Oral Oncology Clinic, Research Institute and Hospital, National Cancer Center, Republic of Korea.
Cancer Registration and Statistics Branch, National Cancer Center, Goyang, Gyeonggi, Republic of Korea.
Oral Oncol. 2019 Aug;95:16-28. doi: 10.1016/j.oraloncology.2019.05.025. Epub 2019 Jun 4.
The improved survival of patients with oral cavity cancer (OCC) has generated interest in factors affecting survivorship, particularly among second primary cancer (SPC) patients. This study aimed to assess the incidence, patterns, and risk factors for SPC after OCC treatment in the Korean population.
Data from 15,261 patients with OCC (ICD-O: C01-C06) identified between 1993 and 2014 were extracted from the Korean Central Cancer Registry. The standardized incidence ratio (SIR) for SPC after index OCC was calculated, and Poisson regression analysis was performed to evaluate the risk factors for SPC among survivors.
The overall SIR for SPC among OCC survivors was 1.47 (95% confidence interval [CI] 1.39-1.56). SIR differed by sex (male: 1.51 vs. female: 1.37), age at diagnosis (<45 years: 2.47 vs. 45-64 years: 1.68 vs. ≥ 65 years: 1.10), index OCC subsite (floor of mouth: 1.95 vs. gum: 1.30), follow-up duration (6-23 months: 1.64 vs. 24-59 months: 1.51 vs. 60-119 months: 1.48 vs. ≥ 120 months: 1.24), histological OCC type (salivary gland malignancy: 1.77 vs. squamous cell carcinoma: 1.44 vs. others: 1.47), and radiation history (any: 1.94 vs. no radiation: 1.37). The risk factors for SPC development among OCC survivors included younger age at diagnosis and history of radiation therapy.
OCC survivors have significantly increased risks of SPCs, exhibiting distinctive site distributions and chronological patterns. These patients would benefit from an SPC surveillance protocol.
口腔癌(OCC)患者生存率的提高引发了人们对生存影响因素的关注,尤其是在第二原发癌(SPC)患者中。本研究旨在评估韩国人群中 OCC 治疗后 SPC 的发生率、模式和危险因素。
从韩国中央癌症登记处提取了 1993 年至 2014 年间诊断为 OCC(ICD-O:C01-C06)的 15261 例患者的数据。计算了 SPC 的标准化发病比(SIR),并对幸存者中 SPC 的危险因素进行了 Poisson 回归分析。
OCC 幸存者的总体 SPC SIR 为 1.47(95%置信区间 [CI] 1.39-1.56)。SIR 因性别(男性:1.51 比女性:1.37)、诊断时年龄(<45 岁:2.47 比 45-64 岁:1.68 比 ≥65 岁:1.10)、OCC 索引部位(口底:1.95 比牙龈:1.30)、随访时间(6-23 个月:1.64 比 24-59 个月:1.51 比 60-119 个月:1.48 比 ≥120 个月:1.24)、OCC 组织学类型(唾液腺癌恶性肿瘤:1.77 比鳞状细胞癌:1.44 比其他:1.47)和放疗史(任何:1.94 比无放疗:1.37)而有所不同。OCC 幸存者发生 SPC 的危险因素包括诊断时年龄较小和放疗史。
OCC 幸存者发生 SPC 的风险显著增加,其 SPC 具有独特的部位分布和时间模式。这些患者将从 SPC 监测方案中受益。