Multiple primary malignant neoplasms of the mouth and oropharynx

Introduction. Probability of development of multiple primary tumors in patients who received treatment due to head and neck cancers varies between 5.6 and 35.9 % per different sources. moreover, treatment capabilities are severely limited by postoperative anatomical changes and previous radiation therapy, and the second tumor frequently causes death in these patients.

The study objective is to identify the epidemiological features of the development of synchronous and metachronous primary multiple tumors in the head and neck.

Materials and methods. The article analyzes data on 103 patients with multiple primary tumors who received treatment due to tumors of the head and neck between 1991 and 2020 at the N.N. Blokhin National medical Research Center of Oncology and A.S. Loginov Moscow Clinical Scientific Center.

Results. During the study, typical locations of metachronous tumors in patients who received treatment due to primary malignant tumors of the head and neck were determined, duration of development of multiple primary tumors, treatment methods and survival rates were analyzed.

Conclusion. Due to high risk of multiple primary tumors in patients who received treatment due to malignant tumors of the head and neck in the next 5 plus years, it is expedient to observe these patients during their whole lifetime. Considering typical locations of metachronous tumors, examination during dynamic observation should include instrumental methods such as panendoscopy. Surgical treatment should involve the whole spectrum of minimally invasive interventions including CO₂ laser surgery and transoral robot-assisted interventions.

1. Gonzalez-Garda R., Naval-G^as L., Roman-Romero L. et al. Local recurrences and second primary tumors from squamous cell carcinoma of the oral cavity: a retrospective analytic study of 500 patients. Head Neck 2009;31(9):1168-80. DOI: 10.1002/hed.21088.

2. Yamashita T., Araki K., Tomifuji M. et al. Clinical features and treatment outcomes of Japanese head and neck cancer patients with a second primary cancer. Asia Pac J Clin Oncol 2017;13(3):172-8. DOI: 10.1111/ajco.12599.

3. Boakye E.A., Buchanan P., Hinyard L. et al. Incidence and risk of second primary malignant neoplasm after a first head and neck squamous cell carcinoma. JAMA Otolaryngol Head Neck Surg 2018;144(8):727-37. DOI: 10.1001/jamaoto.2018.0993.

4. Warren S., Gates O. Multiple primary malignant tumors: a survey of the literature and a statistical study. Am J Cancer 1932;16:1358-414.

5. Boakye E.A., Buchanan P., Hinyard L. et al. Trends in the risk and burden of second primary malignancy among-survivors of smoking-related cancers in the United States. Int J Cancer 2019;145(1): 143-53. DOI: 10.1002/ijc.32101.

6. Jones A.S., Morar P., Phillips D.E. Second primary tumors in patients with head and neck squamous cell carcinoma. Cancer 1995;75(6):1343-53. DOI: 10.1002/1097-0142(19950315)75:6<1343::aid-cncr2820750617>3.0.co;2-t.

7. Adeel M., Siddiqi M.I. Metachronous second primary malignancy in head and neck cancer patients: is five years of follow-up sufficient. J Korean Assoc Oral Maxillofac Surg 2018;44(5):220-4. DOI: 10.5125/jkaoms.2018.44.5.220.

8. Frolov I.M., Kudinova E.A., Rozhkova N.I. Clinical and molecular genetic features of primary multiple cancer. Vestnik Rossijskogo Nauchnogo Centra Rentgenoradiologii Minzdrava Rossii = Bulletin of the Russian Scientific Center of Radiology of the Ministry of Health of Russia 2012;1(12):28-31. (In Russ.).

9. Bunbanjerdsuk S., Vorasan N., Saethang T. et al. Oncoproteomic and gene expression analyses identify prognostic biomarkers for second primary malignancy in patients with head and neck squamous cell carcinoma. Mod Pathol 2019;32(7):943-56. DOI: 10.1038/s41379-019-0211-2.