S151 – The Impact of Second Primary Tumors on Survival

Abstract

Objectives 1) Evaluate what impact second primary tumors have on prognosis in HNSCC. 2) Identify patients that run the highest risk of obtaining a second primary tumor after successful treatment of primary HNSCC. Methods A retrospective analysis of 2063 patients treated over a 15-year period for tumors of the oral cavity, larynx, oropharynx, and hypopharynx, was undertaken. Survival was analysed for the group of patients presenting second primary tumors, and the descriptive characteristics of these patients were compared to the remaining group of patients. Results Second primary tumors correlated with low patient age (p=0.02), less advanced disease (p<0.05), and were more common after primary tumors of the larynx and oral cavity. Mean time to diagnosis of a second primary tumor was more than 4 years from the date of the initial tumor. From the date of primary tumor treatment, overall median survival among patients that later developed second primary tumors compared to all other patients was 6 years vs. 3 years. Prognosis was poor after the diagnosis of a second primary, as median survival was 12 months and 5-year survival, 16%. Conclusions Patients at risk of a second primary tumor were younger than median with stage I and II primary tumors of the larynx and the oral cavity. This group had a favorable outcome after treatment of their primary tumor and therefore initially a better overall survival. However, after diagnosis of the second tumor, prognosis was extremely poor.