De novo head and neck carcinoma in transplant recipients: preliminary results of management.

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.