Secondary primary malignancy in patients with head and neck squamous cell carcinoma: 27-year experience from the perspective of diagnostic tools

doi:10.1371/journal.pone.0263773

. 2022 Feb 15;17(2):e0263773.

doi: 10.1371/journal.pone.0263773. eCollection 2022.

Secondary primary malignancy in patients with head and neck squamous cell carcinoma: 27-year experience from the perspective of diagnostic tools

Shih-Wei Wang¹, Leong-Perng Chan^{1

2

3}, Ling-Feng Wang^{1

2}, Che-Wei Wu^{1

2

4}, Sheng-Hsuan Lin⁵, Tzu-Yen Huang^{1

2

6}, Ka-Wo Lee^{1

2

3}

Affiliations

¹ Department of Otolaryngology-Head and Neck Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
² Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
³ Department of Otolaryngology-Head and Neck Surgery, Kaohsiung Municipal Tatung Hospital, Kaohsiung, Taiwan.
⁴ Department of Otolaryngology-Head and Neck Surgery, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan.
⁵ Institute of Data Science and Engineering, National Chiao Tung University, Hsinchu, Taiwan.
⁶ Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan.

PMID: 35167611
PMCID: PMC8846538
DOI: 10.1371/journal.pone.0263773

Secondary primary malignancy in patients with head and neck squamous cell carcinoma: 27-year experience from the perspective of diagnostic tools

Shih-Wei Wang et al. PLoS One. 2022.

. 2022 Feb 15;17(2):e0263773.

doi: 10.1371/journal.pone.0263773. eCollection 2022.

Authors

Shih-Wei Wang¹, Leong-Perng Chan^{1

2

3}, Ling-Feng Wang^{1

2}, Che-Wei Wu^{1

2

4}, Sheng-Hsuan Lin⁵, Tzu-Yen Huang^{1

2

6}, Ka-Wo Lee^{1

2

3}

Affiliations

¹ Department of Otolaryngology-Head and Neck Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
² Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
³ Department of Otolaryngology-Head and Neck Surgery, Kaohsiung Municipal Tatung Hospital, Kaohsiung, Taiwan.
⁴ Department of Otolaryngology-Head and Neck Surgery, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan.
⁵ Institute of Data Science and Engineering, National Chiao Tung University, Hsinchu, Taiwan.
⁶ Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan.

PMID: 35167611
PMCID: PMC8846538
DOI: 10.1371/journal.pone.0263773

Abstract

Background: The survival rate of head and neck squamous cell carcinoma (HNSCC) patients with secondary primary malignancy (SPM) showed no significant improvement for decades, however, the impact of advances in diagnostic tools is rarely mentioned. This study investigated the clinical characteristic of HNSCC with SPM over a 27-year period especially from the perspective of diagnostic tools.

Methods: This study evaluated 157 HNSCC patients with SPM. The patients were divided into two groups according to the time of SPM diagnosis (Group A:1992-2003; Group B: 2004-2014). Age, gender, stage of first primary malignancy (FPM), SPM interval, overall survival, and disease-free survival were compared between groups.

Results: Group B had significantly more SPM developed rate (p = 0.002), more SPM patients with advanced stage of FPM (p = 0.001), synchronous SPM (p = 0.006), and shorter SPM interval (p<0.001) compared to Group A. The survival rate in Group B was not significantly better than Group A.

Conclusion: Among patients diagnosed with HNSCC recently, more SPMs are diagnosed in a shorter time interval and in a more advanced stage. The overall advances in diagnostic tools cannot significantly improve SPM survival, however, it enables more patients to receive corresponding treatment.

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Conflict of interest statement

The authors declare no competing interests.

Figures

**Fig 1. Flowchart of inclusion and exclusion procedure in each group.**

**Fig 2. Kaplan-Meier survival curves for first primary malignancy subsites in cases who developed secondary primary malignancy.**

**Fig 3. Kaplan-Meier survival curves for different second primary malignancy (SPM) sites in 157 SPM patients.**

**Fig 4. Kaplan-Meier survival curves for synchronous and metachronous second primary malignancy (SPM) in Group A and Group B.**

See this image and copyright information in PMC

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References

1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424. doi: 10.3322/caac.21492 - DOI - PubMed
1. Warren S. Multiple primary malignant tumors. A survey of the literature and a statistical study. Am J cancer 1932:1358–414.
1. Hong WK, Lippman SM, Itri LM, Karp DD, Lee JS, Byers RM, et al.. Prevention of second primary tumors with isotretinoin in squamous-cell carcinoma of the head and neck. N Engl J Med. 1990;323(12):795–801. doi: 10.1056/NEJM199009203231205 - DOI - PubMed
1. Licciardello JT, Spitz MR, Hong WK. Multiple primary cancer in patients with cancer of the head and neck: second cancer of the head and neck, esophagus, and lung. Int J Radiat Oncol Biol Phys. 1989;17(3):467–76. doi: 10.1016/0360-3016(89)90096-5 - DOI - PubMed
1. Priante AV, Castilho EC, Kowalski LP. Second primary tumors in patients with head and neck cancer. Curr Oncol Rep. 2011;13(2):132–7. doi: 10.1007/s11912-010-0147-7 - DOI - PubMed

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[1] Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424. doi: 10.3322/caac.21492 - DOI - PubMed

[2] Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424. doi: 10.3322/caac.21492 - DOI - PubMed

[3] Warren S. Multiple primary malignant tumors. A survey of the literature and a statistical study. Am J cancer 1932:1358–414.

[4] Warren S. Multiple primary malignant tumors. A survey of the literature and a statistical study. Am J cancer 1932:1358–414.

[5] Hong WK, Lippman SM, Itri LM, Karp DD, Lee JS, Byers RM, et al.. Prevention of second primary tumors with isotretinoin in squamous-cell carcinoma of the head and neck. N Engl J Med. 1990;323(12):795–801. doi: 10.1056/NEJM199009203231205 - DOI - PubMed

[6] Hong WK, Lippman SM, Itri LM, Karp DD, Lee JS, Byers RM, et al.. Prevention of second primary tumors with isotretinoin in squamous-cell carcinoma of the head and neck. N Engl J Med. 1990;323(12):795–801. doi: 10.1056/NEJM199009203231205 - DOI - PubMed

[7] Licciardello JT, Spitz MR, Hong WK. Multiple primary cancer in patients with cancer of the head and neck: second cancer of the head and neck, esophagus, and lung. Int J Radiat Oncol Biol Phys. 1989;17(3):467–76. doi: 10.1016/0360-3016(89)90096-5 - DOI - PubMed

[8] Licciardello JT, Spitz MR, Hong WK. Multiple primary cancer in patients with cancer of the head and neck: second cancer of the head and neck, esophagus, and lung. Int J Radiat Oncol Biol Phys. 1989;17(3):467–76. doi: 10.1016/0360-3016(89)90096-5 - DOI - PubMed

[9] Priante AV, Castilho EC, Kowalski LP. Second primary tumors in patients with head and neck cancer. Curr Oncol Rep. 2011;13(2):132–7. doi: 10.1007/s11912-010-0147-7 - DOI - PubMed

[10] Priante AV, Castilho EC, Kowalski LP. Second primary tumors in patients with head and neck cancer. Curr Oncol Rep. 2011;13(2):132–7. doi: 10.1007/s11912-010-0147-7 - DOI - PubMed

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Secondary primary malignancy in patients with head and neck squamous cell carcinoma: 27-year experience from the perspective of diagnostic tools

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Secondary primary malignancy in patients with head and neck squamous cell carcinoma: 27-year experience from the perspective of diagnostic tools

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