High relative risk of a second pulmonary cancer in patients affected by laryngeal cancer: differences by specific site of occurrence and lung cancer histotype.

The frequency of a second primary lung tumor in patients affected by laryngeal cancer has been evaluated on the basis of 128,532 biopsies and 27,753 autopsies carried out from January 1, 1979 through December 31, 1988. Among these cases, 432 laryngeal cancers and 44 synchronous or metachronous pulmonary cancers have been detected (7 during life, 37 at autopsy). The highest risk of developing a lung tumor has been evidenced in patients affected by supraglottic cancer during the first 2 years of follow-up (relative risk [RR]: 32.56 for supraglottic patients versus 5.55 for glottic patients). This is particularly true of patients affected by multicentric supraglottic tumors (RR: 62.5). A significant hyperfrequency of undifferentiated lung cancers also has been noted in supraglottic patients (RR: 45.45 for supraglottic versus 14.28 for glottic patients). The information provided by autopsy allows for a more realistic and detailed outlining of the issue of tumor multiplicity, stressing the importance of strict preventive and follow-up protocols.