Risk Factors for Multiple Malignancies in Head and Neck

Abstract

Objective: Our aim was to assess the prognostic role of several epidemiological, clinical andbiological factors, related to a higher risk for multiple malignancies in head and neck cancer (HNC) patients.

Method: In 76 consecutive patients treated with curative radiotherapy, p53 gene status, microsatellite instability (MSI) of the index tumor, and inherited chromosome fragility (CF), with epidemiological and clinical characters, were analyzed and correlated with the risk for second primary tumor (SPT). The follow-up was 77 months in mean (2-180 months).

Results: SPT was observed in 22 patients (28.9%). p53 mutation was detected in 36 (47.3%) out of 76 first primary HNC analyzed. MSI was documented in the first primary HNC from 22 out of 63 (34.9%). Susceptibility to bleomycin-induced chromatid breaks (CF+) was found in 26 out of 54 (48.1%). Statistical analysis suggests that MSI, CF and smoking persistence after index tumor treatment were significantly correlated with an increased risk of developing multiple malignancies (P = .05, P < .01 and P = .02).

Conclusion: A genetic susceptibility to DNA damage may play a central role in development of multiple malignancies in HNC patients. Testing for MSI phenotype and CF at the time of the original cancer diagnosis could identify high risk patients.