Clinical characteristics and efficacy of second primary malignancies in hypopharyngeal carcinoma: an analysis of 216 real‐world cases
Luo Xi1, Wu Runye1, Liu Shaoyan2, Wang Xiaolei2, Ni Xiaoguang3, Zhang Ye1, Huang Xiaodong1, Wang Kai1, Chen Xuesong1, Wang Jingbo1, Zhang Jianghu1, Qu Yuan1, Luo Jingwei1, Yi Junlin1
1Department 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; 2Department of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China; 3Department of Endoscopy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Abstract：Objective To evaluate the incidence, clinical characteristics and prognosis of second primary malignancies (SPMs) among patients with hypopharyngeal carcinoma (HPC) in real‐world analysis. Methods A total of 594 HPC patients admitted to Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College from 2010 to 2018 were retrospectively analyzed.The incidence and clinical characteristics of HPC patients complicated with SPMs were analyzed. Clinical efficacy was compared among different groups. Results With a median follow‐up time of 66.9 months, SPMs were present in 36.4% (216/594) of HPC patients: 22.2% (132/594) were synchronous and 14.1% (84/594) were metachronous. The upper aerodigestive tract was the most common involved region. Compared with patients without SPMs, patients with synchronous and metachronous carcinoma in situ had similar 5‐year overall survival (OS) of 42.2% vs. 44.5% (P=0.958) and 62.2% vs. 44.5% (P=0.240), respectively. Patients with synchronous invasive SPMs had a worse 5‐year OS of 27.2% vs. 44.5% in their counterparts without SPMs (P=0.001). Patients with metachronous invasive SPMs had similar 5‐year OS of 50.2% vs. 44.5% in their counterparts without SPMs (P=0.587). SPMs accounted for 42.5% of total death in metachronous invasive SPMs group. Conclusions Patients with HPC have a high probability of developing SPMs. Moreover, the incidence of complicated with esophageal/gastric carcinoma in situ or metachronous SPMs exerts no effect on prognosis, while the occurrence of synchronous SPMs significantly affectes the prognosis of patients. However, the incidence of SPMs is still one of the main death causes in metachronous invasive SPMs group.
Luo Xi,Wu Runye,Liu Shaoyan et al. Clinical characteristics and efficacy of second primary malignancies in hypopharyngeal carcinoma: an analysis of 216 real‐world cases[J]. Chinese Journal of Radiation Oncology, 2023, 32(3): 194-200.
[1] Carvalho AL, Nishimoto IN, Califano JA, et al.Trends in incidence and prognosis for head and neck cancer in the United States: a site-specific analysis of the SEER database[J]. Int J Cancer, 2005,114(5):806-816. DOI: 10.1002/ijc.20740.
[2] De Angelis R, Sant M, Coleman MP, et al.Cancer survival in Europe 1999-2007 by country and age: results of EUROCARE--5-a population-based study[J]. Lancet Oncol, 2014,15(1):23-34. DOI: 10.1016/S1470-2045(13)70546-1.
[3] Hall SF, Groome PA, Irish J, et al.The natural history of patients with squamous cell carcinoma of the hypopharynx[J]. Laryngoscope, 2008,118(8):1362-1371. DOI: 10.1097/MLG.0b013e318173dc4a.
[4] Blanchard P, Baujat B, Holostenco V, et al.Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): a comprehensive analysis by tumour site[J]. Radiother Oncol, 2011,100(1):33-40. DOI: 10.1016/j.radonc.2011.05.036.
[5] Chen MC, Chen PT, Chan CH, et al.Second primary esophageal or lung cancer in patients with head and neck carcinoma in Taiwan: incidence and risk in relation to primary index tumor site[J]. J Cancer Res Clin Oncol, 2011,137(1):115-123. DOI: 10.1007/s00432-010-0865-0.
[6] Muto M, Hironaka S, Nakane M, et al.Association of multiple Lugol-voiding lesions with synchronous and metachronous esophageal squamous cell carcinoma in patients with head and neck cancer[J]. Gastrointest Endosc, 2002,56(4):517-521. DOI: 10.1067/mge.2002.128104.
[7] Yamamoto K, Takano K, Kondo A, et al.Clinical and prognostic analysis of hypopharyngeal squamous cell carcinoma with synchronous and metachronous multiple malignancies[J]. In Vivo, 2018,32(1):165-170. DOI: 10.21873/invivo.11220.
[8] Luo X, Huang XD, Liu SY, et al.Evaluation of the prevalence of metachronous second primary malignancies in hypopharyngeal carcinoma and their effect on outcomes[J]. Cancer Med, 2022,11(4):1059-1067. DOI: 10.1002/cam4.4501.
[9] Avinçsal MO, Shinomiya H, Teshima M, et al.Impact of alcohol dehydrogenase-aldehyde dehydrogenase polymorphism on clinical outcome in patients with hypopharyngeal cancer[J]. Head Neck, 2018,40(4):770-777. DOI: 10.1002/hed.25050.
[10] Yamamoto E, Shibuya H, Yoshimura R, et al.Site specific dependency of second primary cancer in early stage head and neck squamous cell carcinoma[J]. Cancer, 2002,94(7):2007-2014. DOI: 10.1002/cncr.10444.
[11] McGurk M, Chan C, Jones J, et al. Delay in diagnosis and its effect on outcome in head and neck cancer[J]. Br J Oral Maxillofac Surg, 2005,43(4):281-284. DOI: 10.1016/j.bjoms.2004.01.016.
[12] Priante AV, Castilho EC, Kowalski LP.Second primary tumors in patients with head and neck cancer[J]. Curr Oncol Rep, 2011,13(2):132-137. DOI: 10.1007/s11912-010-0147-7.
[13] León X, Quer M, Orús C, et al.Can cure be achieved in patients with head and neck carcinomas? The problem of second neoplasm[J]. Expert Rev Anticancer Ther, 2001,1(1):125-133. DOI: 10.1586/14737140.1.1.125.
[14] Hong WK, Lippman SM, Itri LM, et al.Prevention of second primary tumors with isotretinoin in squamous-cell carcinoma of the head and neck[J]. N Engl J Med, 1990,323(12):795-801. DOI: 10.1056/NEJM199009203231205.
[15] Bugter O, van Iwaarden D, Dronkers E, et al. Survival of patients with head and neck cancer with metachronous multiple primary tumors is surprisingly favorable[J]. Head Neck, 2019,41(6):1648-1655. DOI: 10.1002/hed.25595.
[16] Li QW, Zhu YJ, Zhang WW, et al.Chemoradiotherapy for synchronous multiple primary cancers with esophageal squamous cell carcinoma: a case-control study[J]. J Cancer, 2017,8(4):563-569. DOI: 10.7150/jca.17408.
[17] Lee DH, Roh JL, Baek S, et al.Second cancer incidence, risk factor, and specific mortality in head and neck squamous cell carcinoma[J]. Otolaryngol Head Neck Surg, 2013,149(4):579-586. DOI: 10.1177/0194599813496373.
2023, Vol. 32 
