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Synchronous and Metachronous Squamous Cell Carcinomas of the Head and Neck Mucosal Sites

By Haldun . Erkal, William M. Mendenhall, Robert J. Amdur, Douglas B. Villaret, Scott P. Stringer

From the Department of Radiation Oncology, Inönü University Faculty of Medicine, Malatya, Turkey; and Departments of Radiation Oncology and Otolaryngology, University of Florida College of Medicine, Gainesville, FL.

Address correspondence to William M. Mendenhall, MD, Department of Radiation Oncology, University of Florida Health Science Center, PO Box 100385, 2000 SW Archer Road, Gainesville, FL 32610-0385; email: mendewil{at}shands.ufl.edu

PURPOSE: The present study presents the experience at the University of Florida with synchronous and metachronous squamous cell carcinomas of the head and neck mucosal sites.

PATIENTS AND METHODS: This study included 1,112 patients with squamous cell carcinomas of the oropharynx, hypopharynx, and supraglottic larynx treated with radiation therapy with curative intent from 1964 to 1997. All patients had follow-up for at least 2 years. No patients were lost to follow-up.

RESULTS: The overall survival rate was 45% and the disease-specific survival rate was 67% at 5 years after initial diagnosis of carcinoma of the head and neck mucosal sites. Seventy-seven patients (7%) presented with synchronous carcinomas of the head and neck mucosal sites and 103 patients (9%) developed metachronous carcinomas of the head and neck mucosal sites at 0.6 to 21.7 years (median, 3.6 years). The overall survival rate was 31%, and the disease-specific survival rate was 50% at 5 years after metachronous carcinomas of the head and neck mucosal sites. Seven patients (1%) developed metachronous carcinomas of the thoracic esophagus at 1 to 11.1 years (median, 2.8 years), 15 patients (1%) presented with synchronous carcinomas of the lung, and 83 patients (7%) developed metachronous carcinomas of the lung at 0.6 to 17.6 years (median, 3.5 years).

CONCLUSION: Development of synchronous and metachronous squamous cell carcinomas of the head and neck mucosal sites are in part responsible for failure to improve overall survival rates for patients with squamous cell carcinomas of the head and neck mucosal sites, justifying rigorous follow-up and studies on chemoprevention.

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