Background: The purpose of the present study was to investigate the clinicopathological characteristics and prognostic factors of second primary oral squamous cell carcinoma after radiotherapy for head and neck cancer. Methods: The clinicopathological characteristics of 27-second primary oral squamous cell carcinoma patients with a history of radio-therapy for head and neck cancer were retrospectively analyzed by Kaplan-Meier survival analysis and Cox proportional hazards model, including gender, age, alcohol consumption, smoking, clinical stage, margin status, regional lymph node status, tumor differentiation and treatment mode. Results: The second primary oral squamous cell carcinoma mostly occurred on the tongue (11/27), buccal (9/27) and gingiva (7/27), and the 3- and 5-year overall survival (OS) was 60.3% and 39.4%, respectively. Margin status and extranodal extension were significantly associated with OS, while only margin status was found to be an independent prognostic factor of OS in the Cox proportional hazards model (P = 0.003, HR = 3.976, 95% CI: 1.596 - 9.904). Conclusion: Oral squamous cell carcinoma patients who underwent radiotherapy for head and neck cancer show poor survival outcomes. Margin status is an independent prognostic factor of second primary oral squamous cell carcinoma.
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Saoudi, A. , Siyouri, O. , Mhirech, S. , Medyouni, H. , Chouef, J. , Kawtar, S. , Amaadour, L. , Oualla, K. , Benbrahim, Z. , Hassani, W. , Farhane, F. , Alami, Z. , Arifi, S. , Mellas, N. and Bouhafa, T. (2024). Second Primary Oral Squamous Cell Carcinoma after Radiotherapy: A Retrospective Study, over 5 Years, about 27 Cases. Open Access Library Journal, 11, e1462. doi: http://dx.doi.org/10.4236/oalib.1111462.
Xi, M., Liu, S.L., Zhao, L., et al. (2013) Prognostic Factors and Survival in Patients with Radiation-Related Second Malignant Neoplasms Following Radiotherapy for Nasopharyngeal Carcinoma. PLOS ONE, 8, e84586. https://doi.org/10.1371/journal.pone.0084586
Liao, L.J., Chou, H.W., Wang, C.T., et al. (2013) The Impact of Second Primary Malignancies on Head and Neck Cancer Survivors: A Nationwide Cohort Study. PLOS ONE, 8, e62116. https://doi.org/10.1371/journal.pone.0062116
Lin, C., Lin, S.W., Weng, S.F., et al. (2014) Risk of Second Primary Malignancies after Nasopharyngeal Carcinoma: A Population-Based Cohort Study in Taiwan. Head & Neck, 36, 209-214. https://doi.org/10.1002/hed.23281
Chan, J.Y., Gooi, Z., Mydlarz, W.K., et al. (2016) Risk of Second Primary Malignancy after Nasopharyngeal Carcinoma in the United States: A Population-Based Study. Head & Neck, 38, e1130-e1136. https://doi.org/10.1002/hed.24173
Dai, L., Fang, Q., Li, P., et al. (2020) Secondary Squamous Cell Carcinoma of the Oral Cavity after Nasopharyngeal Carcinoma. Cancer Research and Treatment, 52, 109-116. https://doi.org/10.4143/crt.2019.202
Fu, X., Chen, S., Chen, W., et al. (2018) Clinical Analysis of Second Primary Gingival Squamous Cell Carcinoma after Radiotherapy. Oral Oncology, 84, 20-24. https://doi.org/10.1016/j.oraloncology.2018.06.018
Zhang, P., Zhang, L., Liu, H., et al. (2017) Clinicopathologic Characteristics and Prognosis of Tongue Squamous Cell Carcinoma in Patients with and without a History of Radiation for Nasopharyngeal Carcinoma: A Matched Case-Control Study. Cancer Research and Treatment, 49, 695-705. https://doi.org/10.4143/crt.2016.317
Song, M., Zhuang, S.M., Chen, S.W., et al. (2012) Survival Study and Treatment Strategy for Second Primary Tumors in the Oral Cavity in Patients with Nasopharyngeal Carcinoma after Definitive Radiation. Head & Neck, 34, 1551-1555. https://doi.org/10.1002/hed.21959
Teshima, T., Inoue, T., Chatani, M., et al. (1992) Incidence of Other Primary Cancers in 1,569 Patients with Pharyngolaryngeal Cancer and Treated with Radiation Therapy. Strahlentherapie und Onkologie, 168, 213-218.
Scholl, P., Byers, R.M., Batsakis, J.G., et al. (1986) Microscopic Cut-Through of Cancer in the Surgical Treatment of Squamous Carcinoma of the Tongue. Prognostic and Therapeutic Implications. The American Journal of Surgery, 152, 354-360. https://doi.org/10.1016/0002-9610(86)90304-1
Liu, B., Shen, M., Xiong, J., et al. (2015) Synergistic Effects of Betel Quid Chewing, Tobacco Use (in the Form of Cigarette Smoking), and Alcohol Consumption on the Risk of Malignant Transformation of Oral Submucous Fibrosis (OSF): A Case-Control Study in Hunan Province, China. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 120, 337-345. https://doi.org/10.1016/j.oooo.2015.04.013
Lee, C.H., Ko, Y.C., Huang, H.L., et al. (2003) The Precancer Risk of Betel Quid Chewing, Tobacco Use and Alcohol Consumption in Oral Leukoplakia and Oral Submucous Fibrosis in Southern Taiwan. British Journal of Cancer, 88, 366-372. https://doi.org/10.1038/sj.bjc.6600727
Sun, C., Hu, Z., Zhong, Z., et al. (2014) Clinical and Prognostic Analysis of Second Primary Squamous Cell Carcinoma of the Tongue after Radiotherapy for Nasopharyngeal Carcinoma. British Journal of Oral and Maxillofacial Surgery, 52, 715-720. https://doi.org/10.1016/j.bjoms.2014.06.015
Ardenfors, O., Josefsson, D. and Dasu, A. (2014) Are IMRT Treatments in the Head and Neck Region Increasing the Risk of Secondary Cancers? Acta Oncologica, 53, 1041-1047. https://doi.org/10.3109/0284186X.2014.925581
Hu, Q., Wu, T., Chen, X., et al. (2018) The Poor Outcome of Second Primary Oral Squamous Cell Carcinoma Is Attributed to Bmi1 Upregulation. Cancer Medicine, 7, 1056-1069. https://doi.org/10.1002/cam4.1348
