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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 5-year disease-free survival, disease-specific survival, and overall survival in all patients (A). Kaplan–Meier plots of 5-year overall survival in OSCC patients with a single, second, third, and fourth primary tumors calculated from date of treatment for the index OSCC (B), and from the data of diagnosis of each primary tumor (C). Kaplan–Meier plots of 5-year overall survival in OSCC patients with a fourth primary malignancy with and without treatment with radical surgery (D). OSCC = oral cavity squamous cell carcinoma.
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Figure 2: Kaplan–Meier plots of 5-year disease-free survival, disease-specific survival, and overall survival in all patients (A). Kaplan–Meier plots of 5-year overall survival in OSCC patients with a single, second, third, and fourth primary tumors calculated from date of treatment for the index OSCC (B), and from the data of diagnosis of each primary tumor (C). Kaplan–Meier plots of 5-year overall survival in OSCC patients with a fourth primary malignancy with and without treatment with radical surgery (D). OSCC = oral cavity squamous cell carcinoma.

Mentions: The 5-year disease-free, disease-specific, and OS rates in the entire cohort were 73%, 81%, and 68%, respectively (Figure 2A). The 5, 10, 15-year OS rates (calculated from the date of surgery) for patients with single, second, third, and fourth PTs were 68%/61%/57%, 67%/47%/36%, 75%/57%/41%, and 87%/58%/32%, respectively (Figure 2B). At 5 years, patients with fourth PTs had acceptable OS rates. Patients who developed second, third, and fourth PTs showed a tendency toward lower OS rates after 10 years compared with those with a single primary malignancy. The 5 and 10-year OS rates (calculated from the diagnosis of single and multiple 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; Figure 2C). Among patients with a fourth PT (n = 25), those who underwent radical surgical removal showed a significantly higher 3-year OS than those who did not (57% vs 13%, respectively; P = 0.0442; Figure 2D).


Incidence and Outcomes of Patients With Oral Cavity Squamous Cell Carcinoma and Fourth Primary Tumors
Kaplan–Meier plots of 5-year disease-free survival, disease-specific survival, and overall survival in all patients (A). Kaplan–Meier plots of 5-year overall survival in OSCC patients with a single, second, third, and fourth primary tumors calculated from date of treatment for the index OSCC (B), and from the data of diagnosis of each primary tumor (C). Kaplan–Meier plots of 5-year overall survival in OSCC patients with a fourth primary malignancy with and without treatment with radical surgery (D). 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 2: Kaplan–Meier plots of 5-year disease-free survival, disease-specific survival, and overall survival in all patients (A). Kaplan–Meier plots of 5-year overall survival in OSCC patients with a single, second, third, and fourth primary tumors calculated from date of treatment for the index OSCC (B), and from the data of diagnosis of each primary tumor (C). Kaplan–Meier plots of 5-year overall survival in OSCC patients with a fourth primary malignancy with and without treatment with radical surgery (D). OSCC = oral cavity squamous cell carcinoma.
Mentions: The 5-year disease-free, disease-specific, and OS rates in the entire cohort were 73%, 81%, and 68%, respectively (Figure 2A). The 5, 10, 15-year OS rates (calculated from the date of surgery) for patients with single, second, third, and fourth PTs were 68%/61%/57%, 67%/47%/36%, 75%/57%/41%, and 87%/58%/32%, respectively (Figure 2B). At 5 years, patients with fourth PTs had acceptable OS rates. Patients who developed second, third, and fourth PTs showed a tendency toward lower OS rates after 10 years compared with those with a single primary malignancy. The 5 and 10-year OS rates (calculated from the diagnosis of single and multiple 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; Figure 2C). Among patients with a fourth PT (n = 25), those who underwent radical surgical removal showed a significantly higher 3-year OS than those who did not (57% vs 13%, respectively; P = 0.0442; Figure 2D).

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