ABSTRACT
Malignancies of the head and neck are not uncommon in the Far East due to the habit of betel-nut chewing. The development of a second primary neoplasm is a constant fear for those who have had successful treatment of a primary cancer. A total of 82 patients, treated with microvascular reconstruction after surgical resection of head and neck cancer, were studied retrospectively. Twenty-one patients who had repeated reconstructive microsurgery for a second primary head and neck malignancy were enrolled as the study group. Sixty-one patients treated for the first-diagnosed malignancy were considered as the control group. There were no statistical differences between the two groups, either in terms of operation time, hospital stay, successful rate, or complication rate. The results show that, if required, one should not hesitate to repeat the free-tissue transfer after ablating a second primary neoplasm.
KEYWORDS
Head and neck cancer - second primary tumor - microvascular reconstruction
REFERENCES
-
1
Cooper J S, Pajak T F, Rubin P et al..
Second malignancies in patients who have head and neck cancer: incidence, effect on survival and implications based on the RTOG experience.
Int J Radiat Oncol Biol Phys.
1989;
17
449-456
-
2
Eckardt A.
Clinical impact of synchronous and metachronous malignancies in patients with oral cancer.
Int J Oral Maxillofac Surg.
1993;
22
282-284
-
3
Sturgis E M, Miller R H.
Second primary malignancies in the head and neck cancer patient.
Ann Otol Rhinol Laryngol.
1995;
104
946-954
-
4
Leon X, Quer M, Diez S, Orus C, Lopez-Pousa A, Burgues J.
Second neoplasm in patients with head and neck cancer.
Head Neck.
1999;
21
204-210
-
5
Leon X, Ferlito A, Myer 3rd C M et al..
Second primary tumors in head and neck cancer patients.
Acta Otolaryngol.
2002;
122
765-778
-
6
Dhooge I J, De Vos M, Van Cauwenberge P B.
Multiple primary malignant tumors in patients with head and neck cancer: results of a prospective study and future perspectives.
Laryngoscope.
1998;
108
250-256
-
7
Slootweg P J, Hordijk G J, Koole R.
Autopsy findings in patients with head and neck squamous cell cancer and their therapeutic relevance.
Eur J Cancer.
1996;
Part B
413-415
-
8
Khuri F R, Lippman S M, Spitz M R, Lotan R, Hong W K.
Molecular epidemiology and retinoid chemoprevention of head and neck cancer.
J Natl Cancer Inst.
1997;
89
199-211
-
9
Slaughter D P, Southwick H W, Smejkal W.
“Field cancerization” in oral stratified squamous epithelium.
Cancer.
1953;
6
963-968
-
10
Lydiatt W M, Anderson P E, Bazzana T et al..
Molecular support for field cancerization in the head and neck.
Cancer.
1998;
82
1376-1380
-
11
Shin D M, Lee J S, Lippman S M et al..
P53 expressions: predicting recurrence and second primary tumors in head and neck squamous cell carcinoma.
J Natl Cancer Inst.
1996;
88
519-529
-
12
Nogueira C P, Dolan R W, Gooey J et al..
Inactivation of p53 and amplification of cyclin D1 correlate with clinical outcome in head and neck cancer.
Laryngoscope.
1998;
108
345-350
-
13
Gallo O, Sardi I, Pepe G et al..
Multiple primary tumors of the upper aerodigestive tract: is there a role for constitutional mutations in the p53 gene?.
Int J Cancer.
1999;
82
180-186
-
14
Hong W K, Lippman S M, Itri L M et al..
Prevention of second primary tumors with isotretinoin in squamous-cell carcinoma of the head and neck.
N Engl J Med.
1990;
323
795-801
-
15
Warren S, Gates O.
Multiple primary malignant tumors: a survey of the literature and a statistical study.
Am J Cancer.
1932;
16
1358-1414
-
16
Sun T B, Lee J T, Chien S H.
Surgical reconstruction for buccal cancer in eastern Taiwan.
Tzu Chi Med J.
1999;
11
131-138
-
17
Sun T B, Hsu L P, Chen P R.
The “Sun window”-simple and effective alternative to the use of contrast background material during microvascular anastomosis.
J Reconstr Microsurg.
2003;
19
567-569
-
18
Sun T B, Chien S H, Lee J T, Cheng L F, Hsu L P, Chen P R.
Is dextran infusion as an antithrombotic agent necessary in microvascular reconstruction of the upper aerodigestive tract?.
J Reconstr Microsurg.
2003;
19
463-466
-
19
Sun T B, Chien S H, Hsu L P et al..
Using the cephalic vein transposition as a recipient venous drainage for difficult head and neck reconstructions.
J Plast Surg Asso ROC.
2003;
12
247-253
-
20
Wei F C, Demirkan F, Chen H C, Chen I H, Liao C T, Hau S P.
Management of secondary soft-tissue deficits following microsurgical head and neck reconstruction by means of another free flap.
Plast Reconstr Surg.
1999;
103
1158-1166
-
21
Neligan P C, Mulholland S, Irish J et al..
Flap selection in cranial base reconstruction.
Plast Reconstr Surg.
1996;
98
1159-1168
-
22
Talesnik A, Markowitz B, Calcaterra T, Ahn C, Shaw W.
Cost and outcome of osteocutaneous free-tissue transfer versus pedicled soft-tissue reconstruction for composite mandibular defects.
Plast Reconstr Surg.
1996;
97
1167-1178
-
23
Stern J R, Keller A J, Wenig B L.
Evaluation of reconstructive techniques of oropharyngeal defects.
Ann Plast Surg.
1989;
22
332-336
-
24
Jones T R, Jones N F.
Advances in reconstruction of the upper aerodigestive tract and cranial base with free tissue transfer.
Clin Plast Surg.
1992;
19
819-831
-
25
Shestak K C, Jones N F.
Microsurgical free-tissue transfer in the elderly patient.
Plast Reconstr Surg.
1991;
88
259-263
-
26
Rosen I B, Bell M S, Barron P T, Zuker R M, Manktelow R T.
Use of microvascular flaps including free osteocutaneous flaps in reconstruction after composite resection for radiation-recurrent oral cancer.
Am J Surg.
1979;
138
544-549
-
27
Mulholland S, Boyd J B, McCabe S et al..
Recipient vessels in head and neck microsurgery: radiation effect and vessel access.
Plast Reconstr Surg.
1993;
92
628-632
-
28
Boyd J B, Morris S, Rosen I B, Gullane P, Rotstein L, Freeman J L.
The through-and-through oromandibular defect: rationale for aggressive reconstruction.
Plast Reconstr Surg.
1994;
93
44-53
-
29
Demirkan F, Wei F C, Chen H C, Chen I H, Hau S P, Liau C T.
Microsurgical reconstruction in recurrent oral cancer: use of a second free flap in the same patient.
Plast Reconstr Surg.
1999;
103
829-838
-
30
Sisson G A.
The philosophy underlying the treatment of recurrent cancer of the head and neck.
Otolaryngol Clin N Am.
1974;
7
153-161
-
31
Pickford M A, Soutar D S.
Intraoral reconstruction using a second free flap for recurrent or metachronous carcinoma.
Br J Plastic Surgery.
1995;
48
559-563
Tzong-Bor SunM.D. Ph.D.
Division of Plastic Surgery and Center for Hyperbaric Oxygen Therapy, Buddhist Tzu Chi General Hospital
707, Sec. 3, Chung-Yang Road, Hualien 970, Taiwan
