Second malignant neoplasms in patients under 40 years of age with laryngeal cancer

Objectives/Hypothesis: To determine the incidence of second malignant neopl asms (SMN) in patients under 40 years of age with invasive squamous cell ca rcinoma (SCC) of the larynx. Study Design: Retrospective. Meth ods: Using a National Cancer Institute tumor registry database encompassing 1973-1996, the incidence of SMN in patients under 40 years of age with laryngeal cance r was determined and compared with that of the registry's older, more tradi tional laryngeal cancer population. Median follow-up was 136 months. Result s: Among the 364 patients under the age of 40 years with laryngeal cancer, 30 (8.2%) had developed a secondary malignancy to date. In comparison, 4876 (21.4%) of 22,786 patients 40 years or older with laryngeal cancer were af fected by an SMN. Kaplan-Meier analysis of the younger cohort projected 3.0 %, 6.8% and 10.7% relative risk of developing a SMN at any site over 5-, 10 -, and 15-year periods, respectively, after index tumor diagnosis. Similar results for the older cohort were 14.2%, 28.1%, and 39.4% at 5, 10, and 15 years, respectively. Further Kaplan-Meier analysis demonstrated at least a fourfold increased risk for the development of secondary upper aerodigestiv e tract malignancies among older compared with younger patients. Conclusion : Patients under 40 years of age with invasive SCC of the larynx are signif icantly less likely to develop a second malignancy than their older counter parts.