[The effectiveness of follow-up care in tumour patients in the early detection of metachronous second primary tumours after curative treatment of carcinoma of the upper aerodigestive tract].

The effectiveness of screening for metachronous second primary tumours by routine follow-up after curative treatment of carcinoma of the upper aerodigestive tract (UADT) was investigated. Data relating to epidemiology, treatment, follow-up (8,014 consultations), and survival from 819 previously untreated patients were analysed to identify risk factors for second primary tumours and to evaluate their impact on survival. During the follow-up period (median 45.2 months), 10.7% of the patients developed a second carcinoma. The annual incidence, which depended on the localisation of the index tumour, was 1.6% for glottic, 3.0% for oropharyngeal, 3.4% for oral cavity, 3.6% for supraglottic, and 4.6% for hypopharyngeal carcinoma. Male sex and the site of the index tumour were identified as relevant prognostic factors for the time to occurrence of a second carcinoma. Radiotherapy as part of initial treatment was associated with a decreased risk for second tumour. Second primary tumour-specific survival was influenced by age, treatment of the index carcinoma, site and stage of the second carcinoma. Patients with curatively treated UADT cancer should have a long-term follow-up with an annual otolaryngologic examination to screen for second primary tumours. More intensive follow-up strategies do not appear to be beneficial.