Skip to main content

Advertisement

SpringerLink
Log in

Second primary squamous cell carcinoma of the oral cavity – a retrospective cohort study of therapeutic procedures and oncological outcome

  • RESEARCH
  • Published:
Clinical Oral Investigations Aims and scope Submit manuscript

A Correction to this article was published on 23 April 2024

This article has been updated

Abstract

Objectives

In the presented study, the occurrence rates of second primary oral carcinomas and their prognostic relevance were analyzed.

Materials and methods

All patients with surgically treated oral squamous cell carcinomas within the years 2010 and 2022 in our department were included in this retrospective cohort study. Two groups were designed including patients with second primary carcinomas and patients with local tumor recurrences. Occurrence rates, tumor stages and applied therapies were assessed. Primary outcome was overall survival in dependence of the index tumor. Secondary outcomes were overall survival in dependence of local recurrences or second primary tumors.

Results

An overall number of 908 patients was included in the analysis. 98 patients (10.8%) developed a second primary oral squamous cell carcinoma. Patients with second primary tumors presented significantly (p < 0.001) better overall survival in dependence of the index tumor compared to patients suffering from local recurrences. There was no significant difference in overall survival (p = 0.4) in dependence of the date of second primary tumor or local recurrence. Patients with second primary tumors were more likely to receive surgery-based therapy compared to patients with local recurrences who more frequently received definitive radiotherapy.

Conclusion

Our data indicates different clinical courses in terms of therapy and survival of patients suffering from second primary tumors compared to patients with local tumor recurrences. This may be due to a more aggressive biology of local recurrences and earlier detection of second primaries due to oncological follow-up of the index tumor.

Clinical relevance

The differentiation of local tumor recurrences and second primary tumors is of clinical relevance, as applicable therapies and resulting prognosis may differ significantly.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

Data availability

No datasets were generated or analysed during the current study.

Change history

References

  1. Siegel RL et al (2021) Cancer Statistics, CA Cancer J Clin, 2021. 71(1): p. 7–33

  2. Shield KD et al (2017) The global incidence of lip, oral cavity, and pharyngeal cancers by subsite in 2012. CA Cancer J Clin 67(1):51–64

    Article  PubMed  Google Scholar 

  3. Ferlay J et al (2015) Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 136(5):E359–E386

    Article  CAS  PubMed  Google Scholar 

  4. Nokovitch L et al (2023) Oral cavity squamous cell carcinoma risk factors: state of the art. J Clin Med, 12(9)

  5. Slaughter DP, Southwick HW, Smejkal W (1953) Field cancerization in oral stratified squamous epithelium; clinical implications of multicentric origin. Cancer 6(5):963–968

    Article  CAS  PubMed  Google Scholar 

  6. Cooper JS et al (2004) Postoperative concurrent radiotherapy and chemotherapy for high-risk squamous-cell carcinoma of the head and neck. N Engl J Med 350(19):1937–1944

    Article  PubMed  Google Scholar 

  7. Moratin J et al (2020) The prognostic significance of the lymph node ratio in oral cancer differs for anatomical subsites. Int J Oral Maxillofac Surg 49(5):558–563

    Article  CAS  PubMed  Google Scholar 

  8. Ferris RL et al (2016) Nivolumab for Recurrent Squamous-Cell Carcinoma of the Head and Neck. N Engl J Med 375(19):1856–1867

    Article  PubMed  PubMed Central  Google Scholar 

  9. Burtness B et al (2019) Pembrolizumab alone or with chemotherapy versus cetuximab with chemotherapy for recurrent or metastatic squamous cell carcinoma of the head and neck (KEYNOTE-048): a randomised, open-label, phase 3 study. Lancet 394(10212):1915–1928

    Article  CAS  PubMed  Google Scholar 

  10. Horn D et al (2020) Prospective feasibility analysis of salvage surgery in recurrent oral cancer in terms of quality of life. Oral Oncol 102:104580

