Distinct Features of Second Primary Malignancies in Head and Neck Cancer Patients in Japan
Distinct Features of Second Primary Malignancies in Head and Neck Cancer Patients in Japan
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DOI：
10.1620/tjem.225.5
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发表时间：
2011-09-01
影响因子：
2.2
通讯作者：
Kobayashi, Toshimitsu
中科院分区：
文献类型：
--
作者：
Shiga, Kiyoto;Tateda, Masaru;Kobayashi, Toshimitsu
第二原发性恶性肿瘤（SPM）是头颈部肿瘤治疗中最关键的问题之一。我院2002年至2006年5年间共有742例头颈部恶性肿瘤患者。在这项研究中，我们分析了360名被认为有饮酒和吸烟等危险因素的患者：106名口腔癌，120名喉癌，50名口咽癌和84名下咽癌患者。同步SPM被定义为在同一时间或在诊断指数头颈部癌症的6个月内诊断出的第二种癌症。口腔癌患者中有4例（3.8%）和11例（10.4%）同时存在SPM，喉癌患者中有11例（8.3%）和8例（5.8%）同时存在SPM，口咽癌患者中有7例（14.0%）和4例（8.0%）同时存在SPM，下咽癌患者中有30例（28.6%）和7例（8.3%）同时存在SPM。在此期间，具有同步SPM的异时性患者的数量趋于增加。口咽癌和下咽癌患者中SPM的频率与口腔癌和喉癌患者中的频率相似。值得注意的是，与欧洲的肺癌相比，日本最常见的SPM是上消化道癌症。根据Kaplan-Meier分析，同步SPM患者的5年总生存率明显低于除索引癌外无其他肿瘤的患者。总之，在日本，寻找上消化道SPM是头颈癌患者的一个关键问题。
Second primary malignancies (SPMs) are one of the most critical problems in treating head and neck cancer patients. Our hospital had 742 patients with a diagnosis of malignant head and neck tumors during the five-year period from 2002 to 2006. In this study, we analyzed 360 of those patients who were assumed to have risk factors such as alcohol and tobacco use: 106 oral, 120 laryngeal, 50 oropharyngeal and 84 hypopharyngeal cancer patients. Synchronous SPMs are defined as second cancers diagnosed at the same time or within 6 months of the diagnosis of the index head and neck cancers. There were 4 (3.8%) and 11(10.4%) oral cancer patients, 11(8.3%) and 8 (5.8%) laryngeal cancer patients, 7 (14.0%) and 4 (8.0%) oropharyngeal cancer patients, and 30 (28.6%) and 7 (8.3%) hypopharyngeal cancer patients with synchronous and metachronous SPMs, respectively. The number of metachronous patients with synchronous SPMs tended to increase during this time period. The frequencies of SPMs in oropharyngeal and hypopharyngeal cancer patients are similar to those in oral and laryngeal cancer patients. Notably, the most frequent SPMs are upper gastrointestinal tract cancers in Japan, compared to lung cancers in Europe. The five-year overall survival rate of patients with synchronous SPMs was significantly poorer than that of patients without any other tumor except for the index cancer, according to the Kaplan-Meier analysis. In conclusion, searching for SPMs in the upper gastrointestinal tract is a critical issue in head and neck cancer patients in Japan.