Second laryngeal cancers in previously treated larynges

Objectives: To review the management and outcome of patients with new secon d primary cases of laryngeal cancer occurring more than 3 years after the i nitial cancer was treated. Study Design: Retrospective review of 855 patien ts with newly diagnosed and treated laryngeal cancers. Methods: Charts were reviewed and tabulated for occurrence of second primary laryngeal tumors, method of treatment for the index and second primary laryngeal tumors, and effect of smoking status or cessation of smoking. Results: Of the 855 patie nts, 532 patients retained their larynx; of these 377 lived more than 3 yea rs and thus were at risk for a second new primary cancer. Of these 377 pati ents at risk, 19 or 5.1% developed second primary tumors, The rate of secon d primary disease was lower in patients whose index laryngeal cancer was tr eated by irradiation (4.3%) compared with those treated surgically (9.2%). However, surgical treatment of second primary laryngeal tumors resulted in far higher rates of laryngeal voicing (82%) compared with irradiation (33%) . Conclusion:: When possible, management of the index primary tumor by endo scopic resection has resulted in the highest future retention of laryngeal speech, leaving all treatment options available should a second laryngeal c ancer occur. Lifelong follow-up of patients with laryngeal cancer for secon dary primary tumors is important. Second primary tumors were equally distri buted between patients who continued to smoke and ceased to smoke after the ir index primary lesion was diagnosed.