Risk Factors for Multiple Malignancies in Head and Neck

Objective. To define the prognostic role of multiple epidemiological, clinical, and biological factors for the development of multiple malignancies (MM) in patients with head and neck cancer (HNC). Study Design. Historical cohort study. p53 gene status, microsatellite instability (MSI) of the index tumor, and inherited chromosome fragility (CF) were studied. Setting. Ninety-six consecutive patients affected by primary HNC, between January 1987 and October 1991, who were eligible for curative radiation therapy were followed up. Subjects and Methods. p53 gene status, MSI, and CF in 96 curative radiotherapy-treated patients were correlated with the risk for MM. Results. Multiple malignancies occurred in 28.9%. Microsatellite instability (P = 0.05), CF (P 0.01), and smoking after treatment of the index tumor (P = 0.02) were correlated with an increased risk of MM. Conclusion. Genetic susceptibility may play a central role for MM development in patients with HNC.