Background:
Oral cavity cancer (OCC) represents 29.5% of head and neck cancers. Development of second primary tumours (SPT) is a significant cause of morbidity in the context of increasing cancer survivorship. This study examines the occurrence of SPT and recurrence in OCC patients.
Methods:
This retrospective review included 373 OCC patients who were surgically managed. Cases were identified from an institutional database, histopathology and clinical documentation were reviewed to identify risk factors and validate the occurrence of SPT and recurrence.
Results:
SPT occurred in 24.9% (n=93) of cases, with a mean follow-up of 4.2 years. The most common H&N SPT site was the tongue (15.6%, n=7). Lung cancer was the most common non-H&N SPT (53.7%, n=29). Mean time to SPT was 4.1 years. Recurrence developed in 33.8% (n=126) of cases at an average of 2 years. Overall survival averaged 4.3 years.
86.4% of SPT cases and 9.55% of recurrences were surgically manageable. Multivariate analysis revealed higher SPT risk with heavy alcohol use (OR 2.7, p=0.04) and male sex (OR 2.9, p=0.01). Higher recurrence risk was associated with Stage IV disease (OR 3.7, p=0.004).
Conclusion:
SPT and recurrence remain major challenges for OCC survivors, emphasizing the need for ongoing clinical surveillance.