus, head and neck, stomach, and lungs.

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