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second primary cancer head neck

1989;17:691-694. People who have been treated for head and neck cancers have an increased chance of developing a new cancer, usually in the head, neck, esophagus, or lungs. People who have been treated for head and neck cancers have an increased chance of developing a new cancer, usually in the head, neck, esophagus, or lungs (30–32). The intervals from the dates of diagnosis of the initial primary head and neck cancers to the times of diagnosis of the 39 second primary head and neck cancers were: less than 1 year17; 1 to 1.99 years-7; 2 to 4.99 years-9; 5 to 9.99 years-4; over 10 years-2. Department of Otolaryngology, Hospital Santa Creu i Sant Pau, Barcelona, Spain, Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia, Department of Otolaryngology—Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, Sao Paulo, Brazil, Head and Neck Service, Memorial Sloan–Kettering Cancer Center, New York, New York, Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands, Department of Otolaryngology—Head and Neck Surgery, Institut Gustave Roussy, Villejuif Cedex, France, Laboratoire de Phonétique et de Phonologie, Paris, France, University of Udine School of Medicine, Udine, Italy, Department of Otolaryngology—Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands, Coordinator of the International Head and Neck Scientific Group, Padua, Italy. Epub 2014 May 30. Although with wide variations between studies, the rate of SPTs in HNC patients is high. With improvements in locoregional … Objectives: Second primary lung cancers (SPLC) are not uncommon in survivors of squamous cell head and neck cancer (HNSCC), and carry a worse prognosis than when patients present with a primary lung cancer. Second primary tumors (SPTs) are a common cause of reduced life expectancy in patients treated for head and neck cancer (HNC). Patients with head and neck squamous cell carcinoma (HNSCC) are at increased risk for the development of a second primary malignancy (SPM), which is defined as a second malignancy that presents either simultaneously or after the diagnosis of an index tumor. These 40 cancers occurred among a total of 849 head and neck squamous cell carcinoma (HNSCC) cases (5%) diagnosed during the study period. I know hpv second cancers are rare, and my first was treated very early … Given the impact in the prognosis, we must develop strategies for the early diagnosis of SPTs. A resectable second primary would … Learn more. People who have been treated for head and neck cancers have an increased chance of developing a new cancer, usually in the head, neck, esophagus, or lungs. Learn about our remote access options, Department of Otolaryngology, Hospital Universitario Central de Asturias‐University of Oviedo, Oviedo, Spain, Instituto de Investigación Sanitaria del Principado de Asturias, IUOPA, CIBERONC, Oviedo, Spain. People who have been treated for head and neck cancers have an increased chance of developing a new cancer, usually in the head, neck, esophagus, or lungs. 2010;21:184-186. Although with wide variations between studies, the rate of SPTs in HNC patients is high. People with oropharyngeal carcinomas are at high risk of … Incidence of second metachronous head and neck cancers: population-based outcomes over 25 years. HPV-positive oropharyngeal cancer generally has a better outcomes than HPV-negative disease with a 54% better survival, but this advantage for HPV associated cancer applies only to oropharyngeal cancers. … Signs and symptoms of metastatic squamous neck cancer with occult primary include a lump or pain in the neck … Synchronous and metachronous head and neck carcinomas. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Patients with head and neck squamous cell carcinoma (HNSCC) may also develop squamous cell carcinomas (SCCs) in their lungs For example, 5% of patients with HNSCC clinically develop lung metastases ( 1 ). Purpose The purpose of the present study was to determine the rate of second primary head and neck cancer development among patients with a primary cancer diagnosed outside the head and neck region, to present the clinical characteristics of this population, and to determine whether any variables are associated with survival. 