The incidence of second neoplasms in advanced laryngeal cancer. Impact on survival

BACKGROUND: The incidence of second neoplasms in laryngeal cancer is greater than that of other neoplasms. The appearance of a second neoplasm in these patients represents an important decrease in survival. The prevalence of second neoplasms in laryngeal cancer and its impact on survival was determined in this study. METHODS: Seventy-eight patients with advanced laryngeal cancer (stages III and IV of the UICC) who had been treated with erradicative surgery from January 1984 to December 1988; and who were attended in the Radiotherapy and Oncology Department of the Ciutat Sanitària i Universitària Vall d'Hebron were retrospectively studied. All were postoperatively submitted to radiotherapy. RESULTS: Ten of the 78 patients studied (13%) developed a second neoplasm. The most frequent localization was pulmonary (70%). In 9 of the 10 patients the appearance of the second neoplasm was considered metachronic with 60% being detected within the first 24 months after the diagnosis of the laryngeal neoplasm. The survival of the whole group was 80% at 2 years and 51% at 5 years. Survival of the patients with the second neoplasm was lower: 71% at 2 years and 5% at 5 years (p < 0.0001). CONCLUSIONS: The presence of a second neoplasm in patients with laryngeal cancer is high. The survival of patients with advanced laryngeal cancer who develop a second neoplasm is significantly lower than that of other patients with this neoplasm.