    Article  PubMed  Google Scholar 

  11. Zittel S et al (2022) Clinical outcome and prognostic factors in recurrent oral squamous cell carcinoma after primary surgical treatment: a retrospective study. Clin Oral Investig 26(2):2055–2064

    Article  PubMed  Google Scholar 

  12. Suton P et al (2018) Outcomes for patients with second primary malignancy after primary surgical treatment for early-stage squamous cell carcinoma of the oral cavity. Head Neck 40(11):2347–2352

    Article  PubMed  Google Scholar 

  13. van der Waal I, de Bree R (2010) Second primary tumours in oral cancer. Oral Oncol 46(6):426–428

    Article  PubMed  Google Scholar 

  14. Rennemo E, Zatterstrom U, Boysen M (2010) Outcome of local failures after oral cancer - recurrence vs. second primary. J Oral Pathol Med 39(9):657–661

    Article  PubMed  Google Scholar 

  15. Rogers SN et al (2019) Incidence, timing, presentation, treatment, and outcomes of second primary head and neck squamous cell carcinoma after oral cancer. Br J Oral Maxillofac Surg 57(10):1074–1080

    Article  CAS  PubMed  Google Scholar 

  16. de Vries N, Van der Waal I, Snow GB (1986) Multiple primary tumours in oral cancer. Int J Oral Maxillofac Surg 15(1):85–87

    Article  PubMed  Google Scholar 

  17. Warren SJAJc (1932) Multiple primary malignant tumors: a survey of the literature and statistical study. 51:1358–1403

  18. Mroueh R et al (2020) Risk of second primary cancer in oral squamous cell carcinoma. Head Neck 42(8):1848–1858

    Article  PubMed  Google Scholar 

  19. Min SK et al (2019) Second primary cancers in patients with oral cavity cancer included in the Korea Central Cancer Registry. Oral Oncol 95:16–28

    Article  PubMed  Google Scholar 

  20. Cuschieri S (2019) The STROBE guidelines. Saudi J Anaesth 13(Suppl 1):S31–s34

    Article  PubMed  PubMed Central  Google Scholar 

  21. Tiwana MS et al (2014) Incidence of second metachronous head and neck cancers: population-based outcomes over 25 years. Laryngoscope 124(10):2287–2291

    Article  PubMed  Google Scholar 

  22. Kaur P et al (2016) A retrospective evaluation of Clinical Profile of Second Primary Head and Neck Cancer. J Clin Diagn Res 10(10):XC10–XC14

    PubMed  Google Scholar 

  23. Brands MT et al (2019) Time patterns of recurrence and second primary tumors in a large cohort of patients treated for oral cavity cancer. Cancer Med 8(12):5810–5819

    Article  PubMed  PubMed Central  Google Scholar 

  24. Kesting MR et al (2009) Bronchoscopy screening in primary oral squamous cell carcinoma: a 10-year experience. Br J Oral Maxillofac Surg 47(4):279–283

    Article  PubMed  Google Scholar 

  25. Kesting MR et al (2009) Results of esophagogastroduodenoscopy in patients with oral squamous cell carcinoma–value of endoscopic screening: 10-year experience. J Oral Maxillofac Surg 67(8):1649–1655

    Article  PubMed  Google Scholar 

  26. Metzger K et al (2019) Is panendoscopy a necessary staging procedure in patients with lacking risk factors and oral squamous cell carcinoma? J Craniomaxillofac Surg 47(12):1968–1972

    Article  PubMed  Google Scholar 

  27. Weckx A et al (2019) Time to recurrence and patient survival in recurrent oral squamous cell carcinoma. Oral Oncol 94:8–13

    Article  PubMed  Google Scholar 

  28. Sun GW et al (2009) Salvage treatment for recurrent oral squamous cell carcinoma. J Craniofac Surg 20(4):1093–1096

    Article  PubMed  Google Scholar 

  29. Mucke T et al (2009) Recurrence interval affects survival after local relapse of oral cancer. Oral Oncol 45(8):687–691