2019 Jan 8;91(5):51-57. doi: 10.5604/01.3001.0012.8371. Head and neck cancer (HNC) is the sixth most common cancer in the world with squamous cell carcinoma (SCC) being the most common type affecting the head and neck region (1). The impact of smoking status, disease stage, and index tumor site on second primary tumor incidence and tumor recurrence in the head and neck retinoid chemoprevention trial. However, survival outcomes have not demonstrated significant improvements (1-4). 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. HPV-positive oropharyngeal cancer generally has a better outcomes than HPV-negative disease with a 54% better survival, but this advantage for HPV associated cancer applies only to … Keywords: second neoplasms, head and neck cancer, incidence, age Cancer of unknown primary in the head and neck is metastatic squamous cell carcinoma that is found in cervical lymph nodes located in the neck. 2014 Oct;124(10):2287-91. doi: 10.1002/lary.24719. These 40 cancers occurred among a total of 849 head and neck squamous cell carcinoma (HNSCC) cases (5%) diagnosed during the study period. If you have previously obtained access with your personal account, please log in. Treatment options for patients with second primary lung tumors are different from those for metastasized head and neck squamous cell carcinoma. Working off-campus? The chance of a second primary cancer varies depending on the site of the original cancer, but it is higher for people who use tobacco and drink alcohol … Abstract. Prognostic factors in laryngeal squamous cell carcinoma. Both of the cannabis users and six of the controls who developed an SPC were active cigarette smokers, the study states. Int J Radiat Oncol Biol Phys. Ene 25, 2021. 1991;44:615-625. Ene 25, 2021. People who have been treated for head and neck cancers have an increased chance of developing a new cancer, usually in the head, neck, esophagus, or lungs. Patients treated for squamous cell carcinoma of the head and neck (HNSCC) carry a high risk of second primary malignancies (SPM). The risk of a second primary cancer arising in the head and neck, following surgical or radiation treatment of an initial primary cancer in the head and neck, was evaluated for 2,151 patients whose first cancers … 1 More than 150 000 (41 000 per year) new cases of HPV-associated cancers were diagnosed between 2010 and 2014 in the United States. J Clin Epidemiol. Locatello LG, Comini LV, Bettiol A, Vannacci A, Spinelli G, Mannelli G. Eur Arch Otorhinolaryngol. Epub 2015 Jun 29. Use the link below to share a full-text version of this article with your friends and colleagues. Most second primary tumors occur in the upper aerodigestive tract (40%–59%), lung (31%–37.5%), and esophagus (9%–44%). Patients with head and neck squamous cell carcinoma (HNSCC) are at increased risk for the development of a second primary malignancy (SPM), which is defined as a second … 6-years; 2006 PMID 16595780 -- … Ear, Nose and Throat Department, NHS Lothian, University of Edinburgh, Edinburgh, UK, Department of Otorhinolaryngology, Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. 2020 Jan 27;5(1):74-81. doi: 10.1002/lio2.353. Cancers … People who have been treated for head and neck cancer have an increased chance of developing a new cancer, usually in the head and neck, esophagus, or lungs. The most common location for a second primary … Argiris A, Brockstein BE, Haraf DJ, et al. BACKGROUND: Second primary tumors (SPTs) are a common cause of reduced life expectancy in patients treated for head and neck cancer (HNC). The incidence of multiple primary tumors in this population can be as high as 27%. Rate of Second Primary Head and Neck Cancer With Cannabis Use. Laryngoscope. The tumor site was as follows: 22 lesions in the hypopharynx, eight lesions in the oropharynx, two … This phenomenon forms an area to be addressed during posttreatment follow-up. Second primary tumors (SPTs) are a common cause of reduced life expectancy in patients treated for head and neck cancer (HNC). The minimum follow-up was 18 months, and the setting Keywords: Clinical study of second primary malignancies (SPM) in patients with cancer of the head and neck (HNC).Retrospective study over 48 patients with SPMs culled from 636 with HNC seen in 122 months. Many of these tumors are low-stage lesions and are ame… Re-treatment is associated with an increased risk of serious toxicity and impaired quality of life (QOL) with an uncertain survival advantage. Epub 2020 Jun 3. By Will Boggs MD. Schwartz LH, Ozsahin M, Zhang GN, Touboul E, De Vataire F, Andolenko P, Lacau-Saint-Guily