| Objective:To summary and analysis the incidence of head and neck multiple primary cancers(MPCs)in patients who were hospitalized in the department of otolaryngology,describe it's feature,explore it's possible risk factors,increase the understanding of clinicians on pathogenesis and reduce the rate of missed diagnosis and misdiagnosis,thus improve the level of diagnosis and treatment.Materials and Methods:Collected 648 cases of malignant tumors hospitalized in department of otolaryngology in Second affiliated hospital of Fujian Medical University between January1,2014 and December 31,2017.And the clinical data of 68 patients with head and neck MPCs were retrospectively analyzed.Using SPSS21.0 statistical software for data analysis.Results:There were 648(7.40%)cases of malignant tumor in 8758 patients treated in the same period,including 490 males and 158 females.Among them,68 cases were diagnosed with MPC,the occurrence rate was 0.78%(68/8758).The annual occurrence rate of MPC from 2014 to 2017 was 0.72%?0.72%?0.77%?0.86%,showing an upward trend.In the MPC group,there were 61 males and 7 females,the proportion of males was higher than single primary cancer group.The preclinical cancer(PC)was between26 and 85 years old,median age was 57 years old,average age was about 56.85 years old.There were 62 cases of double cancer(91.2%),6 cases of triple cancer(8.8%).The distribution of oral cancer,laryngeal cancer and hypopharyngeal cancer differed between MPC group and single primary cancer group(?~2=7.75,P<0.05).Hypopharyngeal cancer had the highest incidence of MPC(23.81%),followed by oral cancer(14.71%)and laryngeal cancer(9.33%).The most common primary cancer associated with oral cancer,hypopharyngeal cancer,and laryngeal cancer was esophageal cancer.There were 45 cases(66.18%)that second cancer and first cancer less than 5 years apart.Twenty-two patients had undergone radiation/chemotherapy,those patients had a higher proportion of metachronous MPC(?~2=18.64,P<0.05).There were 35 cases of synchronous carcinoma,33 cases of metachronous carcinoma,and no significant difference in gender composition ratio between them(?~2=0.78,P>0.05).Simultaneous multiple primary cancer's(SMPC)age of the first cancer diagnosed was older(?~2=8.95,P<0.05),and also more people abandon treatment(P<0.05).The average survival period of SMPC was about 1.21 years,isochronous multiple primary cancer(IMPC)was about 10 years,and follow-up cancer was about 2.33 years.Forty-four patients had previous history of smoking/drinking,male smoking/drinking events were significantly higher than women(?~2=6.40,P<0.05).There was no difference in the treatment of the first and second cancer(?~2=4.68,P>0.05).Conclusions:1.The highest incidence of MPC in the head and neck is hypopharyngeal,oral,laryngeal cancer.2.There is a high possibility of HNC combined with upper gastrointestinal cancer such as esophageal cancer,it's suggested list gastroscopy as a routine examination in preoperative and follow-up.3.The interval between second and first cancer most are less than 5 years,we should strengthen the first 5 years of follow-up and long-term regular follow-up after radiotherapy for malignant tumors.4.MPC should be considered in developing a radiotherapy program,and pay attention to the radiation protection of the surrounding tissues and organs.5.Early detection and early treatment is important for MPC patients. |
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