HIGH RELATIVE RISK OF A 2ND PULMONARY-CANCER IN PATIENTS AFFECTED BY LARYNGEAL-CANCER - DIFFERENCES BY SPECIFIC SITE OF OCCURRENCE AND LUNG-CANCER HISTOTYPE

The frequency of a second primary lung tumor in patients affected by l aryngeal cancer has been evaluated on the basis of 128,532 biopsies an d 27,753 autopsies carried out from January 1, 1979 through December 3 1, 1988. Among these cases, 432 laryngeal cancers and 44 synchronous o r metachronous pulmonary cancers have been detected (7 during life, 37 at autopsy). The highest risk of developing a lung tumor has been evi denced in patients affected by supraglottic cancer during the first 2 years of follow-up (relative risk [RR]: 32.56 for supraglottic patient s versus 5.55 for glottic patients). This is particularly true of pati ents affected by multicentric supraglottic tumors (RR: 62.5). A signif icant hyperfrequency of undifferentiated lung cancers also has been no ted in supraglottic patients (RR: 45.45 for supraglottic versus 14.28 for glottic patients). The information provided by autopsy allows for a more realistic and detailed outlining of the issue of tumor multipli city, stressing the importance of strict preventive and follow-up prot ocols.