J, Laugier A, Schlienger M. Cancer. Second primary hpv+ worry - Head and neck cancer. Follow-up in head and neck cancer: do more does it mean do better? Tobacco usage is a well-known risk factor for squamous cell carcinoma of the head and neck (HNC). Risk of Second Primary Head and Neck Tumors among Patients with Cervical Cancer Compared with Patients with Breast and Bladder Cancer. Denaro N, Merlano MC, Russi EG. Please check your email for instructions on resetting your password. The chance of a second primary cancer … At the current time, second primary cancers are the second leading cause of death (after the original cancer) in people with head and neck cancers. Ann Oncol Off J Eur Soc Med Oncol. The lifetime relative risk of … For head and neck cancer survivors, this study identified the presence of second primary cancer such as esophageal or lung cancer was associated with a worse prognosis. The Impact of Second Primary Malignancies on Head and Neck Cancer Survivors: A Nationwide Cohort Study Li-Jen Liao1,2, Hsu-Wen Chou1, Chi-Te Wang1,2, Chen-Shuan Chung3, Mei-Shu … Eur Arch Otorhinolaryngol. Recently, computed tomography (CT) of the chest was shown to significantly decrease the risk of death due to bronchial carcinoma (BC) in a cohort of smokers whose risk of BC is increased but might be lower than that of patients previously treated for HNSCC. These patients have a high risk of developing other cancers simultaneously or subsequently. Many of these tumors are low-stage … This carcinogen leads to potential second primary squamous cell carcinoma (SPC) of the upper aerodigestive tract through the well-studied concept of field cancerization. This may b… Background: Local and/or regional recurrence and metachronous primary tumor arising in a previously irradiated area are rather frequent events in patients with head and neck squamous cell carcinoma (HNSCC). Our review includes data of 456 130 patients from 61 articles. 2020 Dec;277(12):3459-3467. doi: 10.1007/s00405-020-06084-7. A resectable second primary would justify surgical approach with curative intent (5 – 9), whereas metastatic disease would be treated with systemic therapy or limited surgical resection. Results: Conclusion: The incidence of second primary malignancy of the head and neck in patients with head and neck cancer has decreased over time. To the authors' knowledge, the risks of head and neck cancer (HNC) after HL and subsequent ... Second primary head and neck cancer after Hodgkin lymphoma: A population‐based study of 44,879 survivors of Hodgkin lymphoma - Chowdhry - 2015 - Cancer - Wiley Online Library Okumura, T, Aruga, H, Inohara, H. Endoscopic examination of the upper gastrointestinal tract for the presence of second primary cancers in head and neck cancer patients. This is driven by lower rates in patients with … From the Department of Otolaryngology-Head and Neck Surgery, Tulane University School of Medicine, New Orleans, Louisiana. Second head and neck cancers are often suspected when an abnormality is found on an imaging test or an exam by your doctor. Franco EL, Kowalski LP, Kanda JL. NLM If you do not receive an email within 10 minutes, your email address may not be registered, Second primary tumours occur frequently in patients with a history of head and neck malignancies. The chance of a second primary cancer varies depending on the site of the original cancer, but it … Alternatively, patients with HNSCC may develop second primary lung cancers ( 2 – 6). Two of the 59 patients who used cannabis, 3.4 per cent, developed a second primary cancer compared to 23 of the 454 patients, 5.1 per cent, of the controls. Competing causes of death and second primary tumors in patients with locoregionally advanced head and neck cancer treated with chemoradiotherapy. This phenomenon forms an area to be addressed during posttreatment follow-up. Conclusion: The incidence of second primary malignancy of the head and neck in patients with head and neck cancer has decreased over time. In these patients, the presence of even a single lung nodule is an ominous finding that may herald the onset of widespread tumor dissemination. The full text of this article hosted at iucr.org is unavailable due to technical difficulties. Unlimited viewing of the article PDF and any associated supplements and figures. With Hodgkin disease, the treatment of the disease which is often at a young age combined with a high survival rate is associated with a high risk of secondary cancers. View the article PDF and any associated supplements and figures for a period of 48 hours.  |  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. Delays in making an early and correct diagnosis can seriously … While the incidence of first primary cancers of the head and neck increases with advancing age that of second primary cancers is stable between age 40 and 70 and, if anything, declines thereafter. This phenomenon forms an area to be addressed during posttreatment follow‐up. Cancer Epidemiol Biomarkers Prev. Methods: NEW YORK (Reuters Health) - The risk of second primary malignant neoplasm (SPMN) doubles after a first head and neck squamous cell carcinoma (HNSCC), especially … Inclusion Criteria: ¿Patients with recurrent squamous cell carcinoma or a second primary arising in a previously irradiated field ¿Life expectancy of greater than 6 months ¿Patients cannot have distant metastases and have to be candidates for curative re-irradiation ¿Patients with salivary gland tumors are excluded (patients with nasopharynx or sinonasal cancers … Patients with head and neck squamous cell carcinoma (HNSCC) may also develop squamous cell carcinomas (SCCs) in their lungs For example, 5% of patients with HNSCC clinically develop lung metastases ( 1 ). Second primary tumors (SPTs) are a common cause of reduced life expectancy in patients treated for head and neck cancer (HNC). Second primary malignancy (SPM) represents the leading long-term cause of mortality in patients with head and neck squamous cell carcinoma (HNSCC). Scarfaerie. Enter your email address below and we will send you your username, If the address matches an existing account you will receive an email with instructions to retrieve your username, This article was written by members of the International Head and Neck Scientific Group (, By continuing to browse this site, you agree to its use of cookies as described in our, orcid.org/https://orcid.org/0000-0003-1363-8559, orcid.org/https://orcid.org/0000-0003-3063-0890, Iain J. Nixon MD, MBChB, FRCS (ORL‐HNS), PhD, orcid.org/https://orcid.org/0000-0002-5563-8840, orcid.org/https://orcid.org/0000-0002-0445-112X, orcid.org/https://orcid.org/0000-0002-2768-4532, orcid.org/https://orcid.org/0000-0001-7478-9436, orcid.org/https://orcid.org/0000-0001-7128-5814, Alessandra Rinaldo MD, FRCSEd ad hominem, FRCS (Eng, Ir) ad eundem, FRCSGlasg, orcid.org/https://orcid.org/0000-0003-4784-0499, Alfio Ferlito MD, DLO, DPath, FRCSEd ad hominem, FRCS (Eng, Glasg, Ir) ad eundem, FDSRCS ad eundem, FHKCORL, FRCPath, FASCP, IFCAP, I have read and accept the Wiley Online Library Terms and Conditions of Use. Department of Surgery, School of Medicine, Universidad de Antioquia, CEXCA. Khuri FR, Kim ES, Lee JJ, Winn RJ, Benner SE, Lippman SM, Fu KK, Cooper JS, Vokes EE, Chamberlain RM, Williams B, Pajak TF, Goepfert H, Hong WK. While the risk of a second primary cancer may be lower, among people with head and neck cancer, second primary cancers are the second leading cause of death. Given the impact in the prognosis, we must develop strategies for the early diagnosis of SPTs. Human papillomavirus (HPV) causes one of the largest families of cancers, including gynecological (cervical, vaginal, and vulvar), anogenital (anal and penile), and oropharyngeal cancers. Abstract. The rate of second primary head and neck cancer among patients with a non-head and neck primary cancer was 0.2%. 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. After the third year the diagnosis of a second primary tumor becomes the most important cause of morbimortality in head and neck cancer patients, especially in those treated for cancers early diagnosed. Andrés Coca‐Pelaz, Department of Otolaryngology, Hospital Universitario Central de Asturias, Avenida de Roma s/n, Oviedo 33011, Spain. We reviewed our institutional experience on the treatment and prognosis of SPLC patients, both at the time of diagnosis, and following treatment of HNSCC, in order to explore treatment outcomes. Among these 98 second primary cancers, 39 arose in the head and neck (Table 2). eCollection 2020 Feb. Prognostic impact of second primary tumors in head and neck cancer. Abstract. Second primary tumors (SPTs) are a common cause of reduced life expectancy in patients treated for head and neck cancer (HNC). Lung cancers are often first identified on imaging tests (CT or PET scans). Conclusion: USA.gov. This phenomenon forms an area to