Second primary squamous cell carcinomas of the upper aerodigestive tract in different locations and age groups.

Background: Second primary tumors are of great importance for diagnostics, therapy and prognosis in patients suffering from squamous cell carcinomas of the upper aerodigestive tract. The clinical observation of an increase of second primaries was the reason for analyzing all patients with head and neck cancer treated for a certain period of time at our institution. Methods: The hospital charts of 576 patients treated for squamous cell carcinoma of the oral cavity, the oropharynx, the hypopharynx and larynx treated from 1993 till 1996 at the Department of Otolaryngology, Head and Neck Surgery of the University of Wurzburg were reviewed retrospectively. Results: 10.1% of all patients developed a second primary tumor. The rate was highest for patients with carcinoma of the oral cavity (17.5%), followed by tumors of the hypo- and oropharynx (11.7% and 11.5%) and the larynx (6.4%). Besides the location, younger age was detected as a risk factor for the formation of second malignancies. The latency between first and second primary tumor was 2.9 years in average. 37% of the second primaries were detected synchronous, 39% metachronous. Conclusion: The results demonstrate that younger patients and patients with carcinomas of the upper digestive tract need a consequent followup. The development of second primaries even years after the first malignoma demonstrates the necessity of lifelong followup and oncological care.