Epidemiology, prognosis and treatment of simultaneous squamous cell carcinomas of the oral cavity and hypopharynx

Abstract

Objective: The study was designed to assess the prevalence, management and survival of patients with simultaneous squamous cell carcinomas of the oral cavity and hypopharynx (OC/HP).

Material and methods: A multicenter, retrospective study (2 university hospitals) was conducted between 2003 and 2007 on a series of 96 patients with simultaneous squamous cell cancers of the OC/HP.

Results: A total of 88 men and 8 women were included in the study: 81 patients presented double sites, 14 presented triple sites and one presented quadruple sites. The tumour sites most frequently observed were: hypopharynx in 61% of cases (involving the pyriform sinus in 42% of cases) and the oropharynx in 59% of cases (involving the palatine tonsil in 30% of cases). Upper aerodigestive tract endoscopy under general anaesthesia revealed a simultaneous lesion not suspected on clinical examination in 45% of patients: the site discovered on endoscopy was hypopharyngeal in 2 out of 3 cases; the tumour was classified T1 or T2 in 95.5% of cases. Patients treated simultaneously for all sites had a better prognosis than patients in whom each tumour was treated separately. The 5-year specific survival was 34% and the 5-year overall survival was 28%.

Conclusion: The prevalence of simultaneous squamous cell carcinomas of the oral cavity and hypopharynx ranges between 1 to 7.4% in the literature and was 4.6% in the present series. A common treatment strategy for each of the patient's tumours appears to be superior to the current theoretical approach that consists of considering each tumour separately.

Keywords: Endoscopy; Head and neck cancer; Multiple primary cancers; Second primary tumour.