SEER17 登记的早期头颈部鳞状细胞癌的第二原发恶性肿瘤。

IF 2.9 3区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral diseases Pub Date : 2024-07-25 DOI:10.1111/odi.15083

Hanqing Lin, Xiaobo Wu, Guangnan Yao, Zhihong Chen, Yuanteng Xu, Gongbiao Lin, Chang Lin

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引用次数: 0

摘要

目的研究早期头颈部鳞状细胞癌（HNSCC）治疗方式与二次原发恶性肿瘤风险的关系：从监测、流行病学和最终结果（SEER）数据库中提取了2000年至2020年早期（I-II期，第七版TNM分期手册）HNSCC患者的5年生存者数据。标准化发病率比和超额绝对风险用于评估第二原发性恶性肿瘤（SPM）的外部发展情况。通过估算相对风险来比较组内的 SPM 风险。Fine-Gray模型估算了第二原发性恶性肿瘤的累积发病率：共有8957名早期HNSCC的5年存活者参与了研究。与手术患者相比，接受确定性放疗的患者生存率较低。手术治疗与较低的二次原发恶性肿瘤风险相关（RR = 0.89，95% CI 0.80-0.99），尤其是口咽鳞癌（RR = 0.56，95% CI 0.39-0.82）。根据临床特征划分的亚组之间发生第二次原发性恶性肿瘤的风险差异并不显著。治疗方式对各亚组间第二次原发性恶性肿瘤的风险没有明显影响：结论：与确定性放疗相比，手术治疗可使5年生存者获得更好的生存率，并降低二次原发性恶性肿瘤的风险。二次原发恶性肿瘤的发生率和部位因原发部位而异，这强调了有针对性的长期监测的重要性。

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Second primary malignancy for early-stage head and neck squamous cell carcinoma by SEER17 registries.

Objective: Investigating treatment modalities' association with second primary malignancy risk in early-stage head and neck squamous cell carcinoma (HNSCC).

Methods: Data of 5-year survivors of early-stage (stages I-II, seventh TNM staging manual) HNSCC from 2000 to 2020 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Standardized incidence ratio and excess absolute risk were used to assess second primary malignancy (SPM) development externally. Relative risk was estimated to compare SPM risk within groups. Fine-Gray's model estimated cumulative incidence of second primary malignancy.

Results: Overall, 8957 5-year survivors with early-stage HNSCC were enrolled. Patients receiving definitive radiotherapy had poorer survival than surgery patients. Surgery correlated with lower risk of second primary malignancy (RR = 0.89, 95% CI 0.80-0.99), especially for oropharyngeal squamous cell carcinoma (RR = 0.56, 95% CI 0.39-0.82). Differences in the risk of second primary malignancy among subgroups based on clinical characteristics were not significant. Treatment modalities did not significantly affect risk of second primary malignancy within each subgroup.

Conclusions: Surgery led to better survival and lower risk of second primary malignancy compared to definitive radiotherapy in 5-year survivors. Incidence and sites of second primary malignancy varied by primary sites, emphasizing targeted long-term surveillance's importance.

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来源期刊

Oral diseases 医学-牙科与口腔外科

CiteScore

7.60

自引率

5.30%

发文量

325

审稿时长

4-8 weeks

期刊介绍： Oral Diseases is a multidisciplinary and international journal with a focus on head and neck disorders, edited by leaders in the field, Professor Giovanni Lodi (Editor-in-Chief, Milan, Italy), Professor Stefano Petti (Deputy Editor, Rome, Italy) and Associate Professor Gulshan Sunavala-Dossabhoy (Deputy Editor, Shreveport, LA, USA). The journal is pre-eminent in oral medicine. Oral Diseases specifically strives to link often-isolated areas of dentistry and medicine through broad-based scholarship that includes well-designed and controlled clinical research, analytical epidemiology, and the translation of basic science in pre-clinical studies. The journal typically publishes articles relevant to many related medical specialties including especially dermatology, gastroenterology, hematology, immunology, infectious diseases, neuropsychiatry, oncology and otolaryngology. The essential requirement is that all submitted research is hypothesis-driven, with significant positive and negative results both welcomed. Equal publication emphasis is placed on etiology, pathogenesis, diagnosis, prevention and treatment.