Second Primary Malignancy in Patients with Hypopharyngeal Carcinoma: A SEER-Based Study

Liqing Guo; Yanpeng Fu; Chunyu Miao; Shuhong Wu; Yaqiong Zhu; Yuehui Liu

doi:10.2147/IJGM.S339595

Second Primary Malignancy in Patients with Hypopharyngeal Carcinoma: A SEER-Based Study

Int J Gen Med. 2021 Nov 25:14:8847-8861. doi: 10.2147/IJGM.S339595. eCollection 2021.

Authors

Liqing Guo¹, Yanpeng Fu¹, Chunyu Miao², Shuhong Wu¹, Yaqiong Zhu¹, Yuehui Liu¹

Affiliations

¹ Department of Otolaryngology, The Second Affiliated Hospital of Nanchang University, NanChang, 330006, JiangXi, People's Republic of China.
² Department of Otolaryngology, Nanchang Affiliated Hospital of Sun Yat-Sen University, NanChang, 330009, JiangXi, People's Republic of China.

Abstract

Background: A population-based analysis of the risk of secondary primary malignancy (SPM) in patients with hypopharyngeal carcinoma (HPC) has been lacking in the literature. Therefore, we conducted this study to determine the risk factors and assess the effects of SPM on the overall survival (OS) and cancer-specific survival (CSS) of patients with HPC.

Methods: Data on selected patients diagnosed with HPC from the Surveillance, Epidemiology and End Results (SEER) database between 1973 and 2015 were examined through logistic regression, Cox regression and nomogram methods.

Results: The overall risk of SPM in patients with HPC was higher than that in the general population (SIR: 2.77; P < 0.05). The specific-site, including the oral cavity, pharynx, digestive system, respiratory system and endocrine system, had a relatively higher risk of SPM. The overall risks of the subgroup of people 55-75 years of age and all subgroups of sex, race and latency were significantly elevated. In addition, patients with HPC were more likely to have been diagnosed in 2010-2015 (vs 2004-2009; P = 0.002), to be unmarried (vs married; P = 0.008), to have distant metastasis (vs no metastasis; P = 0.016) and to have had no surgery for the first tumor (vs surgery for the first tumor; P = 0.021), and these aspects were associated with a significantly elevated risk of developing SPM. SPM was independently associated with better OS and CSS. The OS and CSS in patients with HPC with SPM were better than those in patients without SPM (log rank P < 0.0001). The C indexes of the nomogram constructed with ten influencing factors including SPM were 0.681:0.699 for OS and 0.705:0.724 for CSS (training cohort:validation cohort).

Conclusion: Although the overall risk of SPM in patients with HPC was elevated, SPM did not decrease the OS and CSS in patients with HPC. This finding is inconsistent with clinical observations and thus requires further research and exploration. It possibly because HPC might have a shorter survival time, or the follow-up time was not long enough.

Keywords: HPC; SEER; SPM; hypopharyngeal carcinoma; nomogram; secondary primary malignancy.

Grants and funding

The National Natural Science Fund of China supported this study (Grant No. 81760184 and 82060185).