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Journal Information
Vol. 74. Issue 5.
Pages 271-276 (September - October 2023)
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Vol. 74. Issue 5.
Pages 271-276 (September - October 2023)
Original article
Is long-term screening for lung cancer justified in patients with head and neck carcinoma?
¿Está justificado hacer un screening a largo plazo para el cáncer de pulmón en los pacientes con un carcinoma de cabeza y cuello?
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Xavier Leóna,b,c,
Corresponding author
xleon@santpau.cat

Corresponding author.
, Ana Gimenezd, Julia de Juana, Camilo Rodrígueza, Miquel Quera,b, Albert Pujola
a Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
b Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
c Universitat de Vic (UVIC), Universitat Central de Catalunya, Vic, Barcelona, Spain
d Servicio de Radiodiagnóstico, Hospital de la Santa Creu i Sant Pau, Universitat Autónoma de Barcelona, Barcelona, Spain
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Tables (3)
Table 1. Characteristics of patients included in the study.
Table 2. Frequency of appearance of second pulmonary neoplasms in accordance with the characteristics of the patients included in the study.
Table 3. Multivariate study considering second pulmonary neoplasm-free survival as dependent variable.
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Abstract
Objective

Patients with head and neck squamous cell carcinoma (HNSCC) have a higher risk of second lung neoplasms than the general population. The aim of the present study is to evaluate the long-term incidence of second lung malignancies after the diagnosis of a HNSCC and to consider the convenience of the screening for lung cancer in these patients.

Material and methods

We conducted a retrospective study performed on 4954 patients with an index tumor located in the oral cavity, oropharynx, hypopharynx, or larynx during the period 1985–2017.

Results

During the follow-up period 469 patients (9.5%) presented a second pulmonary neoplasm. The incidence of second lung neoplasm was 1.26% per year and remained practically constant throughout the 25-year follow-up period analyzed. According to the results of a multivariate study, male patients, aged between 50 and 80 years, with a history of tobacco use, and with tumors located in the oropharynx or the supraglottis were those with the highest risk of second lung neoplasms.

Conclusion

Patients with a HNSCC index tumor have a high risk of second neoplasms located in the lung. In order to achieve an early diagnosis of these second neoplasms, it would be advisable to establish screening protocols based on the use of low-dose lung CT, which should be maintained indefinitely during the follow-up period.

Keywords:
Head and neck cancer
Second tumor
Lung cancer
Screening
Follow-up
Resumen
Objetivo

Los pacientes con un carcinoma escamoso de cabeza y cuello (CECC) tienen un mayor riesgo de aparición de segundas neoplasias localizadas en el pulmón que la población general. El objetivo del presente estudio es evaluar la incidencia a largo plazo de segundas neoplasias pulmonares tras el diagnóstico de un CECC y considerar la conveniencia de la realización de un cribado de cáncer de pulmón en estos pacientes.

Material y métodos

Realizamos un estudio retrospectivo en 4.954 pacientes con un tumor índice localizado en la cavidad oral, orofaringe, hipofaringe o laringe durante el periodo 1985–2017.

Resultados

Durante el periodo de seguimiento 469 pacientes (9,5%) presentaron una segunda neoplasia pulmonar. La incidencia de segunda neoplasia pulmonar fue del 1,26% anual, y se mantuvo prácticamente constante a lo largo de los 25 años de seguimiento analizados. Según los resultados de un estudio multivariante, los pacientes varones, con edades comprendidas entre los 50 y los 80 años, con antecedentes de tabaquismo y con tumores localizados en la orofaringe o en la supraglotis fueron los que presentaron un mayor riesgo de segunda neoplasia pulmonar.

Conclusiones

Los pacientes con un CECC como tumor índice tienen un alto riesgo de segundas neoplasias localizadas en el pulmón. Para conseguir un diagnóstico precoz de estas segundas neoplasias sería conveniente establecer protocolos de cribado basados en el uso de la TAC pulmonar de baja dosis, que deberían mantenerse indefinidamente durante el periodo de seguimiento.

Palabras clave:
Cáncer de cabeza y cuello
Segunda neoplasia
Cáncer de pulmón
Cribado
Seguimiento

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