Open AccessSurvival prognostic factors for metachronous second primary head and neck squamous cell carcinoma
Author(s) -
Chen JinHua,
Yen YuChun,
Chen TsungMing,
Yuan Kevin ShengPo,
Lee FeiPeng,
Lin KuanChou,
Lai MingTang,
Wu ChiaChe,
Chang ChiaLun,
Wu SzuYuan
Publication year - 2017
Publication title -
cancer medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 53
ISSN - 2045-7634
DOI - 10.1002/cam4.976
Subject(s) - medicine , head and neck squamous cell carcinoma , oncology , hazard ratio , proportional hazards model , stage (stratigraphy) , head and neck cancer , radiation therapy , chemoradiotherapy , cohort , confidence interval , multivariate analysis , paleontology , biology
We examined the overall survival rates of a national cohort to determine optimal treatments and prognostic factors for patients with metachronous second primary head and neck squamous cell carcinomas (msp HNSCC s) at different stages and sites. We analyzed data of msp HNSCC patients collected from the Taiwan Cancer Registry database. The patients were categorized into four groups based on the treatment modality: Group 1 (control arm; chemotherapy [ CT ] alone), Group 2 (reirradiation [re‐ RT ] alone with intensity‐modulated radiotherapy [ IMRT ]), Group 3 (concurrent chemoradiotherapy alone [irradiation with IMRT ]), and Group 4 (salvage surgery with or without RT or CT ). We enrolled 1741 msp HNSCC patients without distant metastasis. Multivariate Cox regression analyses revealed that Charlson comorbidity index ( CCI ) ≥6, stage of second HNSCC , stage of first HNSCC , and duration from first primary HNSCC of <3 years were significant poor independent prognostic risk factors for overall survival. After adjustment, adjusted hazard ratios and 95% confidence intervals for the overall all‐cause mortality risk at msp HNSCC clinical stages III and IV were 0.72 (0.40–1.82), 0.52 (0.35–0.75), and 0.32 (0.22–0.45) in Groups 2, 3, and 4, respectively. A Cox regression analysis indicated that a re‐ RT dose of ≥6000 cG y was an independent protective prognostic factor for treatment modalities. CCI ≥ 6, stage of second HNSCC , stage of first HNSCC , and duration from first primary HNSCC of <3 years were significant poor independent prognostic risk factors for overall survival. A re‐ RT dose of ≥6000 cG y may be necessary for msp HNSCC s.