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Risk factors of secondary cancer in laryngeal, oropharyngeal, or hypopharyngeal cancer after definitive therapy

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International Journal of Clinical Oncology Aims and scope Submit manuscript

Abstract

Background

Our previous research showed that a high rate of secondary carcinogenesis is observed during follow-up after transoral surgery in patients with early-stage laryngeal, oropharyngeal, and hypopharyngeal cancers. We speculate that the contributing factors are alcohol drinking, smoking, and aging; however, we could not provide clear evidence. In this study, we aimed to identify the risk factors for secondary carcinogenesis in patients with these cancers, particularly factors associated with drinking and/or smoking.

Methods

The medical records of all-stage laryngeal, oropharyngeal, and hypopharyngeal cancer patients who had undergone definitive treatment were retrospectively analyzed. Assessments included visual and endoscopic observations of the primary site, enhanced cervical CT or US of the primary site and regional lymph nodes, PET-CT, and enhanced whole-body CT. Clinical characteristics were compared in patients with and without secondary carcinogenesis and in patients with hypopharyngeal cancer and patients with other cancers.

Results

Hypopharyngeal cancer was an independent risk factor for secondary cancer. The 5-year incidence rate of secondary cancer was 25.5%, 28.6%, and 41.2% in laryngeal, oropharyngeal, and hypopharyngeal cancers, respectively. Radiotherapy was defined as an independent risk factor in hypopharyngeal cancer patients with secondary cancers. No direct correlation was found between secondary carcinogenesis and alcohol consumption, smoking, or aging.

Conclusions

Patients with hypopharyngeal cancer require close follow-up as they are at high risk of developing secondary cancer, possibly because out-of-field radiation exposure may induce systemic secondary carcinogenesis in hypopharyngeal cancer patients with genetic abnormality induced by alcohol consumption.

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Availability of data

The datasets used in the present study are available from the corresponding author upon request. All data generated or analyzed in this study are included in this published article.

Abbreviations

PET-CT:

Positron emission tomography-computed tomography

NBI:

Narrow-band imaging

TOS:

Transoral surgery

HPV:

Human papilloma virus

ROC:

Receiver operating characteristic

ALDH2:

Acetaldehyde dehydrogenase 2

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Head and Neck Surgery, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, 236-0004, Japan

    Goshi Nishimura, Hideaki Takahashi, Daisuke Sano, Yasuhiro Arai, Takashi Hatano, Yosuke Kitani & Nobuhiko Oridate

Authors
  1. Goshi Nishimura
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  2. Hideaki Takahashi
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  3. Daisuke Sano
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  4. Yasuhiro Arai
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  5. Takashi Hatano
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  6. Yosuke Kitani
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  7. Nobuhiko Oridate
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Contributions

GN and NO conceived the study, performed statistical analyses, and edited the manuscript. GN and HT designed the study. GN, DS, YA, TH, and YK acquired, analyzed, and interpreted the data. GN and HT evaluated the quality of the data and algorithms. GN prepared the manuscript and all authors reviewed and approved the final version of the manuscript.

Corresponding author

Correspondence to Goshi Nishimura.

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Conflict of interest

The authors declare no conflicts of interest.

Ethics approval and consent to participate

Ethical approval for the study was obtained from the Yokohama City University Institutional Review Board (#F230200009). Written informed consent was obtained from the participants to publish their data.

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Not applicable.

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Nishimura, G., Takahashi, H., Sano, D. et al. Risk factors of secondary cancer in laryngeal, oropharyngeal, or hypopharyngeal cancer after definitive therapy. Int J Clin Oncol 29, 103–114 (2024). https://doi.org/10.1007/s10147-023-02433-8

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  • DOI: https://doi.org/10.1007/s10147-023-02433-8

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