Synchronous and metachronous squamous cell carcinomas of the head and neckmucosal sites

Purpose: The present study presents the experience at the University of Flo rida with synchronous and meta-chronous squamous cell carcinomas of the hea d and neck mucosal sites. Patients and Methods: This study included 1,112 patients with squamous cell carcinomas of the oropharynx, hypopharynx, and supraglottic larynx treated with radiation therapy with curative intent from 1964 to 1997. All patient s had follow-up far at least 2 years. No patients were lost to follow-up. Results: The overall survival rate was 45% and the disease-specific surviva l rate wets 67% at 5 years after initial diagnosis of carcinoma of the head and neck mucosal sites. Seventy-seven patients (7%) presented with synchro nous carcinomas of the head and neck mucosal sites and 103 patients (9%) de veloped meta-chronous carcinomas of the head and neck mucosal sites at 0.6 to 21.7 years (median, 3.6 years). The overall survival rate wets 31%, and the disease-specific survival rate was 50% at 5 years after metachronous ca rcinomas of the head and neck mucosal sites. Seven patients (1%) developed metachronous carcinomas of the thoracic esophagus at 1 to 11.1 years (media n, 2.8 years), 15 patients (1%) presented with synchronous carcinomas of th e lung, and 83 patients (7%) developed metachronous carcinomas of the lung at 0.6 to 17.6 years (median, 3.5 years). Conclusion: Development of synchronous and meta-chronous squamous cell carc inomas of the head and neck mucosal sites are in part responsible for failu re to improve overall survival rates for patients with squamous cell carcin omas of the head and neck mucosal sites, justifying rigorous follow-up and studies on chemoprevention. J Clin Oncol 19:1358-1362. (C) 2001 by American Society of Clinical Oncology.