Evaluation of second malignancy in patients with T1-T4 squamous cell carcinoma (SCC) of the larynx

Abstract

Evaluate second malignancy rate in patients with T1-T4 laryngeal cancer treated with radiation therapy. Retrospective review of 281 patients with SCC of the larynx, stage T1 (45.2%), T2 (23.8%), T3 (20.3%) and T4 (10.7%), N0-N3, treated with radiation therapy from 1/1975 through 12/1995. Median age was 61 years and median follow-up was 4.3, 2.9, 2.2 and 1.6 years for patients with T1, T2, T3 and T4 disease, respectively. The time to second malignancy is the duration from the last radiation therapy treatment to the biopsy proven second malignancy. A total of 56 second malignancies were documented, including 25 (19.7%), 15 (22.4%), 11 (19.3%) and 5 (16.7%) second malignancies in patients with T1, T2, T3 and T4 disease, respectively. Median time to second malignancy was 41, 33, 26 and 14 months for patients with T1, T2, T3 and T4 disease, respectively. The time to second malignancy ranged from 2-218, 1-142, 4-82 and 8-66 months for patients with T1, T2, T3 and T4 disease, respectively. Location of second malignancy for all stages included 28 lung, 7 upper GI, 6 other HeadsNeck sites, 4 skin, 3 colorectal, 2 prostate, 2 hematological, 2 CNS, 1 sarcoma, and 1 bladder. For the subgroup of patients who developed a second malignancy, the lung was involved in 10, 6, 8 and 4 patients with T1, T2, T3 and T4 disease of the larynx, respectively. The median time to second malignancy of the lung was 53, 25, 27 and 11 months for patients with T1, T2, T3 and T4 disease, respectively. The risk of second malignancies is comparable in all stages of larynx cancer. The lung was the most common site for second malignancy regardless of T-stage, and this information may have an impact on radiological surveillance programs