Inzidenz von Zweittumoren bei Patienten mit zuvor kurativ behandeltem Tumor im Hals-Nasen-Ohren-Bereich - eine prospektive Analyse

Incidence of secondary malignant tumors in patients with curatively treated head and neck cancer - a prospective analysis

by Cornelia Ruth Marie Wolff
Doctoral thesis
Date of Examination:2012-05-22
Date of issue:2012-05-16
Advisor:Prof. Dr. Hans Christiansen
Referee:Prof. Dr. Hans Christiansen
Referee:Prof. Dr. Christian Hommerich
Persistent Address: http://dx.doi.org/10.53846/goediss-1520

 

 

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Abstract

English

Patients treated previously for a head and neck squamous cell carcinoma (HNSCC) carry a high-risk for second malignant tumors, particularly for other head and neck tumors, lung cancer and esophageal cancer. The main risk factors for the development of such malignancies are widespread agents like tobacco smoking often in combination with abuse of alcohol. Since the long-term outcome of patients with HNSCC has improved through optimized multimodal approaches including surgery, radio(chemo)therapy, or combination of both, the incidence of subsequent cancers has become a life-limiting factor. The present study evaluated the potential benefit of a CT of the chest, an endoscopy of the esophagus and stomach and an ear-nose-throat endoscopy for early detection of second malignant tumors for HNSCC patients at high-risk. Therefore, between 07/2008 and 11/2011 participants underwent a systematic examination for second malignant tumors. All patients had been treated for a HNSCC 1 to 140 months before examination and showed no loco-regional relapse or distant metastases, so far. Overall, 118 consecutive patients were recruited. In total 33 suspicious findings were clarified by additional investigations. By these procedures, 26 second malignant tumors were confirmed within 21 patients (10 lung, 7 head and neck, 3 gastrointestinal, 1 renal tumor(s)). Subsequently, 18 of these 21 patients (86%) could be treated again in curative intent. In summary we found a high prevalence of curable second malignant tumors in a defined subgroup of patients at high-risk with prior HNSCC. All tumors were asymptomatic at the point of examination and were mostly detected in an early tumor stage, which may lead to a lower rate of tumor dependent mortality. To proof a lower rate of mortality prospective multicenter long-term studies are necessary.
Keywords: head and neck cancer; HNSCC; risk factor; nicotine; alcohol; second tumor; lung cancer; esophageal cancer; CT-Thorax; gastroscopy; screening; early diagnosis

Other Languages

Durch eine Vielzahl von Studien und Literaturnachweisen ist bekannt, dass Patienten mit den Risikofaktoren Nikotin- und Alkoholabusus ein deutlich erhöhtes Risiko aufweisen, an malignen Tumoren zu erkranken. Dies führt zu der Überlegung, bei diesen Patienten mittels Screeningverfahren die Früherkennung von Tumoren zu verbessern. Dies gilt insbesondere auch für Patienten, welche zuvor bereits kurativ aufgrund eines Tumors im HNO-Bereich behandelt worden sind, da die heutige multimodale Therapie immer bessere Überlebensraten ermöglicht und gerade diese Patienten häufig entsprechende Risikofaktoren aufweisen. Somit werden insbesondere bei diesen Patienten im weiteren Verlauf nach kurativer Behandlung des Kopf-Hals-Tumors zunehmend Zweittumore in der Lunge oder dem
Schlagwörter: HNO-Tumor; Risikofaktoren; Nikotin; Alkohol; Zweittumor; Bronchialkarzinom; Oesophaguskarzinom; CT-Thorax; Gastroskopie; Screening; Früherkennung
 
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