Multiple primary malignant neoplasms of the mouth and oropharynx

M. Kropotov, L. Yakovleva, L. G. Zhukova, G. Agabekyan, A. V. Khodos, D. Safarov, P. A. Gavrishchuk, M. S. Tigrov, A. S. Vyalov
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Abstract

Introduction. Probability of development of multiple primary tumors in patients who received treatment due to head and neck cancers varies between 5.6 and 35.9 % per different sources. moreover, treatment capabilities are severely limited by postoperative anatomical changes and previous radiation therapy, and the second tumor frequently causes death in these patients.The study objective is to identify the epidemiological features of the development of synchronous and metachronous primary multiple tumors in the head and neck.Materials and methods. The article analyzes data on 103 patients with multiple primary tumors who received treatment due to tumors of the head and neck between 1991 and 2020 at the N.N. Blokhin National medical Research Center of Oncology and A.S. Loginov Moscow Clinical Scientific Center.Results. During the study, typical locations of metachronous tumors in patients who received treatment due to primary malignant tumors of the head and neck were determined, duration of development of multiple primary tumors, treatment methods and survival rates were analyzed.Conclusion. Due to high risk of multiple primary tumors in patients who received treatment due to malignant tumors of the head and neck in the next 5 plus years, it is expedient to observe these patients during their whole lifetime. Considering typical locations of metachronous tumors, examination during dynamic observation should include instrumental methods such as panendoscopy. Surgical treatment should involve the whole spectrum of minimally invasive interventions including CO2 laser surgery and transoral robot-assisted interventions.
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口腔及口咽部多发原发性恶性肿瘤
介绍。因头颈癌接受治疗的患者发生多发性原发肿瘤的概率在不同来源的5.6%至35.9%之间。此外,由于术后解剖改变和既往放射治疗,治疗能力受到严重限制,这些患者的第二肿瘤经常导致死亡。研究目的是确定头颈部同步性和异时性原发性多发肿瘤的流行病学特征。材料和方法。本文分析了1991年至2020年间在N.N. Blokhin国家肿瘤医学研究中心和A.S. Loginov莫斯科临床科学中心因头颈部肿瘤接受治疗的103例多发性原发性肿瘤患者的数据。本研究确定了头颈部原发恶性肿瘤患者异时性肿瘤的典型部位,分析了多发原发肿瘤的病程、治疗方法及生存率。因头颈部恶性肿瘤而接受治疗的患者未来5年以上发生多发原发肿瘤的风险较高,故对患者进行终身观察较为有利。考虑到异时性肿瘤的典型位置,动态观察时的检查应包括仪器方法,如全内窥镜检查。手术治疗应包括全谱的微创干预,包括CO2激光手术和经口机器人辅助干预。
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