Second Primary Non-Small-Cell Lung Cancer After Head and Neck Cancer: A Population-Based Study of Clinical and Pathologic Characteristics and Survival Outcomes in 3597 Patients.

Abstract:

INTRODUCTION:Retrospective studies have shown an increased risk of second primary lung cancer in patients with a history of head and neck cancer (HNC). No population-based study has examined the overall survival (OS) outcomes of patients with second primary non-small-cell lung cancer (NSCLC) after HNC comparison with patients with first primary NSCLC. PATIENTS AND METHODS:Individuals with histologically confirmed NSCLC diagnosed after nonmetastatic squamous-cell carcinoma of the head and neck (HNC-NSCLC; n = 3597) were identified in Surveillance, Epidemiology, and End Results 18 registries (1988-2013). OS and baseline characteristics were compared in patients with first primary NSCLC (NSCLC-1; n = 365,551) in the same registries. RESULTS:Squamous NSCLC was more common in HNC-NSCLC (n = 745 [64.1%] localized, n = 833 [71.9%] regional, and n = 811 [63.5%] distant) than in the NSCLC-1 (n = 30,901 [38.3%] localized, n = 50,557 [48.2%] regional, and n = 53,720 [29.8%] distant; P < .001). The leading cause of death in HNC-NSCLC was NSCLC (n = 2183; 60.6%), and median OS after localized, regional, and distant NSCLC diagnosis was 2.50 years, 1.17 years, and 5 months, respectively. For NSCLC-1, median OS was 4.58 years, 1.58 years, and 6 months, respectively. These differences were significant (P < .001). In multivariable analysis, a history of HNC remained associated with worse OS for localized (hazard ratio [HR], 1.40; 95% confidence interval [CI], 1.29-1.51; P < .001), regional (HR, 1.26; 95% CI, 1.19-1.35; P < .001) and distant (HR, 1.11; 95% CI, 1.04-1.18; P < .01) stage NSCLC. CONCLUSION:A history of HNC adversely affects OS in patients who subsequently develop NSCLC. This OS decrement might have implications for NSCLC surveillance and NSCLC therapy selection in this population.

journal_name

Clin Lung Cancer

journal_title

Clinical lung cancer

authors

Budnik J,DeNunzio NJ,Singh DP,Milano MT

doi

10.1016/j.cllc.2019.02.017

subject

Has Abstract

pub_date

2020-05-01 00:00:00

pages

195-203

issue

3

eissn

1525-7304

issn

1938-0690

pii

S1525-7304(19)30067-1

journal_volume

21

pub_type

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