Yeh Chien-Fu, Ho Ching-Yin, Chin Yu-Ching, Shu Chih-Hung, Chao Yun-Ting, Lan Ming-Ying
Department of Otorhinolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Taipei 11217, Taiwan; Department of Otorhinolaryngology, School of Medicine, National Yang-Ming University, No. 155, Sec. 2, Linong St., Taipei 11221, Taiwan.
Department of Otorhinolaryngology, School of Medicine, National Yang-Ming University, No. 155, Sec. 2, Linong St., Taipei 11221, Taiwan; Department of Otolaryngology, Cheng Hsin General Hospital, No. 45, Zhenxing St., Taipei 11220, Taiwan.
Oral Oncol. 2020 Nov;110:104990. doi: 10.1016/j.oraloncology.2020.104990. Epub 2020 Sep 12.
Nasopharyngeal carcinoma (NPC) is a common cancer and is treated primarily by chemotherapy and radiotherapy. However, NPC with synchronous second primary cancer (SSPC) is very rare and its risk factors, treatment and prognosis remain unclear. In this study, we aimed to analyze patients with NPC and SSPC, and attempt to find potential predictors for these patients.
We retrospectively collected 681 patients with NPC from 2006 to 2018. Patients in this study were divided into two groups: those patients with SSPC and those without SSPC. We then analyzed the demographic data and survival of these two groups. Independent predictors of SSPC were determined by multivariate regression analysis. A comprehensive review of the literature was also performed.
We identified 17 NPC patients with SSPC in our case series and 13 cases in the literatures, and the most common SSPC is lung (16.1%). In univariate analysis, NPC patients with SSPC had older age (P < 0.001) and higher serum lactate dehydrogenase (LDH) (P = 0.008), compared with those without SSPC. In multivariate analysis, old age (P = 0.001) and high serum LDH (P = 0.023) remained independent predictors of SSPC, and a predictive equation model was established. NPC patients with SSPC had a significantly lower 5-year disease-specific survival rate compared with patients without SSPC (34.0% vs. 77.6%, P < 0.001) CONCLUSION: This study demonstrated that pretreatment age and serum LDH were independent predictors for SSPC in NPC patients. These independent factors can be used for early detection, and better facilitate the design of more appropriate treatment by medical professionals.
鼻咽癌（NPC）是一种常见癌症，主要通过化疗和放疗进行治疗。然而，伴有同步性第二原发癌（SSPC）的鼻咽癌非常罕见，其危险因素、治疗方法及预后仍不明确。在本研究中，我们旨在分析患有NPC和SSPC的患者，并试图找出这些患者的潜在预测因素。
我们回顾性收集了2006年至2018年间681例NPC患者。本研究中的患者分为两组：患有SSPC的患者和未患有SSPC的患者。然后我们分析了这两组患者的人口统计学数据和生存率。通过多因素回归分析确定SSPC的独立预测因素。我们还对文献进行了全面综述。
在我们的病例系列中，我们确定了17例患有SSPC的NPC患者，文献中报道了13例，最常见的SSPC是肺癌（16.1%）。在单因素分析中，与未患有SSPC的患者相比，患有SSPC的NPC患者年龄更大（P < 0.001）且血清乳酸脱氢酶（LDH）水平更高（P = 0.008）。在多因素分析中，高龄（P = 0.001）和高血清LDH（P = 0.023）仍然是SSPC的独立预测因素，并建立了一个预测方程模型。与未患有SSPC的患者相比，患有SSPC的NPC患者5年疾病特异性生存率显著更低（34.0%对77.6%，P < 0.001）。结论：本研究表明，治疗前年龄和血清LDH是NPC患者发生SSPC的独立预测因素。这些独立因素可用于早期检测，并更好地帮助医学专业人员设计更合适的治疗方案。
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