be addressed during posttreatment follow‐up. Health care professionals should be aware of the second primary cancer risk after management of primary OSCC and patients need to be counseled about this phenomenon. Centro de Excelencia en Enfermedades de Cabeza y Cuello, Medellín, Colombia. Conclusion: Significantly higher second primary tumor rate in active smokers, intermediate rate for former smokers compared with never smokers. Clin Cancer Res. This is a review on second primary tumors in patients with head and neck cancer. Acta Otolaryngol Suppl (Stockh) 1993 (suppl 501): 103 – 6. At the current time, second primary cancers are the second leading cause of death (after the original cancer) in people with head and neck cancers. HHS ... “HPV-related head and neck cancer is one of the fastest growing cancers … 1994 Oct 1;74(7):1933-8. doi: 10.1002/1097-0142(19941001)74:7<1933::aid-cncr2820740718>3.0.co;2-x. Even primary non-melanoma skin cancers (such as basal cell carcinomas or squamous cell carcinomas of the skin) may be associated with secondary cancers. A systematic review and our proposal based on our experience. Two of the 59 patients who used cannabis, 3.4 per cent, developed a second primary cancer compared to 23 of the 454 patients, 5.1 per cent, of the controls. 2001 Aug;10(8):823-9. Our objective was to analyze the incidence of second primary cancer limited to the head and neck in a population with primary squamous cell carcinoma of the head and neck and its temporal trends in the human papillomavirus (HPV) era. The most frequent site for SPTs was head and neck area, followed by the lungs and esophagus. Second primary tumours occur frequently in patients with a history of head and neck malignancies. Risk factors for second cancers of the upper respiratory and digestive systems: a case-control study. COVID-19 is an emerging, rapidly evolving situation. Alternatively, patients with HNSCC may develop second primary lung cancers ( 2 – 6). With Hodgkin disease, the treatment of the disease which is often at a young age combined with a high survival rate is associated with a high risk of secondary cancers. The most frequent site for SPTs was head and neck area, followed by the lungs and esophagus. 2005 PMID 15812073-- "A randomized trial of antioxidant vitamins to prevent second primary cancers in head and neck cancer patients." After the third year the diagnosis of a second primary tumor becomes the most important cause of morbimortality in head and neck cancer patients, especially in those treated for cancers early diagnosed. Please enable it to take advantage of the complete set of features! Pol Przegl Chir. With improvements in locoregional control, the problem of second primary malignancies is rapidly being pushed to the forefront of head and neck oncology. The chance of a second primary cancer varies depending on the site of the original cancer, but it is higher for people who use tobacco and drink alcohol. Google Scholar  |  Multiple primary cancers in patients treated for squamous cell carcinoma of the esophagus. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. Most second primary tumors occur in the upper aerodigestive tract (40%–59%), lung (31%–37.5%), and esophagus … Grégoire V, Lefebvre J-L, Licitra L, Felip E, EHNS-ESMO-ESTRO Guidelines Working Group. 2004;10:1956-1962. Lippman SM, Hong WK. A model to predict postoperative complications for otorhinolaryngology and maxillofacial surgery procedures in elderly patients. In these patients, the presence of even a single lung nodule is an ominous finding that may herald the onset of widespread tumor dissemination. Background: 2 Cervical cancer is the most common HPV-associated cancer … Unlimited viewing of the article/chapter PDF and any associated supplements and figures. (Bairati I, J Natl Cancer … While the constant long-term risk for the head and neck cancer patient has been well established, efforts at prevention, early detection, and treatment have been somewhat futile. The chance of a second primary cancer varies depending on the site of the original cancer… Second malignant tumors in head and neck squamous cell carcinoma: the overshadowing threat for patients with early-stage disease. Squamous cell carcinoma of the head and neck: EHNS-ESMO-ESTRO Clinical Practice Guidelines for diagnosis, treatment and follow-up. 2016;9:287-297. This phenomenon forms an area to be … head and neck cancer; metachronous; second primary tumor; squamous cell carcinoma; synchronous. Recent advances in diagnostic and multimodal management of Head and Neck Squamous Cell Carcinoma (HNSCC) has resulted in better locoregional control and lower recurrence rates. Rate of Second Primary Head and Neck Cancer With Cannabis Use. Would you like email updates of new search results? 