De Novo Head and Neck Carcinoma in Transplant Recipients: Preliminary Results of Management

Ampil, Federico L.; Ghali, Ghali E.; Munker, Reinhold; Kim, David D.

doi:10.1016/j.joms.2006.03.014

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Volume 64, Issue 7 , Pages 1081-1085, July 2006

De Novo Head and Neck Carcinoma in Transplant Recipients: Preliminary Results of Management

Federico L. Ampil, MD
- Professor, Department of Radiology, Louisiana State University Health Sciences Center, Shreveport, LA
- Address correspondence and reprint requests to Dr Ampil: Division of Therapeutic Radiology, Louisiana State University Health Sciences Center, 1501 Kings Highway, Shreveport, LA 71130
Ghali E. Ghali, MD, DDS
- Professor, Department of Oral and Maxillofacial–Head and Neck Surgery, Louisiana State University Health Sciences Center, Shreveport, LA
Reinhold Munker, MD
- Associate Professor, Department of Medicine, Louisiana State University Health Sciences Center, Shreveport, LA
David D. Kim, MD, DMD
- Associate Professor, Department of Oral and Maxillofacial–Head and Neck Surgery, Louisiana State University Health Sciences Center, Shreveport, LA

Purpose

To evaluate the stage-based definitive management approach of de novo head and neck cancer (HNC) developing in immunocompromised transplant recipients.

Patients and Methods

A retrospective analysis was performed on 5 patients with HNC who had previously received an organ or bone marrow transplant. Surgery, radiotherapy, and chemotherapy (alone or in combination) were the employed therapeutic methods for stage I to IV HNC.

Results

At diagnosis of HNC, the average patient age was 60 years. The average interval between transplantation and the appearance of HNC was 5 years. In addition to immunosuppressive therapy, 4 patients had another risk factor for HNC development—long history of smoking; also, another person was treated by total body irradiation. With appropriate management that included local treatment for early-stage disease and bimodal therapy in cases of locally advanced neoplasms, all patients (4 being tumor-free) were alive at 6 to 38 months’ follow-up.

Conclusion

Although longer follow-up information is needed, we contend that judicious stage-based management of HNC in transplant recipients is associated with outcomes not necessarily different from patients who are not immunosuppressed.