He Meilin, Wu Runye, Zhang Ye, Huang Xiaodong, Wang Kai, Chen Xuesong, Wang Jingbo, Qu Yuan, Luo Jingwei, Yi Junlin
Department of Radiation Oncology National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College，Beijing，100021，China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2023 Sep;37(9):721-728. doi: 10.13201/j.issn.2096-7993.2023.09.007.
To analysis the clinical features and prognosis in oropharyngeal carcinoma with secondary primary tumor. A retrospective analysis was performed on 468 pathologically confirmed oropharyngeal cancer as the primary tumor patients with p16 status, excluded distant metastasis, and admitted to the Chinese Academy of Medical Sciences from January 2010 to December 2020. The clinical features and prognosis of the secondary primary tumor were analyzed. Among 468 patients with oropharyngeal cancer treated at initial diagnosed, 222 cases were P16-negative. With a median follow-up time of 64.3 months, 66 cases developed second primary cancer, with an incidence of 29.3%, among which 63.6%（42/66） were synchronous and 36.4%（24/66） were heterochronous, esophagus was the most commonly involved site. The 5-year OS of p16-negative oropharyngeal carcinoma with synchronous second primary cancer, without second primary cancer and with heterogeneous second primary cancer were 26.3% and 57.3% and 73.2%（=0.001）; The second primary cancer accounted for 11.2%（12/107） of the deaths in the whole group, among them, the heterochronous second primary accounted for 75.0%（9/12）. There were 246 patients with p16 positive, with a median follow-up time of 52.4 months, 20 patients developed second primary cancer（8.1%）. Among them, 65.0%（13/20） were synchronous and 35.0%（7/20） were heterochronous. Esophagus was the most commonly involved site. The 4-year OS of p16-positive with synchronous, heterochronous and non-second primary cancer group were 51.9%, 80.7% and 83.3%. Secondary primary cancer accounted for 3.8%（2/52） of all deaths in p16 positvie group. The incidence of second primary cancer of p16 positive and negative oropharyngeal carcinoma were different. The esophagus was the most commonly involved site regardless of p16 status. Regardless of p16 status, the survival of patients with synchronous second primary cancer was worse than those without second primary cancer. For p16-negative oropharyngeal carcinoma, the prognosis was better in patients with heterogeneous second primary cancer, the second primary cancer is one of the main causes of death.
分析口咽癌伴发第二原发肿瘤的临床特征及预后。对2010年1月至2020年12月在中国医学科学院收治的468例经病理确诊为口咽癌且为原发肿瘤、排除远处转移且有p16状态的患者进行回顾性分析。分析第二原发肿瘤的临床特征及预后。在468例初诊时接受治疗的口咽癌患者中，222例为P16阴性。中位随访时间为64.3个月，66例发生第二原发癌，发生率为29.3%，其中63.6%（42/66）为同时性，36.4%（24/66）为异时性，食管是最常受累部位。p16阴性口咽癌伴同时性第二原发癌、无第二原发癌和异时性第二原发癌的5年总生存率分别为26.3%、57.3%和73.2%（P=0.001）；第二原发癌占全组死亡人数的11.2%（12/107），其中异时性第二原发癌占75.0%（9/12）。p16阳性患者246例，中位随访时间52.4个月，20例发生第二原发癌（8.1%）。其中65.0%（13/20）为同时性，35.0%（7/20）为异时性。食管是最常受累部位。p16阳性伴同时性、异时性和无第二原发癌组的4年总生存率分别为51.9%、80.7%和83.3%。第二原发癌占p16阳性组所有死亡人数的3.8%（2/52）。p16阳性和阴性口咽癌的第二原发癌发生率不同。无论p16状态如何，食管是最常受累部位。无论p16状态如何，伴同时性第二原发癌患者的生存率低于无第二原发癌患者。对于p16阴性口咽癌，异时性第二原发癌患者预后较好，第二原发癌是主要死亡原因之一。
