Time‐varying association of second primary malignancy and long‐term survival outcomes in patients with head and neck cancer

Zhu, Xiaoke; Heng, Yu; Zhou, Jian; Lin, Hanqing; Zhou, Liang; Zhang, Ming; Cao, Pengyu; Tao, Lei

doi:10.1002/ijc.34520

Cited by 2 publications

(1 citation statement)

References 34 publications

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“…In this study, extensive analysis was conducted to determine the prognostic factors in patients diagnosed with T1–T2 SGSCC. In contrast to studies that used the SEER database to analyze head and neck diseases and other systemic diseases [ 17 , 18 ], this study was conducted using both the SEER database and similar cases from the First Affiliated Hospital of Xinjiang Medical University. Subsequently, a nomogram predictive model for prognosis was developed using multivariate and univariate Cox regression analysis.…”

Section: Discussionmentioning

confidence: 99%

Nomogram for predicting survival in T1–T2 stage patients with supraglottic squamous cell carcinoma

Maimaitituerxun,

Kamilijiang,

Maimaiti

et al. 2024

Discov Onc

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Background Supraglottic squamous cell carcinoma (SGSCC) is characterized by low differentiation, rapid growth, and inconspicuous initial manifestations. Early detection and prompt treatment can significantly improve survival rates. The main focus of treatment is to maintain optimal laryngeal function. Methods Using the Surveillance, Epidemiology, and End Results (SEER) database, we conducted univariate and multivariate Cox regression analyses to identify independent prognostic factors for T1–T2 SGSCC. We also enrolled 109 patients with T1–T2 SGSCC from the First Affiliated Hospital of Xinjiang Medical University as an external validation set. In addition, we developed a nomogram to predict the prognosis of T1–T2 SGSCC, assessed the predictive accuracy and discriminatory ability of the nomogram using the area under the curve (AUC), C-index, receiver operating characteristic (ROC) curve and calibration curve, and confirmed the clinical validity of the nomogram using decision curve analysis (DCA). Results Our investigation identified nine prognostic indicators for T1–T2 SGSCC: age (≥ 65 years), marital status, American Joint Committee on Cancer (AJCC) stage (II–IV), grade (III–IV), M stage (M1), radiotherapy, chemotherapy, sex (female), and surgery. These variables were used to create accurate nomograms that predict overall and specific survival rates at 1, 3, and 5 years. The nomograms demonstrated superior prognostic value and accuracy compared to AJCC staging. Laryngectomy with partial laryngectomy is the preferred treatment option for T1–T2 SGSCC cases, providing superior overall survival (OS) and cancer-specific survival (CSS). Radiotherapy also improves OS and CSS. Our results were based on a comprehensive analysis of various indicators, including the C-index, ROC curve, calibration curve, and DCA curve. Conclusion Nomograms provide significant advantages in treatment decision making and diagnosis. Laryngectomy with partial laryngectomy is the most appropriate method for T1–T2 SGSCC cases. However, radiotherapy can also be used. Thus, patients with T1–T2 SGSCC should be evaluated to determine if combination therapy is the optimal treatment approach. Nevertheless, further research is needed to understand the role of chemotherapy. Overall, this study identified nine key predictors of future outcomes, aiding healthcare professionals in assessing risks and making treatment decisions for T1–T2 SGSCC patients.

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Section: Discussionmentioning

confidence: 99%

Nomogram for predicting survival in T1–T2 stage patients with supraglottic squamous cell carcinoma

Maimaitituerxun,

Kamilijiang,

Maimaiti

et al. 2024

Discov Onc

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Risk of Second Primary Malignancy after Surgery or Definitive Radiotherapy for Early-Stage Head and Neck Squamous Cell Carcinoma: A Population-based Study

Lin,

Wu,

Yao

et al. 2023

Preprint

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Background The primary treatment modalities for patients with early-stage head and neck squamous cell carcinoma (HNSCC) predominantly include surgical resection and definitive radiotherapy (RT). However, RT may increase the risk of second primary malignancy (SPM) in cancer patients. This study aimed to investigate the association between treatment modalities and SPM risk in early-stage HNSCC patients. Methods Data of 5-year survivors of early-stage (stage I-II, 7th AJCC staging manual) HNSCC from 2000 to 2020 was extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Standardized incidence ratio (SIR) and excess absolute risk (EAR) were used to assess SPM development externally. Relative risk (RR) was estimated to compare SPM risk within treatment groups. Fine-Gray's competing risk model was applied to estimate cumulative SPM incidence after the diagnosis of index early-stage HNSCC. Results The study included 8957 5-year survivors with early-stage HNSCC. Patients who received definitive RT had poorer long-term survival compared to those who underwent surgical resection. Surgical resection was associated with a lower SPM risk (RR = 0.89, 95% CI 0.80–0.99), particularly in patients with primary oropharyngeal squamous cell carcinoma (RR = 0.56, 95% CI 0.39–0.82). Differences in the risk of SPM development among subgroups based on clinical characteristics were not significant. Treatment modalities did not significantly affect SPM risk within each subgroup. Conclusions Surgical treatment in early-stage HNSCC patients was associated with better overall survival and a lower risk of SPM compared to definitive RT. SPM incidence and sites varied among different primary sites, emphasizing the importance of targeted long-term follow-up surveillance.

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Time‐varying association of second primary malignancy and long‐term survival outcomes in patients with head and neck cancer

Cited by 2 publications

References 34 publications

Nomogram for predicting survival in T1–T2 stage patients with supraglottic squamous cell carcinoma

Nomogram for predicting survival in T1–T2 stage patients with supraglottic squamous cell carcinoma

Risk of Second Primary Malignancy after Surgery or Definitive Radiotherapy for Early-Stage Head and Neck Squamous Cell Carcinoma: A Population-based Study

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