Synchronicity, Multicentricity, and Metachronicity of Head and Neck Cancer

Abstract

Two hundred patients with squamous carcinoma of the head and neck were evaluated prospectively for synchronous second primary tumors. Complete head and neck examination, chest x-ray, and barium study (when indicated) revealed synchronous tumors of the upper aerodigestive tract in 24 patients (12%). Eleven patients had a second primary in the head and neck area. Nine patients had carcinoma of the lung, while four had carcinoma of the esophagus. Seven patients had a second primary outside the upper aerodigestive tract either in large bowel or prostate. During the period of this study, an additional 13 patients were seen with metachronous tumors 1-12 years after initial treatment of their index tumor. Most of these metachronous tumors were in the lung and esophagus and were noted within 1-3 years of treatment of the primary head and neck cancer. Detection of synchronous second primary is very important for prognosis and management of the index tumor, while early diagnosis of metachronous lesion is crucial in the follow-up of these patients.

Unrelated clonal chromosomal aberrations in carcinomas of the oral cavity

“…These findings fit the predictions inherent in the "field cancerization" concept (Slaughter et al, 1953). Support for this hy- pothesis also comes from more recent clinical observations of patients with oral and upper aerodigestive squamous cell carcinomas (Gluckman et al, 1980;Hodge et al, 1985;Wey et al, 1987;Shaha et al, 1988). Of importance in the pathogenesis of head and neck cancers is probably the massive exposure of the mucosa to a wide variety of ingested and inhaled exogenous carcinogens.…”

Pulmonary Metastasectomy for Head and Neck Cancers

“…The squamous cell cancers originated from the pharynx, larynx, and oral cavity. Adenoid cystic 16 and thyroid carcinomas 8 composed the majority of glandular tumors and were mostly from the salivary and thyroid glands (Tables 1 and 2). Other glandular tumors included were mucoepidermoid, 5 adenocarcinoma, 4 and parathyroid.…”

Experience in the treatment of synchronous and metachronous carcinoma of the oesophagus and the head and neck

“…Thus, the surgical indications are often more limited than for solitary oesophageal carcinomas [15,16]. In metachronous cancers, the mean interval between the diagnosis of head and neck cancer and oesophageal cancer ranges from 4 to 5 years [15,17,18]. Consequently, at the diagnosis of oesophageal cancer, the head and neck cancer is generally considered cured.…”