Shikhani A H, Matanoski G M, Jones M M, Kashima H K, Johns M E
Arch Otolaryngol Head Neck Surg. 1986 Nov;112(11):1172-9. doi: 10.1001/archotol.1986.03780110048006.
Multiple primary (MP) malignancies were found in 9.7% of 1961 patients with primary head and neck cancer diagnosed at The Johns Hopkins Hospital, Baltimore, during the years 1975 to 1985. The index tumors were divided into six main groups. Out of the 190 MP malignancies, 46.9% were synchronous and 53.1% were metachronous. Seventy-four percent of MP lesions were noted during the first year after diagnosis of the index primary tumor. Patients with an index tumor in the upper aerodigestive tract had a significantly increased risk of developing a second cancer in the head and neck area. This risk was 5.94 for the oral cavity, 6.98 for the pharynx, 3.57 for the larynx, and 7.02 for the esophagus. Patients with an index tumor in the salivary gland or the thyroid gland had, respectively, a 3.59 and a 7.38 higher risk than the general population of developing a second tumor. Efforts aimed at improving the survival of patients with head and neck cancer must incorporate strategies for the prevention, early detection, and treatment of MP neoplasms.
1975年至1985年间，在巴尔的摩约翰霍普金斯医院确诊的1961例原发性头颈癌患者中，9.7%发现有多发原发性（MP）恶性肿瘤。索引肿瘤分为六个主要组。在190例MP恶性肿瘤中，46.9%为同步性，53.1%为异时性。74%的MP病变在索引原发性肿瘤诊断后的第一年内被发现。上消化道有索引肿瘤的患者发生头颈区域第二种癌症的风险显著增加。口腔的这种风险为5.94，咽部为6.98，喉部为3.57，食管为7.02。唾液腺或甲状腺有索引肿瘤的患者发生第二种肿瘤的风险分别比普通人群高3.59和7.38。旨在提高头颈癌患者生存率的努力必须纳入预防、早期检测和治疗MP肿瘤的策略。
