顎口腔領域における多重癌の臨床的研究

DOI 被引用文献9件 参考文献29件
  • 田中 彰
    日本歯科大学新潟歯学部口腔外科学教室第二講座

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  • Clinical study of multiple primary cancers in the oral and maxillofacial region.

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A trend toward an increased incidence of multiple primary cancers has been reported. This report is consistent with this trend and describes the results of an investigation of patients registered at our hospital. Seventy-two patients with multiple primary cancers (7.8% incidence) were identified among 927 patients with oral and maxillofacial cancers from January 1975 through December 1992.<BR>In the former period (1975 to 1983) and the latter period (1984 to 1992), multiple primary cancers accounted for 5.4% and 10.2% of all oral and maxillofacial cancers, respectively. As for tumor site, the socalled multicentric zone, which includes the oral cavity, pharynx, larynx, esophagus, and lung, accounted for 68.3%. Among 20 cases of synchronous occurrence, 9 subsequent cancers were detected in an early stage. However, among 26 cases of metachronous occurrence, 16 cases were in an advanced stage.<BR>Smoking tobacco, alcohol intake, and familial history were also investigated as risk factors for malignancy. A family history was present in 23 patients (31.9%), a smoking history in 47 patients (65.3%), and a drinking history in 37 patients (51.4%). The degrees of smoking and drinking were evaluated on the basis of Brinkman index and Sake index respectively. The mean Brinkman in the 72 patients was 486.7, and the Sake index was 56.4. The mean average of Brinkman index in the smokers was 745.5, and the Sake index was 109.7. A high Brinkman index score was related to cancers of the oral floor and, soft palate, and a high Sake index score to cancers of the soft palate and esophagus.<BR>Histologically, the incidence of squamous cell carcinoma was 65.2%, and coincident squamous cell carcinomas were found in 31 patients (43.1%).

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