Pretreatment age and serum lactate dehydrogenase as predictors of synchronous second primary cancer in patients with nasopharyngeal carcinoma

Chien-Fu Yeh; Ching-Yin Ho; Yu-Ching Chin; Chih-Hung Shu; Yun-Ting Chao; Ming-Ying Lan

doi:10.1016/j.oraloncology.2020.104990

Pretreatment age and serum lactate dehydrogenase as predictors of synchronous second primary cancer in patients with nasopharyngeal carcinoma

Oral Oncol. 2020 Nov:110:104990. doi: 10.1016/j.oraloncology.2020.104990. Epub 2020 Sep 12.

Authors

Chien-Fu Yeh¹, Ching-Yin Ho², Yu-Ching Chin³, Chih-Hung Shu⁴, Yun-Ting Chao⁵, Ming-Ying Lan⁶

Affiliations

¹ Department of Otorhinolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Taipei 11217, Taiwan; Department of Otorhinolaryngology, School of Medicine, National Yang-Ming University, No. 155, Sec. 2, Linong St., Taipei 11221, Taiwan.
² Department of Otorhinolaryngology, School of Medicine, National Yang-Ming University, No. 155, Sec. 2, Linong St., Taipei 11221, Taiwan; Department of Otolaryngology, Cheng Hsin General Hospital, No. 45, Zhenxing St., Taipei 11220, Taiwan.
³ Department of Otorhinolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Taipei 11217, Taiwan.
⁴ Department of Otorhinolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Taipei 11217, Taiwan; Department of Otorhinolaryngology, School of Medicine, National Yang-Ming University, No. 155, Sec. 2, Linong St., Taipei 11221, Taiwan; Occupational Safety and Health Office, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Taipei 11217, Taiwan.
⁵ Department of Otorhinolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Taipei 11217, Taiwan; Department of Otorhinolaryngology, School of Medicine, National Yang-Ming University, No. 155, Sec. 2, Linong St., Taipei 11221, Taiwan; Institute of Brain Science, National Yang-Ming University, No. 155, Sec. 2, Linong St., Taipei 11221, Taiwan.
⁶ Department of Otorhinolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Taipei 11217, Taiwan; Department of Otorhinolaryngology, School of Medicine, National Yang-Ming University, No. 155, Sec. 2, Linong St., Taipei 11221, Taiwan. Electronic address: mylan@vghtpe.gov.tw.

PMID: 32932171
DOI: 10.1016/j.oraloncology.2020.104990

Abstract

Objectives: Nasopharyngeal carcinoma (NPC) is a common cancer and is treated primarily by chemotherapy and radiotherapy. However, NPC with synchronous second primary cancer (SSPC) is very rare and its risk factors, treatment and prognosis remain unclear. In this study, we aimed to analyze patients with NPC and SSPC, and attempt to find potential predictors for these patients.

Materials and methods: We retrospectively collected 681 patients with NPC from 2006 to 2018. Patients in this study were divided into two groups: those patients with SSPC and those without SSPC. We then analyzed the demographic data and survival of these two groups. Independent predictors of SSPC were determined by multivariate regression analysis. A comprehensive review of the literature was also performed.

Results: We identified 17 NPC patients with SSPC in our case series and 13 cases in the literatures, and the most common SSPC is lung (16.1%). In univariate analysis, NPC patients with SSPC had older age (P < 0.001) and higher serum lactate dehydrogenase (LDH) (P = 0.008), compared with those without SSPC. In multivariate analysis, old age (P = 0.001) and high serum LDH (P = 0.023) remained independent predictors of SSPC, and a predictive equation model was established. NPC patients with SSPC had a significantly lower 5-year disease-specific survival rate compared with patients without SSPC (34.0% vs. 77.6%, P < 0.001) CONCLUSION: This study demonstrated that pretreatment age and serum LDH were independent predictors for SSPC in NPC patients. These independent factors can be used for early detection, and better facilitate the design of more appropriate treatment by medical professionals.

Keywords: Age; Lactate dehydrogenase; Nasopharyngeal carcinoma; Predictor; Synchronous second primary cancer.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Age Factors
Aged
Aged, 80 and over
Biomarkers
Clinical Decision-Making
Combined Modality Therapy
Disease Management
Early Detection of Cancer
Endoscopy
Female
Humans
Lactate Dehydrogenases / blood*
Magnetic Resonance Imaging
Male
Middle Aged
Multimodal Imaging / methods
Nasopharyngeal Carcinoma / blood*
Nasopharyngeal Carcinoma / diagnosis
Nasopharyngeal Carcinoma / therapy
Nasopharyngeal Neoplasms / blood*
Nasopharyngeal Neoplasms / diagnosis
Nasopharyngeal Neoplasms / therapy
Neoplasm Grading
Neoplasm Staging
Neoplasms, Second Primary / diagnosis*
Neoplasms, Second Primary / etiology*
Neoplasms, Second Primary / mortality
Neoplasms, Second Primary / therapy
Prognosis
Retrospective Studies
Young Adult

Substances

Biomarkers
Lactate Dehydrogenases