Multiple primary tumors in patients with head and neck cancer.

Background: Multiple primary tumors can lead to diagnostic and therapeutica l problems. In this study we surveyed frequency, localisation, diagnostic, chronologic and therapeutic aspects of multiple primary carcinomas in patie nts with head and neck tumors. Patients and Methods: The data of 843 patien ts from the tumor registry of the ENT-clinic Aachen were retrospectively st udied. Results: Larynx (41.87%) and oropharynx (12.57%) were the main local isation of the first primary neoplasma. In 65 patients (7.71%) multiple pri mary tumors were observed. 24.6% of these tumors occurred synchronously. Pr eferential localisation of a second tumor were lung (20%), oral cavity (15. 3%) and larynx (13.8%). 28.57% of the metachronous tumors were observed aft er more than five years. In 46.15% clinical complaints led to the suspicion of a second tumor. Panendoscopy was the most reliable diagnostic procedure . The survival rate and time was significantly reduced in patients with syn chronous tumors. 3-year survival rate was 15% compared to 81% in patients w ith metachronous tumor appearance (p < 0.0001). Conclusion: Patients with h ead and neck tumors have a high incidence of multiple primary malignomas va rying from the region of the first presentation of a malignant tumor. Conce pts comprising surgery provide the highest survival rates. Because of the h igh incidence of metachronous carcinomas after five years found in this stu dy, the authors regard a prolonged follow-up period as necessary.