Second primary cancers in patients with laryngeal cancer: A population-based study
Second primary cancers in patients with laryngeal cancer: A population-based study
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DOI：
10.1016/s0360-3016(02)04613-8
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发表时间：
2003-06-01
影响因子：
7
通讯作者：
Emami, B
中科院分区：
文献类型：
--
作者：
Gao, X;Fisher, SG;Emami, B
背景：有关喉癌后特定部位第二种癌症发生率的文献有限。与第二原发相关联的危险因素是unknow.Methods：第二原发喉癌后的SEER数据库（1973-1996年）进行了分析的发病率，相对风险与一般人群相比，和潜在的危险因素，包括放射治疗。化疗和吸烟的信息是不可用的SEER database.Results：20,074喉癌患者生存至少3个月，3533（17.6%）发展为第二癌。10年时发生第二次癌症的累积风险为26%，20年时为47%。与一般人群中年龄调整、性别和肿瘤特异性比率相比，喉癌患者总体上具有更高的第二种癌症风险（预期值/预期值比值[O/E] = 1.68，95%置信区间[CI] = 1.58-1.79），头颈部（4.81 [4.31-5.58]）、食管癌（3.99 [3.29-4.83]）和肺癌（3.56 [3.34-3.79]）。初次诊断时的高龄与第二种癌症的风险增加相关（p = 0.0001）。放射治疗与总体上第二种癌症的风险增加有关（相对风险[RR] = 1.10 [1.02-1.18]，p = 0.012），尤其是继发性肺癌（RR = 1.18，[1.05-1.33]，p = 0.006）和可能的头颈部第二癌（RR 1.26，[0.99-1.60]，p = 0.061）。放射治疗与生存5年以上的患者发生第二次头颈癌的风险增加68%（RR = 1.68，[1.16-2.43]，p = 0.007）相关。第二原发癌与生存率低相关（p = 0.0001）。结论：喉癌后第二癌很常见，尤其是长期生存者。放射治疗与总体第二种癌症和头颈部癌症的长期风险的小幅增加有关。鉴于SEER数据库中缺乏关于化疗和吸烟的信息，应谨慎解释该数据。预防和早期发现是必要的。(C)2003年爱思唯尔公司
Background: Literature regarding incidence of site-specific second cancers after laryngeal cancer is limited. Risk factors associated with second primaries are unknown.Methods: Second primaries after laryngeal cancer in the SEER database (1973-1996) were analyzed for incidence, relative risk compared with the general population, and potential risk factors, including radiotherapy. Information on chemotherapy and tobacco smoking was not available in the SEER database.Results: Of 20,074 laryngeal cancer patients surviving at least 3 months, 3533 (17.6%) developed second cancers. The cumulative risk of developing a second cancer was 26% at 10 years and 47% at 20 years. Compared with age-adjusted, gender, and tumor-specific rates in the general population, laryngeal cancer patients had higher risks of second cancers overall (observed-to-expected ratio [O/E] = 1.68, 95% confidence interval [CI] = 1.58-1.79), head-and-neck (4.81 [4.31-5.58]), esophageal (3.99 [3.29-4.83]), and lung (3.56 [3.34-3.79]) cancer. Advanced age at initial diagnosis was associated with increased risks of second cancers (p = 0.0001). Radiotherapy was associated with increased risk of second cancers overall (relative risk [RR] = 1.10 [1.02-1.18], p = 0.012), especially second cancers of the lung (RR = 1.18, [1.05-1.33], p = 0.006) and possibly second cancers of the head and neck (RR 1.26, [0.99-1.60], p = 0.061). Radiotherapy was associated with a 68% excess risk (RR = 1.68, [1.16-2.43],p = 0.007) of developing a second head-and-neck cancer in patients who survived more than 5 years. Second primary was associated with a poor survival (p = 0.0001).Conclusions: Second cancers after laryngeal cancer are common, especially for long-term survivors. Radiotherapy was associated with a small increased risk of developing second cancers overall and long-term risk of head-and-neck cancers. This data should be interpreted with caution in light of the lack of information on chemotherapy and tobacco smoking in the SEER database. Prevention and early detection are indicated. (C) 2003 Elsevier Inc.