Schwager K, Nebel A, Baier G, Hoppe F
Klinik und Poliklinik für Hals-, Nasen- und Ohrenkranke, Universität Würzburg.
Laryngorhinootologie. 2000 Oct;79(10):599-603. doi: 10.1055/s-2000-7675.
Second primary tumors are of great importance for diagnostics, therapy and prognosis in patients suffering from squamous cell carcinomas of the upper aerodigestive tract. The clinical observation of an increase of second primaries was the reason for analyzing all patients with head and neck cancer treated for a certain period of time at our institution.
The hospital charts of 576 patients treated for squamous cell carcinoma of the oral cavity, the oropharynx, the hypopharynx and larynx treated from 1993 till 1996 at the Department of Otolaryngology, Head and Neck Surgery of the University of Würzburg were reviewed retrospectively.
10.1% of all patients developed a second primary tumor. The rate was highest for patients with carcinoma of the oral cavity (17.5%), followed by tumors of the hypo- and oropharynx (11.7% and 11.5%) and the larynx (6.4%). Besides the location, younger age was detected as a risk factor for the formation of second malignancies. The latency between first and second primary tumor was 2.9 years in average. 31% of the second primaries were detected synchronous, 39% metachronous.
The results demonstrate that younger patients and patients with carcinomas of the upper digestive tract need a consequent follow-up. The development of second primaries even years after the first malignoma demonstrates the necessity of lifelong follow-up and oncological care.
第二原发性肿瘤对于上消化道鳞状细胞癌患者的诊断、治疗及预后具有重要意义。第二原发性肿瘤数量增加这一临床观察结果，是我们对本机构在特定时间段内接受治疗的所有头颈癌患者进行分析的原因。
回顾性分析了1993年至1996年期间在维尔茨堡大学耳鼻咽喉头颈外科接受治疗的576例口腔、口咽、下咽和喉鳞状细胞癌患者的病历。
所有患者中有10.1%发生了第二原发性肿瘤。口腔癌患者的发生率最高（17.5%），其次是下咽和口咽肿瘤（分别为11.7%和11.5%）以及喉癌（6.4%）。除了肿瘤部位外，年龄较小被发现是发生第二原发性恶性肿瘤的一个危险因素。第一和第二原发性肿瘤之间的平均间隔时间为2.9年。31%的第二原发性肿瘤为同时性，39%为异时性。
结果表明，年轻患者和上消化道癌患者需要进行持续随访。即使在首次恶性肿瘤发生数年之后出现第二原发性肿瘤，也表明终身随访和肿瘤护理的必要性。
