Intended for healthcare professionals


Recurrence of malignant tumours in the head and neck

BMJ 1996; 313 doi: (Published 21 September 1996) Cite this as: BMJ 1996;313:700
  1. G R Ogden, Senior lecturer in oral surgery Dental Surgery and Periodontology
  1. Dental School, University of Dundee, Dundee DD1 4HR

    Field cancerisation may hold the clue to who will develop another cancer

    One of the greatest challenges in the treatment of cancers in the head and neck is the occurrence of further tumours.1 World wide, cancer of the head and neck is the sixth most common cancer, and its prevalence is increasing.2 Despite therapeutic advances over the past 20 years, survival rates remain poor.3 Why?

    As treatment of local disease has improved, so the opportunity has arisen for further tumours to develop, which adversely affect survival. In 1953 Slaughter et al first proposed the concept of field cancerisation, based on finding satellites of dysplastic epithelium adjacent to the main lesion.4 Such a concept helps to explain why multiple primary cancers and recurrence can occur, particularly in patients who stop smoking and drinking alcohol. Although alcohol and tobacco are the most important aetiological factors, second malignant tumours can arise in those who have never drunk …

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