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

Published online by Cambridge University Press:  06 February 2015

K Koo
Affiliation:
Department of Surgery, The University of Melbourne, The Royal Melbourne Hospital, Parkville, Victoria, Australia
R Harris*
Affiliation:
Department of Otolaryngology, Royal Devon and Exeter Hospital, UK
D Wiesenfeld
Affiliation:
Department of Surgery, The University of Melbourne, The Royal Melbourne Hospital, Parkville, Victoria, Australia
T A Iseli
Affiliation:
Department of Surgery, The University of Melbourne, The Royal Melbourne Hospital, Parkville, Victoria, Australia
*
Address for correspondence: Mr Richard Harris, Department of Otolaryngology, Royal Devon and Exeter Hospital, Barrack Rd, Exeter EX2 5DW, UK E-mail: richardharris3@nhs.net

Abstract

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.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2015 

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