The incidence of newly diagnosed secondary cancer; sub-analysis the prospective study of the second-look procedure for t
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ORIGINAL ARTICLE
The incidence of newly diagnosed secondary cancer; sub‑analysis the prospective study of the second‑look procedure for transoral surgery in patients with T1 and T2 head and neck cancer Goshi Nishimura1 · Daisuke Sano1 · Yasuhiro Arai1 · Takashi Hatano1 · Hideaki Takahashi1 · Yosuke Kitani1 · Kentaro Takada1 · Takashi Wada1 · Nobuhiko Oridate1 Received: 11 June 2020 / Accepted: 27 August 2020 © Japan Society of Clinical Oncology 2020
Abstract Background Our prospective study of patients with early T-stage head and neck cancer indicated a high incidence of newly diagnosed secondary malignancies during the follow-up period. We aimed to determine the incidence rate and risk factors of secondary malignancies in early-stage head and neck cancer patients. Methods We sub-analyzed the patient data of a previous study focusing on secondary cancer incidence. The endpoints were statistical analyses of risk factors and survival and incidence rates. Results The incidence rate of secondary cancer was 37%, the crude incidence of second primary cancers was 10.6 per 100 person-years, and the 5 year secondary cancer-free survival rate was 63%. The hypopharynx as the primary site was an independent significant predictive factor (odds ratio 3.96, 95% confidence interval 1.07–14.6, p = 0.039). Conclusions Early stages of laryngeal, oropharyngeal, and hypopharyngeal cancer had a risk of secondary cancer, especially hypopharyngeal cancer. Attention to the secondary cancer has to be paid during the follow-up period after controlling the early-stage disease. These findings highlight the need for awareness of the incidence of secondary cancer in cases of earlystage primary head and neck cancer. Keywords Early stage head and neck cancer · Newly diagnosed secondary cancer · Incidence rate
Introduction The incidence of head and neck cancer is about 5% among all malignancies in Japan [1]. About 60% of head and neck cancer patients are at an advanced stage at the first visit because of poor symptoms, except for glottis and oral cancers, and lack of awareness for head and neck cancers. These advanced-stage patients have a high risk of local recurrence or regional lymph node metastasis. Between 60 and 70% of these cases have unsuccessful treatments within the first year since the diagnosis, and 90–100% within 2 years. Moreover, the percentage of the presence of second primary cancers exceeded that of primary head and neck cancer treatment * Goshi Nishimura gnishimu@yokohama‑cu.ac.jp 1
Department of Otorhinolaryngology, Head and Neck Surgery, Yokohama City University, School of Medicine, 3‑9 Fukuura, Kanazawa‑ku, Yokohama 236‑0004, Japan
failures, which began at 4 years after the diagnosis of the primary cancer [2–4]. Recently, the number of early-stage patients has been increasing following the emergence of advanced diagnostic techniques, such as positron emission tomography-computed tomography (PET-CT) [5] and narrow-band imaging (NBI) endoscopy [6] as well as increased awareness of head and neck cancer among physic
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