THE INCIDENCE OF 2ND NEOPLASMS IN ADVANCE D LARYNGEAL-CANCER - IMPACTON SURVIVAL

BACKGROUND: The incidence of second neoplasms in laryngeal cancer is g reater than that of other neoplasms. The appearance of a second neopla sm 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 ha d been treated with erradicative surgery from January 1984 to December 1988; and who were attended in the Radiotherapy and Oncology Departme nt of the Ciutat Sanitaria i Universitaria Vall d'Hebron were retrospe ctively studied. All were postoperatively submitted to radiotherapy. R ESULTS: Ten of the 78 patients studied (13 %) developed a second neopl asm. The most frequent localization was pulmonary (70 %). In 9 of the 10 patients the appearance of the second neoplasm was considered metac hronic with 60 % being detected within the first 24 months after the d iagnosis of the laryngeal neoplasm. The survival of the whole group wa s 80 % at 2 years and 51 % at 5 years. Survival of the patients with t he 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 wi th laryngeal cancer is high. The survival of patients with advanced la ryngeal cancer who develop a second neoplasm is significantly lower th an that of other patients with this neoplasm.