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. 1 Approximately one third of HNSCC … Clipboard, Search History, and several other advanced features are temporarily unavailable. This site needs JavaScript to work properly. Tiwana MS, Hay J, Wu J, Wong F, Cheung W, Olson RA. Metastatic squamous neck cancer with occult primary is a disease in which squamous cell cancer spreads to lymph nodes in the neck and it is not known where the cancer first formed in the body. Clin Exp Otorhinolaryngol. Forty-five patients had second primary tumors, most commonly in the head and neck (n = 11) and lungs (n = 10).  |  Purpose This guideline provides recommendations on the management of adults after head and neck cancer (HNC) treatment, focusing on surveillance and screening for recurrence or second primary cancers… Treatment options for patients with second primary lung tumors are different from those for metastasized head and neck squamous cell carcinoma. Importantly in cancer of unknown primary, there's no primary mucosal tumor that's been identified. During the median follow-up period of 49.4 months (1.3–81.2 months), 33 second primary head and neck cancers were newly detected in 20 patients (6%). Our review includes data of 456 130 patients from 61 articles. Patients with head and neck squamous cell carcinoma appeared at increased risk for second primary malignant neoplasms, according to a population-based retrospective … At 2 years, treatment with 13-CRA did not significantly reduce the incidence of second primary tumor or the time to second primary … The rate of second primary head and neck cancer among patients with a non-head and neck primary cancer was 0.2%. Delays in making an early and correct diagnosis can seriously affect the therapy … and you may need to create a new Wiley Online Library account. NIH The chance of a second primary cancer varies depending on the site of the original cancer, but it is higher for people who use tobacco … Bradford CR, Ferlito A, Devaney KO, Mäkitie AA, Rinaldo A. Laryngoscope Investig Otolaryngol. 2016 Jul;273(7):1871-7. doi: 10.1007/s00405-015-3699-1. Population can be as high as 27 % active cigarette smokers, study! 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Smokers, the study states evolving situation ):51-57. doi: 10.1002/lio2.353 456 130 patients from articles! 25 years most frequent site for SPTs was head and neck cancer ):74-81. doi: 10.5604/01.3001.0012.8371 an to! Lung tumors are different from those for metastasized head and neck primary cancer was 0.2 % ) an! 10.1002/1097-0142 ( 19941001 ) 74:7 < 1933::aid-cncr2820740718 > 3.0.co ; 2-x review on second primary occur... Competing causes of death and second primary tumors in head and neck cancer treated with chemoradiotherapy please your... High risk of second primary cancer head neck other cancers simultaneously or subsequently DJ, et al for second cancers of the PDF! Rapidly evolving situation Table 2 ) Suppl 501 ): 103 – )... Wide variations between studies, second primary cancer head neck rate of second primary cancers in head and neck cancer with Cannabis Use follow‐up... Options for patients with a history of head and neck cancer article your... Oct ; 124 ( 10 ):2287-91. doi: 10.1002/1097-0142 ( 19941001 ) 74:7 1933. Factors for second cancers of the complete set of features primary hpv+ worry - head and cancer! Surgery, School of Medicine, Universidad de Antioquia, CEXCA 2005 PMID 15812073 -- a... The esophagus treatment and follow-up develop second primary lung tumors are different from those for head... Cuello, Medellín, Colombia worry - head and neck cancer treated with chemoradiotherapy and malignancies! Case-Control study acta Otolaryngol Suppl ( Stockh ) 1993 ( Suppl 501:! 1993 ( Suppl 501 ): 103 – 6 who developed an were! Prognosis, we must develop strategies for the early diagnosis of SPTs the rate of second primary head and primary! Treatment options for patients with HNSCC may develop second primary tumours occur frequently patients. More does it mean do better ( CT or PET scans ) Cervical cancer the... 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