Risk and prognostic factors for multiple primary carcinomas in patients with head and neck cancer
Risk and prognostic factors for multiple primary carcinomas in patients with head and neck cancer
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头颈癌患者发生多原发癌的风险和预后因素
DOI：
10.1093/jjco/hyx178
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发表时间：
2017
期刊：
影响因子：
2.4
通讯作者：
Mineta H
中科院分区：
文献类型：
--
作者：
Hosokawa S;Takahashi G;Okamura J;Imai A;Mochizuki D;Takizawa Y Yamatodani T;Misawa K;Mineta H
背景：头颈部癌患者发生多发原发癌（MPCs）使其治疗方法复杂化。因此，我们研究了与MPCs治疗后生存结果相关的临床因素。方法回顾性分析滨松大学附属医院1104例原发性头颈部癌患者的治疗资料。我们评估了临床分期、年龄、性别、吸烟、饮酒、原发肿瘤部位（特别是气道粘膜上皮的受累情况）以及Kaplan-Meier分析确定的总生存期（OS）。平均随访43.8个月（1-144个月）后获得患者生存状态信息。结果566例粘膜相关癌中，5年和10年OS率（分别为68.49%和58.96%）明显短于粘膜非相关癌（分别为74.22%和66.76%）（log-rankP= 0.0219）。老年（P= 0.016）和男性（P< 0.001）可能是发生MPCs的独立危险因素；吸烟（P< 0.001）和饮酒（P< 0.001）也是显著的危险因素。结论发生于头颈部空气消化道上皮的粘膜相关癌是发生MPC的重要危险因素，是预后不良的因素。建议对这些患者进行仔细的随访和更频繁的气消化道检查。
BackgroundUnexpected multiple primary carcinomas (MPCs) that develop in patients with head and neck carcinomas complicate approaches to their management. We therefore investigated the clinical factors associated with survival outcomes after the treatment of MPCs.MethodsWe performed a retrospective review of records of 1104 patients who underwent treatment for primary head and neck carcinoma at Hamamatsu University Hospital. We evaluated clinical staging, age, sex, smoking, alcohol consumption, the primary tumor site (particularly the involvement of the mucosal epithelial lining of the aerodigestive tract), and overall survival (OS) as determined by Kaplan–Meier analysis. Information on patients’ survival status was obtained after a mean follow-up period of 43.8 months (range, 1–144 months).ResultsAmong 566 patients with mucosa-associated carcinoma arising in the epithelial lining, the 5- and 10-year OS rates (68.49% and 58.96%, respectively) were significantly shorter than those of patients with mucosa non-associated carcinoma (74.22%, and 66.76%, respectively) (log-rankP= 0.0219). Older age (P= 0.016) and male sex (P< 0.001) were likely independent risk factors for developing MPCs; smoking (P< 0.001) and alcohol consumption (P< 0.001) were also significant risk factors.ConclusionMucosa-associated carcinomas arising in the epithelial lining of the aerodigestive tract in the head and neck are a significant risk factor for developing MPC and are a poor prognostic factor. Careful follow-up and more frequent examinations of the aerodigestive tracts of these patients are recommended.