    Article  PubMed  Google Scholar 

  30. Masuda M et al (2013) Somatic evolution of head and neck cancer - biological robustness and latent vulnerability. Mol Oncol 7(1):14–28

    Article  PubMed  Google Scholar 

  31. Leemans CR, Snijders PJF, Brakenhoff RH (2018) The molecular landscape of head and neck cancer. Nat Rev Cancer 18(5):269–282

    Article  CAS  PubMed  Google Scholar 

  32. Johnson DE et al (2020) Head and neck squamous cell carcinoma. Nat Rev Dis Primers 6(1):92

    Article  PubMed  PubMed Central  Google Scholar 

  33. Horn D et al (2016) Outcome of heavily pretreated recurrent oral squamous cell carcinoma after salvage resection: a monocentric retrospective analysis. J Craniomaxillofac Surg 44(8):1061–1066

    Article  PubMed  Google Scholar 

  34. Moratin J et al (2021) Full-thickness tumor resection of oral Cancer involving the facial skin-Microsurgical Reconstruction of extensive defects after Radical Treatment of Advanced Squamous Cell Carcinoma. Cancers (Basel), 13(9).

  35. Held T et al (2020) Carbon ion reirradiation compared to intensity-modulated re-radiotherapy for recurrent head and neck cancer (CARE): a randomized controlled trial. Radiat Oncol 15(1):190

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Held T et al (2022) Ways to unravel the clinical potential of carbon ions for head and neck cancer reirradiation: dosimetric comparison and local failure pattern analysis as part of the prospective randomized CARE trial. Radiat Oncol 17(1):121

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

The presented data are part of Theresa Maas’ doctoral thesis.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Department of Oral and Cranio-Maxillofacial Surgery, University of Heidelberg, Im Neuenheimer Feld 400, D-69120, Heidelberg, Germany

    Julius Moratin, Theresa Maas, Karl Semmelmayer, Sven Zittel, Marcel Oehme, Michael Engel, Jürgen Hoffmann, Christian Freudlsperger & Oliver Ristow

  2. Department of Oral and Cranio-Maxillofacial Surgery, Saarland University Hospital, Kirrberger Straße, D-66424, Homburg, Germany

    Dominik Horn & Kolja Freier

Authors
  1. Julius Moratin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Theresa Maas
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dominik Horn
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Karl Semmelmayer
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sven Zittel
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Marcel Oehme
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Michael Engel
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Jürgen Hoffmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Christian Freudlsperger
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Kolja Freier
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Oliver Ristow
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

JM: Conceptualization, Methodology, Investigation, Formal analysis, Writing—review & editing. TM: Investigation, Formal analysis, Writing—review & editing. DH: Investigation, Formal analysis, Writing—review & editing. KS: Investigation, Formal analysis, Writing—review & editing. SZ: Investigation, Formal analysis, Writing—review & editing. MO: Investigation, Formal analysis, Writing—review & editing. ME: Investigation, Formal analysis, Writing—review & editing. JH: Investigation, Formal analysis, Writing—review & editing. CF: Investigation, Formal analysis, Writing—review & editing. OR: Conceptualization, Investigation, Formal analysis, Writing—review & editing, Supervision. All authors reviewed the manuscript.

Corresponding author

Correspondence to Julius Moratin.

Ethics declarations

Ethics approval and consent to participate

The study was approved by the Ethics Committee of the Medical Faculty of the University of Heidelberg (Ethic vote: S-183/2015). Written informed consent was provided by all included patients.

Conflict of interest

The authors declare that they have no conflict of interest.

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

The original version of this article was revised: This article was originally published with two errors occurred in the author and affiliation information of author Kolja Freier (incomplete name and wrong affiliation).

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Moratin, J., Maas, T., Horn, D. et al. Second primary squamous cell carcinoma of the oral cavity – a retrospective cohort study of therapeutic procedures and oncological outcome. Clin Oral Invest 28, 229 (2024). https://doi.org/10.1007/s00784-024-05606-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s00784-024-05606-5

Keywords

Search

Navigation