A role for panendoscopy? Second primary tumour in early stage squamous cell carcinoma of the oral tongue

作者：Koo K; Harris R^*; Wiesenfeld D; Iseli T A

来源：Journal of Laryngology and Otology, 2015, 129(S1): S27-S31.

DOI：10.1017/S0022215114002989

• Oral Cancer
• Head And Neck Cancer
• Tongue
• Endoscopy
• Cancer
• Second Primary
• Neoplasms
• Synchronous
• Smoking
• Drinking

Background: Panendoscopy is routinely used for the identification of occult second primary tumours in head and neck squamous cell carcinoma. However, its role in low risk subgroups, particularly non-smoking, non-drinking patients and patients presenting with early stage oral cavity lesions, is debatable.
Methods: The records of 112 patients with T1 or T2 oral tongue squamous cell carcinoma were retrospectively reviewed. Demographic, disease characteristics and survival data were collected.
Results: Average follow-up duration was 71.7 months (range, 3.6-238.3 months). Thirty-five patients died within this period. Thirteen second primary events were identified in 11 patients, with all but 2 tumours in the oral cavity or oropharynx. There was a single synchronous primary - a lung adenocarcinoma; all other events were metachronous. No non-smoking, non-drinking patients re-presented with a second primary tumour; tobacco and alcohol use are clearly risk factors for development of a second primary tumour.
Conclusion: The role of panendoscopy for identifying synchronous primary tumours in patients with early stage oral tongue squamous cell carcinoma should be re-evaluated, particularly in non-smoking, non-drinking patients who are at low risk of second primary development. Close follow up with regular clinical examination including flexible fibre-optic endoscopy may be sufficient in this subgroup.

• 出版日期2015-1