Survival prognostic factors for metachronous second primary head and neck squamous cell carcinoma
Open Access
- 17 December 2016
- journal article
- research article
- Published by Wiley in Cancer Medicine
- Vol. 6 (1), 142-153
- https://doi.org/10.1002/cam4.976
Abstract
We examined the overall survival rates of a national cohort to determine optimal treatments and prognostic factors for patients with metachronous second primary head and neck squamous cell carcinomas (mspHNSCCs) at different stages and sites. We analyzed data of mspHNSCC patients collected from the Taiwan Cancer Registry database. The patients were categorized into four groups based on the treatment modality: Group 1 (control arm; chemotherapy [CT] alone), Group 2 (reirradiation [re-RT] alone with intensity-modulated radiotherapy [IMRT]), Group 3 (concurrent chemoradiotherapy alone [irradiation with IMRT]), and Group 4 (salvage surgery with or without RT or CT). We enrolled 1741 mspHNSCC patients without distant metastasis. Multivariate Cox regression analyses revealed that Charlson comorbidity index (CCI) ≥6, stage of second HNSCC, stage of first HNSCC, and duration from first primary HNSCC of <3 years were significant poor independent prognostic risk factors for overall survival. After adjustment, adjusted hazard ratios and 95% confidence intervals for the overall all-cause mortality risk at mspHNSCC clinical stages III and IV were 0.72 (0.40–1.82), 0.52 (0.35–0.75), and 0.32 (0.22–0.45) in Groups 2, 3, and 4, respectively. A Cox regression analysis indicated that a re-RT dose of ≥6000 cGy was an independent protective prognostic factor for treatment modalities. CCI ≥ 6, stage of second HNSCC, stage of first HNSCC, and duration from first primary HNSCC of <3 years were significant poor independent prognostic risk factors for overall survival. A re-RT dose of ≥6000 cGy may be necessary for mspHNSCCs.Keywords
Funding Information
- Taipei Medical University
This publication has 35 references indexed in Scilit:
- Metachronous Second Primary Malignancies after Head and Neck Cancer in a Korean Cohort (1993-2010)PLOS ONE, 2015
- Causes of death in long‐term survivors of head and neck cancerCancer, 2014
- Second Primary Cancers After an Index Head and Neck Cancer: Subsite-Specific Trends in the Era of Human Papillomavirus–Associated Oropharyngeal CancerJournal of Clinical Oncology, 2011
- Randomized Trial of Postoperative Reirradiation Combined With Chemotherapy After Salvage Surgery Compared With Salvage Surgery Alone in Head and Neck CarcinomaJournal of Clinical Oncology, 2008
- Use of External Beam Radiotherapy Is Associated With Reduced Incidence of Second Primary Head and Neck Cancer: A SEER Database AnalysisInternational Journal of Radiation Oncology*Biology*Physics, 2008
- Second primary malignancy of the aerodigestive tract in patients treated for cancer of the oral cavity and larynxHead & Neck, 2005
- Metachronous second primary tumours in the aerodigestive tract in patients with early stage head and neck squamous cell carcinomasEuropean Archives of Oto-Rhino-Laryngology, 2005
- Second Primary Malignancies in the Head and Neck Cancer PatientAnnals of Otology, Rhinology & Laryngology, 1995
- Second malignancies in patients who have head and neck cancer: Incidence, effect on survival and implications based on the RTOG experienceInternational Journal of Radiation Oncology*Biology*Physics, 1989
- Second malignant tumors in head and neck squamous cell carcinoma: The overshadowing threat for patients with early-stage diseaseInternational Journal of Radiation Oncology*Biology*Physics, 1989