A risk factor for newly diagnosed secondary cancer in patients with early-stage laryngeal, oropharyngeal, or hypopharyngeal cancer: sub-analysis of a prospective observation study
A risk factor for newly diagnosed secondary cancer in patients with early-stage laryngeal, oropharyngeal, or hypopharyngeal cancer: sub-analysis of a prospective observation study
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DOI：
10.1007/s10147-021-02080-x
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发表时间：
2021-11-17
影响因子：
3.3
通讯作者：
Oridate，Nobuhiko
中科院分区：
文献类型：
--
作者：
Nishimura，Goshi;Sano，Daisuke;Oridate，Nobuhiko
背景我们先前发现下咽癌是早期喉癌、口咽癌和下咽癌治疗后新诊断的继发性癌症发生率的独立危险因素。我们随后使用不同的患者队列来验证这一因素在这些患者的随访期内的有效性。方法纳入在2016年4月1日至2020年9月30日期间接受经口腔手术(TOS)作为最终治疗的患者。继发性癌症的发生率在下咽癌和其他癌症中进行了评估。评估总生存期(OS)、无复发生存期(RFS)和无病生存期(DFS)。结果下咽癌患者新发癌症的发生率为30%，高于其他癌症患者的11%，头颈部肿瘤确诊治疗后，新发癌症的风险增加了3.60倍(95%可信区间1.07~12.10)。3年OS、RFS和DFS率分别为98%、86%和67%。结论在最初接受TOS治疗的早期喉癌、口咽癌和下咽鳞癌患者中，观察到在随访期内，下咽癌患者发生新诊断的继发性癌症的风险更高。
BackgroundWe previously identified hypopharyngeal cancer as an independent risk factor for the incidence of newly diagnosed secondary cancers after the treatment of early-stage laryngeal, oropharyngeal, and hypopharyngeal cancers. We subsequently used a different patient cohort to validate the usefulness of this factor during the follow-up period in these patients.MethodsPatients who underwent transoral surgery (TOS) as a definitive treatment between April 1, 2016, and September 30, 2020, were included. The incidence of secondary cancer was evaluated in hypopharyngeal and other cancers. Overall survival (OS), recurrence-free survival (RFS), and disease-free survival (DFS) outcomes were evaluated. Statistical analyses based on the risk factors were also performed.ResultsIncidence of new secondary cancer was 30% in hypopharyngeal cancer patients as compared to 11% in other cancer patients, and the risk was 3.60-fold (95% confidence interval 1.07–12.10) higher after definitive treatment for initial head and neck cancers. The 3-year OS, RFS, and DFS rates were 98%, 86%, and 67%, respectively.ConclusionsAmong patients with early-stage laryngeal, oropharyngeal, and hypopharyngeal squamous cell carcinoma, who were initially treated with TOS, hypopharyngeal cancer patients had a higher risk of newly diagnosed secondary cancers as observed during the follow-up period.