血液系统恶性肿瘤后发生的第二原发性口腔鳞状细胞癌的预后：一项回顾性队列分析。

Prognosis of second primary oral squamous cell carcinoma after hematologic malignancy: a retrospective cohort analysis.

作者信息

Yu Huajiao, Li Bo, Huang Yu, Zhang Xue, Zhou Hanchen, Feng Zhien, Han Zhengxue

机构信息

Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, China.

Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China.

出版信息

Front Oncol. 2025 Sep 3;15:1667226. doi: 10.3389/fonc.2025.1667226. eCollection 2025.

DOI:10.3389/fonc.2025.1667226

PMID:40969273

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12442044/

Abstract

BACKGROUNDS

Prognosis and optimal management strategies of second primary oral squamous cell carcinoma (OSCC) following a history of hematologic malignancies (HM) remain uncertain. We investigated whether HM history affects OSCC outcomes or necessitates treatment modifications.

PATIENTS AND METHODS

This retrospective cohort study included 2486 OSCC patients: 14 with OSCC as a second primary malignancy post-HM (SPM group) and 2472 with primary OSCC (non-SPM group). Using propensity score matching (PSM), we created two cohorts: 1:17 (13 SPM vs 232 non-SPM) and 1:3 (13 SPM vs 38 non-SPM). Outcomes were disease-free survival (DFS), overall survival (OS), and disease-specific survival (DSS). Survival differences were analyzed using log-rank tests. Multivariate Cox regression identified prognostic predictors.

RESULTS

No significant survival differences existed between SPM and non-SPM groups in either cohort (1:17: DFS 53.8% vs 68.9%, p=0.102; OS 69.2% vs 81.3%, p=0.170; DSS 69.2% vs 82.2%, p=0.147. 1:3: DFS 53.8% vs 63.2%, p=0.302; OS 69.2% vs 76.3%, p=0.532; DSS 69.2% vs 78.9%, p=0.430). Cox regression identified independent predictors: DFS: Age (p=0.001), T stage (p<0.001), N stage (p<0.001); OS and DSS: Age (p<0.001), T stage (p<0.001), N stage (p<0.001), pathological grade (p<0.001), prior HM was not an independent predictor.

CONCLUSIONS

A history of HM does not independently predict the prognosis of second primary OSCC nor necessitate modifications to standard OSCC treatment.

摘要

背景

血液系统恶性肿瘤（HM）病史后的第二原发性口腔鳞状细胞癌（OSCC）的预后和最佳管理策略仍不明确。我们研究了HM病史是否会影响OSCC的预后或是否需要调整治疗方案。

患者与方法

这项回顾性队列研究纳入了2486例OSCC患者：14例为HM后发生的第二原发性恶性肿瘤OSCC（SPM组），2472例为原发性OSCC（非SPM组）。使用倾向评分匹配（PSM），我们创建了两个队列：1:17（13例SPM对232例非SPM）和1:3（13例SPM对38例非SPM）。结局指标为无病生存期（DFS）、总生存期（OS）和疾病特异性生存期（DSS）。使用对数秩检验分析生存差异。多变量Cox回归确定预后预测因素。

结果

在两个队列中，SPM组和非SPM组之间均无显著的生存差异（1:17：DFS为53.8%对68.9%，p = 0.102；OS为69.2%对81.3%，p = 0.170；DSS为69.2%对82.2%，p = 0.147。1:3：DFS为53.8%对63.2%，p = 0.302；OS为69.2%对76.3%，p = 0.532；DSS为69.2%对78.9%，p = 0.430）。Cox回归确定的独立预测因素：DFS：年龄（p = 0.001）、T分期（p < 0.001）、N分期（p < 0.001）；OS和DSS：年龄（p < 0.001）、T分期（p < 0.001）、N分期（p < 0.001）、病理分级（p < 0.001），既往HM不是独立预测因素。