Laccourreye Ollivier, Veivers France David, Hans Stéphane, Brasnu France Daniel, Garcia Dominique, Laccourreye France Laurent
Department of Otorhinolaryngology-Head and Neck Surgery, Hopital Européen Georges Pompidou, University of Paris V, France.
Ann Otol Rhinol Laryngol. 2002 Mar;111(3 Pt 1):204-9. doi: 10.1177/000348940211100303.
The current retrospective studies documented the incidence, sites of occurrence, risk factors, and outcome of metachronous second primary cancers (MSPCs) among an inception cohort of 410 patients with invasive squamous cell carcinoma of the true vocal cord successfully treated with partial laryngectomy at a single institution. The Kaplan-Meier actuarial life-table method was used to document the relationship between the incidence of MSPCs and survival data. Univariate analysis was performed for potential statistical relationships among the incidence of MSPCs, the site of occurrence, and different variables. The overall incidence of MSPCs was 23.9% (98/410). The 10-year actuarial survival estimate for MSPCs was 20.4%. The incidence curve of MSPCs was linear, resulting in a 2%/y rate of development for MSPCs. In univariate analysis, the only variable that demonstrated a statistical correlation with the incidence of MSPCs was smoking, with MSPCs being statistically more likely to occur in smokers than in nonsmokers (p = .04). The main sites of origin for MSPCs were the lung (25.5% of cases), other non-upper aerodigestive tract sites (32.7%), and the upper aerodigestive tract (41.8%). The 10-year actuarial estimates for MSPCs were 9.1% in the upper aerodigestive tract, 7.1% in sites other than the lung or upper aerodigestive tract, and 6.6% in the lung. The incidence curve for MSPCs was linear, whatever the site of origin, resulting in 1 %/y, 0.7%/y, and 0.6%/y rates of development for MSPCs in the upper aerodigestive tract, sites other than the lung or upper aerodigestive tract, and the lung, respectively. Survival was statistically reduced when an MSPC developed; the 10-year actuarial survival estimates were 76.8% in patients who did not develop an MSPC and 43.7% in patients who developed an MSPC (p < .0001). Overall, 68.4% of patients who developed an MSPC (67/98) died of this disease. The 10-year actuarial survival estimates were 24% for lung MSPCs, 43.7% for non-lung, non-upper aerodigestive tract MSPCs, and 63.4% for upper aerodigestive tract MSPCs.
目前的回顾性研究记录了在一家机构接受部分喉切除术成功治疗的410例真性声带浸润性鳞状细胞癌起始队列患者中异时性第二原发性癌（MSPC）的发病率、发生部位、危险因素和结局。采用Kaplan-Meier精算生命表法记录MSPC发病率与生存数据之间的关系。对MSPC发病率、发生部位和不同变量之间的潜在统计关系进行单因素分析。MSPC的总体发病率为23.9%（98/410）。MSPC的10年精算生存率估计为20.4%。MSPC的发病率曲线呈线性，导致MSPC的年发生率为2%。在单因素分析中，与MSPC发病率显示出统计学相关性的唯一变量是吸烟，MSPC在吸烟者中发生的统计学可能性高于非吸烟者（p = 0.04）。MSPC的主要起源部位是肺（25.5%的病例）、其他非上消化道呼吸道部位（32.7%）和上消化道呼吸道（41.8%）。MSPC的10年精算估计生存率在上消化道呼吸道为9.1%，在肺或上消化道呼吸道以外的部位为7.1%，在肺为6.6%。无论起源部位如何，MSPC的发病率曲线均呈线性，导致上消化道呼吸道、肺或上消化道呼吸道以外部位以及肺中MSPC的年发生率分别为1%、0.7%和0.6%。当发生MSPC时，生存率在统计学上降低；未发生MSPC的患者10年精算生存率估计为76.8%，发生MSPC的患者为43.7%（p < 0.0001）。总体而言，发生MSPC的患者中有68.4%（67/98）死于该病。肺MSPC的10年精算生存率估计为24%，非肺、非上消化道呼吸道MSPC为43.7%，上消化道呼吸道MSPC为63.4%。
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