头颈部多原发癌68例临床分析

doi:10.6040/j.issn.1673-3770.0.2018.329

Abstract

Abstract: Objective To summarize and analyze the incidence of multiple primary cancers(MPCs)of the head and neck region in patients hospitalized in the otolaryngology department. Methods Retrospective analysis of the clinical data of 68 patients with head and neck MPCs was conducted using SPSS 21.0. Results Overall, 648 cases of malignant tumors were found in 8758 patients treated in the same period. Among them, 68 cases were diagnosed with MPC with an occurrence rate of 0.78%. The annual occurrence rate of MPC during 2014-2017 was 0.72%, 0.72%, 0.77%, and 0.86%, successively, and showed an upward trend. The MPC group included 61 males and 7 females, and the proportion of males was higher than that in a single primary cancer group. There were 62 cases of double cancer, 6 of triple cancer, 35 of synchronous carcinoma, and 33 of metachronous carcinoma. Forty-four patients had a previous history of smoking/drinking, and male smokers/drinkers were significantly higher than females(χ2 = 6.40, P=0.006). Hypopharyngeal cancer accounted for the highest incidence of MPC(23.81%), followed by oral cancer(14.71%)and laryngeal cancer(9.33%). The most common primary cancer associated with oral cancer, hypopharyngeal cancer, and laryngeal cancer was esophageal cancer. There were 45 cases(66.18%)that presented the second cancer in less than 5 years after the first. Twenty-two patients had received radiation/chemotherapy, and these patients had a higher proportion of metachronous MPC(χ2 = 18.64, P<0.001). Conclusion The highest incidence of MPC in the head and neck in consecutive order is hypopharyngeal, oral, and laryngeal cancer. There is a high possibility of head and neck cancer presenting in combination with upper gastrointestinal cancers, such as esophageal cancer. It has been suggested that gastroscopy be listed as a routine examination both pre-operatively and at follow-up. Commonly, the interval between the second and first cancer was less than 5 years; hence, the first 5 years of follow-up and long-term regular follow-up should be fortified after radiotherapy for malignant tumors. MPC should be considered when devising a radiotherapy program, and special attention should be paid to the radiation protection of the surrounding tissues and organs.

Key words: Multiple primary cancer, Head and neck cancer, Onset risk

CLC Number:

R739.6

HUANG Fang, WEI Guifang, HUANG Sicheng, HUANG Xiangqin. Clinical analysis of 68 cases of multiple primary cancers of head and neck[J].Journal of Otolaryngology and Ophthalmology of Shandong University, 2018, 32(6): 43-47.

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Clinical analysis of 68 cases of multiple primary cancers of head and neck

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