人乳头瘤病毒阳性口咽鳞癌经口手术后第二原发恶性肿瘤的发生。
Development of second primary malignancies after transoral surgery in human papilloma virus-positive oropharyngeal squamous cell carcinoma.
机构信息
Department of Otolaryngology - Head and Neck Surgery, Northwestern Medicine, Chicago, Illinois, USA.
Department of Otolaryngology - Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.
出版信息
Head Neck. 2022 May;44(5):1069-1078. doi: 10.1002/hed.27002. Epub 2022 Feb 17.
BACKGROUND
Little data exists regarding the incidence of oropharyngeal and upper aerodigestive tract (UADT) second primary malignancies (SPM) among human papilloma virus (HPV)-positive oropharyngeal squamous cell carcinoma (OPSCC). Here we evaluate SPM rates among patients with HPV-related OPSCC.
METHODS
A retrospective cohort study of 412 patients with HPV-related OPSCC who underwent transoral resection +/- adjuvant therapy at a single center between 1996 and 2018.
RESULTS
Twenty patients (4.9%) developed SPM of the UADT, nine (2.2%) occurring in the oropharynx. Median time to diagnosis was 59.5 months (0-173 months). Risk of SPM was lower for patients receiving adjuvant radiation (aHR: 0.25, 95%CI: 0.08-0.78). There was no difference in overall or disease-free survival between those with and without SPM.
CONCLUSION
The rate of SPM among patients with HPV-positive OPSCC is lower than reported rates among HPV-negative OPSCC. To date, this is the largest study evaluating SPM in patients with surgically treated HPV-positive OPSCC.
背景
关于人乳头瘤病毒（HPV）阳性口咽鳞状细胞癌（OPSCC）患者中口咽和上呼吸消化道（UADT）第二原发恶性肿瘤（SPM）的发病率的数据很少。在此，我们评估了 HPV 相关 OPSCC 患者的 SPM 发生率。
方法
这是一项回顾性队列研究，纳入了 1996 年至 2018 年间在一家中心接受经口切除术 +/- 辅助治疗的 412 例 HPV 相关 OPSCC 患者。
结果
20 例（4.9%）患者发生了 UADT 的 SPM，其中 9 例（2.2%）发生在口咽。诊断的中位时间为 59.5 个月（0-173 个月）。接受辅助放疗的患者 SPM 风险较低（aHR：0.25，95%CI：0.08-0.78）。有和没有 SPM 的患者的总生存率和无病生存率无差异。
结论
HPV 阳性 OPSCC 患者的 SPM 发生率低于 HPV 阴性 OPSCC 患者报告的发生率。迄今为止，这是评估接受手术治疗的 HPV 阳性 OPSCC 患者 SPM 的最大研究。
Zotero 插件