Evaluation of the prevalence of metachronous second primary malignancies in hypopharyngeal carcinoma and their effect on outcomes

• Published in: Cancer medicine (Malden, MA) Vol. 11; no. 4; pp. 1059 - 1067
• Main Authors: Luo, Xi, Huang, Xiaodong, Liu, Shaoyan, Wang, Xiaolei, Luo, Jingwei, Xiao, Jianping, Wang, Kai, Qu, Yuan, Chen, Xuesong, Zhang, Ye, Wang, Jingbo, Zhang, Jianghu, Xu, Guozhen, Gao, Li, Wu, Runye, Yi, Junlin
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.02.2022; John Wiley and Sons Inc; Wiley
• Subjects: Alcohol; Body mass index; Cancer; Carcinoma, Squamous Cell - pathology; Clinical Cancer Research; Esophagus; Ethanol; Humans; hypopharyngeal cancer; Hypopharyngeal Neoplasms - epidemiology; Hypopharyngeal Neoplasms - therapy; incidence; Invasiveness; Medical prognosis; metachronous second primary neoplasm; Metastasis; Neoplasms, Second Primary - etiology; Oral cavity; Oropharynx; Patients; Prevalence; Prognosis; Radiation therapy; Retrospective Studies; second primary neoplasm; Smoking; Stomach; Surgery; Survival; Survival analysis; Throat cancer; Thyroid; Tumors; metachronous second primary neoplasm; survival analysis; incidence; second primary neoplasm; hypopharyngeal cancer
• ISSN: 2045-7634; 2045-7634
• DOI: 10.1002/cam4.4501

Background To investigate the clinical characteristics of metachronous second primary malignancies (Met‐SPMs) and its impact on prognosis in hypopharyngeal carcinoma (HPC). Methods We reviewed 593 newly diagnosed HPC patients without invasive synchronous SPMs (Syn‐SPMs) who were treated in our cancer center between 2009 and 2019. According to the status during follow‐up, patients were classified into three groups: (a) without SPMs (No‐SPMs, n = 440), (b) with tumors in situ in the esophagus or stomach (Tis, n = 80), or (c) with Met‐SPMs (n = 73). Results The median follow‐up time for entire cohort (n = 593) was 66.7 months. Met‐SPMs were present in 12.3% of the cohort (73/593). The predominant site of SPMs was esophagus, followed by lung, oral cavity, thyroid, stomach, and oropharynx. In Met‐SPMs group, both index tumor and SPMs were the main causes of death. Tis group exhibited comparable 5‐year overall survival (OS) and disease‐specific survival (DSS) with that of No‐SPMs group. The Met‐SPMs group had similar 5‐year OS rate and better 5‐year DSS rate of 47.3% versus 43.6% (odds ratio [OR], 0.931; 95% confidence interval [CI], 0.681–1.274, p = 0.657) and 66.3% vs. 46.2% (OR, 0.600; 95% CI, 0.402–0.896, p = 0.012), respectively, compared with the No‐SPMs group. Conclusion The overall incidence of Met‐SPMs in HPC was 12.3%. The occurrence of Met‐SPMs does not jeopardize the survival outcome of HPC. Routine surveillance of Met‐SPMs was requisite for patients with HPC. (1) Our study only focused on HPC as the index tumor; (2) Patients with Met‐SPMs achieved favorable outcome before and after PSM which shows these patients were high‐selected patients who had favorable index tumor control; (3) The routine surveillance and screening for Met‐SPMs are requisite for patients with HPC, and the UADT mucosa and the lung should receive more attention.