Yeh Chien-Fu, Chin Yu-Ching, Huang Wei-Hao, 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 Otolaryngology, National Yang Ming Chiao Tung University School of Medicine, Taipei, 11221, Taiwan.
Eur Arch Otorhinolaryngol. 2022 Nov;279(11):5381-5387. doi: 10.1007/s00405-022-07444-1. Epub 2022 Jun 22.
Previous cancers can be observed in patients with nasopharyngeal carcinoma (NPC). However, whether prior cancer diagnosis affects survival outcomes remains unknown. This study aimed to explore the impact of prior cancer on the survival of patients with NPC.
We retrospectively collected data from 666 NPC patients between 2006 and 2018. The patients in this study were divided into those without prior cancer, with prior head and neck cancer, and prior non-head and neck cancer. The demographic data and survival of these groups were then analyzed. The independent prognostic factors for NPC were determined using multivariate Cox regression analysis.
We identified 25 NPC patients with prior cancer in our case series, most of whom had a history of colorectal cancer. Patients with a history of cancer were older than those without a history of cancer (p = 0.001). In the subgroup analysis stratified by the timing of prior cancer, NPC patients with prior non-head and neck cancer within 24, 36, 60, and 120 months showed worse survival than patients without prior cancer (all p < 0.05). When stratified by cancer stage, stage III NPC patients with prior non-head and neck cancer showed worse survival than patients without prior cancer (p < 0.001). Prior cancer and diabetes can predict worse survival in patients with stage III NPC.
This study demonstrated that prior cancer and diabetes are independent prognostic factors in patients with stage III NPC.
在鼻咽癌（NPC）患者中可观察到既往患癌情况。然而，既往癌症诊断是否会影响生存结局仍不清楚。本研究旨在探讨既往癌症对NPC患者生存的影响。
我们回顾性收集了2006年至2018年间666例NPC患者的数据。本研究中的患者被分为无既往癌症、有既往头颈癌和有既往非头颈癌患者。然后分析这些组的人口统计学数据和生存情况。使用多因素Cox回归分析确定NPC的独立预后因素。
在我们的病例系列中，我们确定了25例有既往癌症的NPC患者，其中大多数有结直肠癌病史。有癌症病史的患者比无癌症病史的患者年龄更大（p = 0.001）。在按既往癌症发生时间分层的亚组分析中，在24、36、60和120个月内有既往非头颈癌的NPC患者的生存情况比无既往癌症的患者更差（所有p < 0.05）。按癌症分期分层时，有既往非头颈癌的III期NPC患者的生存情况比无既往癌症的患者更差（p < 0.001）。既往癌症和糖尿病可预测III期NPC患者的生存情况更差。
本研究表明，既往癌症和糖尿病是III期NPC患者的独立预后因素。
