頭頚部領域の重複癌の検討

Abstract

The incidence of multiple primary cancers in patients with head and neck cancer has increased recently. Recent reports descrive the frequency of second primary cancers as being over 10% of the incidence of first primary cancers.Fifty five cases with multiple primary cancers were found among 501 cases with head and neck cancer who had been treated at the Department of Head and Neck Surgery, Kanagawa Cancer Center from 1986 to 1996. These patients were evaluated according to prognosis and therapy. The highest incidence of second primary cancers was found in hypopharyngeal cancers. Second primary cancers also developed frequently in stomach, esophagus and lung cancers. The 5-year survival rate of the patients was 24.4%. There was a significance in the survival rate according to the presence or the absence of curative treatment for first primary cancers. However, there was no significant difference between treatments for the second primary cancers, either curatively or palliatively.Therefore, it was concluded that the control of first primary cancers is the most important factor in treatment, and it is suggested that second primary cancers be treated considering a patient's prognosis, quality of life and volition according to the tumor location.