Wang Xin, Mauer Elizabeth A, Christos Paul, Manzerova Julia, Wernicke A Gabriella, Parashar Bhupesh
Stich Radiation Oncology, NewYork-Presbyterian/Weill Cornell Medical Center.
Division of Biostatistics and Epidemiology, Department of Healthcare Policy and Research, New York-Presbyterian/Weill Cornell Medical Center.
Cureus. 2017 May 29;9(5):e1284. doi: 10.7759/cureus.1284.
To compare patients' survival of second primary malignancy (SPM) after head and neck squamous cell carcinoma (HNSCC).
The Surveillance, Epidemiology, and End Results (SEER) database was utilized (1973-2011). The Kaplan-Meier method with log-rank test was used to compare the overall survival (OS) and cause-specific survival (CSS) among treatment methods from the time of diagnosis of SPMs. Cox proportional regression models were used to adjust the impact for risk factors on CSS.
A total of 3,038 patients were identified (5-yr OS 22.6% (21.0-24.3%)). For head and neck (HN) SPMs, the patients who received 'conservative surgery with radiation' had the best 5-yr OS (65.2% (48.9-86.9%)); and the 'conservative surgery' group had the best 5-yr CSS (89.9% (85.6-94.5%)). For lung SPMs, the 'radical surgery' group showed the best survival (2-yr OS 60.8% (56.0-66.1%), 2-yr CSS 70.6% (65.8-75.8%), respectively). Esophagus SPMs had poor prognosis, with no difference among the treatment groups. In lung SPMs, younger age (p<0.001) and black race (p<0.05) were most favorable CSS predictors.
The prognosis of SPMs after HNSCC is worse compared with corresponding primary tumor. Conservative surgery with or without radiation showed the most favorable outcomes in HN SPMs..
比较头颈部鳞状细胞癌（HNSCC）患者发生第二原发性恶性肿瘤（SPM）后的生存率。
使用监测、流行病学和最终结果（SEER）数据库（1973 - 2011年）。采用带有对数秩检验的Kaplan - Meier方法，从SPM诊断时间起比较各治疗方法之间的总生存期（OS）和病因特异性生存期（CSS）。使用Cox比例回归模型调整危险因素对CSS的影响。
共纳入3038例患者（5年OS为22.6%（21.0 - 24.3%））。对于头颈部（HN）SPM，接受“保守手术加放疗”的患者5年OS最佳（65.2%（48.9 - 86.9%））；“保守手术”组5年CSS最佳（89.9%（85.6 - 94.5%））。对于肺部SPM，“根治性手术”组生存率最佳（2年OS分别为60.8%（56.0 - 66.1%），2年CSS为70.6%（65.8 - 75.8%））。食管SPM预后较差，各治疗组之间无差异。在肺部SPM中，年龄较小（p<0.001）和黑人种族（p<0.05）是最有利的CSS预测因素。
与相应的原发性肿瘤相比，HNSCC后SPM的预后更差。在HN SPM中，保守手术加或不加放疗显示出最有利的结果。
