头颈部鳞状细胞癌后第二原发肺癌：危险因素的基于人群研究。

Second primary lung cancer after head and neck squamous cell cancer: population-based study of risk factors.

机构信息

Department of Radiation Oncology, University of Rochester Medical Center, Rochester, NY 14642, USA.

出版信息

Head Neck. 2012 Dec;34(12):1782-8. doi: 10.1002/hed.22006. Epub 2012 Feb 9.

DOI:10.1002/hed.22006

PMID:22319019

Abstract

BACKGROUND

Patients with head and neck squamous cell cancer (HNSCC) are at risk of developing second primary lung cancer (SPLC).

METHODS

Among 61,883 patients with HNSCC from the Surveillance, Epidemiology and End Results (SEER) database, 4522 developed SPLC (any histology) ≥2 months after HNSCC. We correlated risk with demographic and tumor-related parameters.

RESULTS

The risk of SPLC after HNSCC was 5.8%, 11.4%, and 16.4% at 5, 10, and 15 years, respectively. From Cox regression, significantly adverse (p < .0001) risk factors for SPLC included: regional versus localized HNSCC stage (hazard ratio [HR] = 1.16), hypopharyngeal or supraglottic laryngeal site (HR = 1.57), increased age (HR = 1.26/decade), black race (HR = 1.27), and male sex (HR = 1.26). Glottic (HR = 0.75) and tonsillar or oral cavity sites (HR = 0.80) were associated with significantly (p < .0001) lower risks of SPLC.

CONCLUSION

From population-based actuarial analyses, HNSCCs with more aggressive clinicopathologic features were more apt to develop SPLC, suggestive of similar environmental and/or host factors for these cancers.

摘要

背景

头颈部鳞状细胞癌（HNSCC）患者有发展第二原发性肺癌（SPLC）的风险。

方法

在监测、流行病学和最终结果（SEER）数据库中，有 61883 例 HNSCC 患者，其中 4522 例（任何组织学）在 HNSCC 后≥2 个月发生 SPLC。我们将风险与人口统计学和肿瘤相关参数相关联。

结果

HNSCC 后 SPLC 的风险分别为 5.8%、11.4%和 16.4%，在 5、10 和 15 年时。从 Cox 回归来看，SPLC 的显著不利（p<0.0001）风险因素包括：局部 HNSCC 分期（危险比[HR] = 1.16）、下咽或喉上声门部位（HR = 1.57）、年龄增加（HR = 1.26/decade）、黑种人（HR = 1.27）和男性（HR = 1.26）。声门（HR = 0.75）和扁桃体或口腔部位（HR = 0.80）与 SPLC 的风险显著降低相关（p<0.0001）。