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Incidence and Outcomes of Patients With Oral Cavity Squamous Cell Carcinoma and Fourth Primary Tumors

View Article: PubMed Central - PubMed

ABSTRACT

The aim of this study was to explore the incidence and outcomes of patients with oral cavity squamous cell carcinoma (OSCC) and fourth primary tumors (PTs) in a betel-chewing endemic area.

We retrospectively examined the records of 1836 OSCC patients who underwent radical tumor resection between 1996 and 2014. The outcome measures included the incidence and number of multiple PTs, the main risk factors, and their associations with overall survival (OS).

Of the 1836 patients, 1400 (76.3%) had a single PT, 344 (18.7%) a second PT, 67 (3.6%) a third PT, and 25 (1.4%) a fourth PT. Univariate analyses (log-rank test) identified the following factors as significantly associated with a fourth PT: simultaneous first and second PTs, betel quid chewing, buccal subsite, and pT3–4 status. After allowance for the potential confounding effect of other risk factors, all of these factors retained their independent prognostic significance in stepwise multivariate analyses, the only exception being betel chewing. The incidences of second, third, and fourth PTs at 5 and 10 years were 20.2%/34.6%, 4.0%/8.6%, and 1.0%/2.3%, respectively. The 5 and 10-year OS rates (calculated from the diagnosis of each PTs) for patients with a single, second, third, and fourth PTs were 68%/61%, 43%/37%, 45%/39%%, and 30%/30%, respectively (P < 0.0001). Among patients with a fourth PT, those who underwent radical surgery showed a significantly higher 3-year OS than those who did not (57% vs 13%; P = 0.0442).

Fourth PTs are rarely observed in OSCC patients in a betel quid-chewing endemic area. Long-term survival rates of patients treated with radical surgery seems acceptable, being 4-fold higher than their counterparts.

No MeSH data available.


Related in: MedlinePlus

Kaplan–Meier plots of the incidence of second, third, and fourth primary tumors in OSCC patients (A), and 5-year incidence of fourth primary tumors in OSCC patients stratified according to the presence of simultaneous first and second primary tumors (B), betel quid chewing (C), buccal subsite (D), and pT status (E). OSCC = oral cavity squamous cell carcinoma.
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Figure 1: Kaplan–Meier plots of the incidence of second, third, and fourth primary tumors in OSCC patients (A), and 5-year incidence of fourth primary tumors in OSCC patients stratified according to the presence of simultaneous first and second primary tumors (B), betel quid chewing (C), buccal subsite (D), and pT status (E). OSCC = oral cavity squamous cell carcinoma.

Mentions: Of the 1836 patients, 1400 (76.3%) had a single PT, 344 (18.7%) a second PT, 67 (3.6%) a third PT, and 25 (1.4%) a fourth PT. The incidences of second, third, and fourth PTs for all patients (n = 1836) at 5 and 10 years were 20.2%/34.6%, 4.0%/8.6%, and 1.0%/2.3%, respectively (Figure 1A). The time intervals between the first and the second, the second and the third, and the third and the fourth PTs were 0 to 203 months (median: 36 months, mean: 47 months), 0 to 121 months (median: 26 months, mean: 28 months), and 0 to 82 months (median: 22 months, mean: 25 months), respectively. Table 2 summarizes the general characteristics of the study patients who presented with a single, second, third, and fourth PTs. Compared with other groups (single PT, second PT, or third PT), patients with a fourth PT were found to differ in terms of the following risk factors: sex (P = 0.005), preoperative betel quid chewing (P = 0.001), tumor subsite (P < 0.001), pathological N-status (P = 0.001), tumor differentiation (P = 0.002), and perineural invasion (P = 0.009).


Incidence and Outcomes of Patients With Oral Cavity Squamous Cell Carcinoma and Fourth Primary Tumors
Kaplan–Meier plots of the incidence of second, third, and fourth primary tumors in OSCC patients (A), and 5-year incidence of fourth primary tumors in OSCC patients stratified according to the presence of simultaneous first and second primary tumors (B), betel quid chewing (C), buccal subsite (D), and pT status (E). OSCC = oral cavity squamous cell carcinoma.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4998365&req=5

Figure 1: Kaplan–Meier plots of the incidence of second, third, and fourth primary tumors in OSCC patients (A), and 5-year incidence of fourth primary tumors in OSCC patients stratified according to the presence of simultaneous first and second primary tumors (B), betel quid chewing (C), buccal subsite (D), and pT status (E). OSCC = oral cavity squamous cell carcinoma.
Mentions: Of the 1836 patients, 1400 (76.3%) had a single PT, 344 (18.7%) a second PT, 67 (3.6%) a third PT, and 25 (1.4%) a fourth PT. The incidences of second, third, and fourth PTs for all patients (n = 1836) at 5 and 10 years were 20.2%/34.6%, 4.0%/8.6%, and 1.0%/2.3%, respectively (Figure 1A). The time intervals between the first and the second, the second and the third, and the third and the fourth PTs were 0 to 203 months (median: 36 months, mean: 47 months), 0 to 121 months (median: 26 months, mean: 28 months), and 0 to 82 months (median: 22 months, mean: 25 months), respectively. Table 2 summarizes the general characteristics of the study patients who presented with a single, second, third, and fourth PTs. Compared with other groups (single PT, second PT, or third PT), patients with a fourth PT were found to differ in terms of the following risk factors: sex (P = 0.005), preoperative betel quid chewing (P = 0.001), tumor subsite (P < 0.001), pathological N-status (P = 0.001), tumor differentiation (P = 0.002), and perineural invasion (P = 0.009).

View Article: PubMed Central - PubMed

ABSTRACT

The aim of this study was to explore the incidence and outcomes of patients with oral cavity squamous cell carcinoma (OSCC) and fourth primary tumors (PTs) in a betel-chewing endemic area.

We retrospectively examined the records of 1836 OSCC patients who underwent radical tumor resection between 1996 and 2014. The outcome measures included the incidence and number of multiple PTs, the main risk factors, and their associations with overall survival (OS).

Of the 1836 patients, 1400 (76.3%) had a single PT, 344 (18.7%) a second PT, 67 (3.6%) a third PT, and 25 (1.4%) a fourth PT. Univariate analyses (log-rank test) identified the following factors as significantly associated with a fourth PT: simultaneous first and second PTs, betel quid chewing, buccal subsite, and pT3&ndash;4 status. After allowance for the potential confounding effect of other risk factors, all of these factors retained their independent prognostic significance in stepwise multivariate analyses, the only exception being betel chewing. The incidences of second, third, and fourth PTs at 5 and 10 years were 20.2%/34.6%, 4.0%/8.6%, and 1.0%/2.3%, respectively. The 5 and 10-year OS rates (calculated from the diagnosis of each PTs) for patients with a single, second, third, and fourth PTs were 68%/61%, 43%/37%, 45%/39%%, and 30%/30%, respectively (P&#8202;&lt;&#8202;0.0001). Among patients with a fourth PT, those who underwent radical surgery showed a significantly higher 3-year OS than those who did not (57% vs 13%; P&#8202;=&#8202;0.0442).

Fourth PTs are rarely observed in OSCC patients in a betel quid-chewing endemic area. Long-term survival rates of patients treated with radical surgery seems acceptable, being 4-fold higher than their counterparts.

No MeSH data available.


Related in: MedlinePlus