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The risk of second primary tumors in head and neck cancer: A systematic review.

  • Coca-Pelaz, Andrés1, 2
  • Rodrigo, Juan P1, 2
  • Suárez, Carlos2
  • Nixon, Iain J3
  • Mäkitie, Antti4
  • Sanabria, Alvaro5
  • Quer, Miquel6
  • Strojan, Primož7
  • Bradford, Carol R8
  • Kowalski, Luiz P9
  • Shaha, Ashok R10
  • de Bree, Remco11
  • Hartl, Dana M12, 13
  • Rinaldo, Alessandra14
  • Takes, Robert P15
  • Ferlito, Alfio16
  • 1 Department of Otolaryngology, Hospital Universitario Central de Asturias-University of Oviedo, Oviedo, Spain. , (Spain)
  • 2 Instituto de Investigación Sanitaria del Principado de Asturias, IUOPA, CIBERONC, Oviedo, Spain. , (Spain)
  • 3 Ear, Nose and Throat Department, NHS Lothian, University of Edinburgh, Edinburgh, UK.
  • 4 Department of Otorhinolaryngology, Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. , (Finland)
  • 5 Department of Surgery, School of Medicine, Universidad de Antioquia, CEXCA. Centro de Excelencia en Enfermedades de Cabeza y Cuello, Medellín, Colombia. , (Colombia)
  • 6 Department of Otolaryngology, Hospital Santa Creu i Sant Pau, Barcelona, Spain. , (Spain)
  • 7 Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia. , (Slovenia)
  • 8 Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan.
  • 9 Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, Sao Paulo, Brazil. , (Brazil)
  • 10 Head and Neck Service, Memorial Sloan-Kettering Cancer Center, New York, New York.
  • 11 Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands. , (Netherlands)
  • 12 Department of Otolaryngology-Head and Neck Surgery, Institut Gustave Roussy, Villejuif Cedex, France. , (France)
  • 13 Laboratoire de Phonétique et de Phonologie, Paris, France. , (France)
  • 14 University of Udine School of Medicine, Udine, Italy. , (Italy)
  • 15 Department of Otolaryngology-Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands. , (Netherlands)
  • 16 Coordinator of the International Head and Neck Scientific Group, Padua, Italy. , (Italy)
Published Article
Head & neck
Publication Date
Nov 21, 2019
DOI: 10.1002/hed.26016
PMID: 31750595


Second primary tumors (SPTs) are a common cause of reduced life expectancy in patients treated for head and neck cancer (HNC). This phenomenon forms an area to be addressed during posttreatment follow-up. We conducted a systematic review of literature following PRISMA guidelines, from 1979 to 2019, to investigate incidence of SPTs, synchronous, and metachronous, in HNC population. Our review includes data of 456 130 patients from 61 articles. With a minimum follow-up of 22 months, mean incidence of SPTs was 13.2% (95% CI: 11.56-14.84): 5.3% (95% CI: 4.24-6.36) for synchronous SPTs and 9.4% (95% CI: 7.9-10.9) for metachronous SPTs. The most frequent site for SPTs was head and neck area, followed by the lungs and esophagus. Although with wide variations between studies, the rate of SPTs in HNC patients is high. Given the impact in the prognosis, we must develop strategies for the early diagnosis of SPTs. © 2019 Wiley Periodicals, Inc.

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