Second Primary Non-Small-Cell Lung Cancer After Head and Neck Cancer: A Population-Based Study of Clinical and Pathologic Characteristics and Survival Outcomes in 3597 Patients
Second Primary Non-Small-Cell Lung Cancer After Head and Neck Cancer: A Population-Based Study of Clinical and Pathologic Characteristics and Survival Outcomes in 3597 Patients
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DOI：
10.1016/j.cllc.2019.02.017
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发表时间：
2020-05-01
影响因子：
3.6
通讯作者：
Milano, Michael T.
中科院分区：
文献类型：
--
作者：
Budnik, Justin;DeNunzio, Nicholas J.;Milano, Michael T.
与仅患有原发性 NSCLC 的患者相比，头颈癌 (HNC) 病史与随后发展为非小细胞肺癌 (NSCLC) 的患者的生存率下降相关。与仅患有原发性 NSCLC 的患者相比，HNC 幸存者中诊断出局部期 NSCLC 的比例有所增加，这可能会影响随后的 NSCLC 治疗选择。 简介：回顾性研究表明，有头颈癌 (HNC) 病史的患者患第二原发性肺癌的风险增加。尚无基于人群的研究对 HNC 与首次原发性 NSCLC 患者进行比较后第二次原发性非小细胞肺癌 (NSCLC) 患者的总生存 (OS) 结果进行检验。患者和方法：在监测、流行病学和最终结果 18 个登记处（1988-2013 年）中确定了在非转移性头颈部鳞状细胞癌（HNC-NSCLC；n = 3597）后诊断为组织学确诊为 NSCLC 的个体。对同一登记处首例原发性 NSCLC (NSCLC-1；n = 365,551) 患者的 OS 和基线特征进行了比较。结果：鳞状 NSCLC 在 HNC-NSCLC 中（n = 745 [64.1%] 局限性、n = 833 [71.9%] 区域性和 n = 811 [63.5%] 远处性）比 NSCLC-1（n = 30,901 [38.3%] 局限性、n = 50,557 [48.2%] 区域性和 n = 53,720 [29.8%] 遥远；P < .001)。 HNC-NSCLC 的主要死亡原因是 NSCLC（n = 2183；60.6%），局部、区域和远处 NSCLC 诊断后的中位 OS 分别为 2.50 年、1.17 年和 5 个月。对于 NSCLC-1，中位 OS 分别为 4.58 年、1.58 年和 6 个月。这些差异非常显着 (P < .001)。在多变量分析中，HNC 病史仍然与局部（风险比 [HR]，1.40；95% 置信区间 [CI]，1.29-1.51；P < .001）、区域（HR，1.26；95% CI，1.19-1.35；P < .001）和远处（HR，1.11；95% CI， 1.04-1.18；P < .01) 期非小细胞肺癌。结论：HNC 病史会对随后发展为 NSCLC 的患者的 OS 产生不利影响。这种 OS 下降可能会对该人群的 NSCLC 监测和 NSCLC 治疗选择产生影响。 (C) 2019 Elsevier Inc. 保留所有权利。
A history of head and neck cancer (HNC) is associated with a survival decrement in patients who subsequently develop non small-cell lung cancer (NSCLC), compared with patients with primary NSCLC only. An increased proportion of localized stage NSCLC is diagnosed in HNC survivors compared with patients with primary NSCLC only, and this might affect subsequent NSCLC therapy selection.Introduction: Retrospective studies have shown an increased risk of second primary lung cancer in patients with a history of head and neck cancer (HNC). No population-based study has examined the overall survival (OS) outcomes of patients with second primary non-small-cell lung cancer (NSCLC) after HNC comparison with patients with first primary NSCLC. Patients and Methods: Individuals with histologically confirmed NSCLC diagnosed after non-metastatic squamous-cell carcinoma of the head and neck (HNC-NSCLC; n = 3597) were identified in Surveillance, Epidemiology, and End Results 18 registries (1988-2013). OS and baseline characteristics were compared in patients with first primary NSCLC (NSCLC-1; n = 365,551) in the same registries. Results: Squamous NSCLC was more common in HNC-NSCLC (n = 745 [64.1%] localized, n = 833 [71.9%] regional, and n = 811 [63.5%] distant) than in the NSCLC-1 (n = 30,901 [38.3%] localized, n = 50,557 [48.2%] regional, and n = 53,720 [29.8%] distant; P < .001). The leading cause of death in HNC-NSCLC was NSCLC (n = 2183; 60.6%), and median OS after localized, regional, and distant NSCLC diagnosis was 2.50 years, 1.17 years, and 5 months, respectively. For NSCLC-1, median OS was 4.58 years, 1.58 years, and 6 months, respectively. These differences were significant (P < .001). In multivariable analysis, a history of HNC remained associated with worse OS for localized (hazard ratio [HR], 1.40; 95% confidence interval [CI], 1.29-1.51; P < .001), regional (HR, 1.26; 95% CI, 1.19-1.35; P < .001) and distant (HR, 1.11; 95% CI, 1.04-1.18; P < .01) stage NSCLC. Conclusion: A history of HNC adversely affects OS in patients who subsequently develop NSCLC. This OS decrement might have implications for NSCLC surveillance and NSCLC therapy selection in this population. (C) 2019 Elsevier Inc. All rights reserved.