Second primary respiratory tract malignant neoplasms in supraglottic carcinoma.

In this study, a second respiratory tract malignant neoplasm developed in 20 of 163 cases of supraglottic carcinoma either at the time of diagnosis or after diagnosis. Using an actuarial method of calculation, 19% of the survivors will experience a second respiratory tract malignant neoplasm within five years after the diagnosis of supraglottic carcinoma. This is three times the incidence in patients who survive glottic carcinoma and 14 times the incidence in the normal population. A third of this group of patients with supraglottic carcinoma are alive and well at five years, a third died of supraglottic cancer, and a third died of intercurrent disease. The death rate from intercurrent disease is twice that seen in the general population, and this difference is due almost entirely to second respiratory tract tumors. Even if the cure rate of patients with primary supraglottic carcinoma was 100%, only half of these patients would actually be alive at five years, owing to deaths from intercurrent disease. More emphasis needs to be placed on the reduction of the mortality from second respiratory tract tumors with the use of screening or preventive methods.