The Incidence, Survival, and HPV Impact of Second Primary Cancer following Primary Oropharyngeal Squamous Cell Carcinoma: A 20-Year Retrospective and Population-Based Study
Lasse Andersen,
Kathrine Kronberg Jakobsen,
Amanda-Louise Fenger Carlander,
Martin Garset-Zamani,
Jeppe Friborg,
Katalin Kiss,
Rasmus L. Marvig,
Caroline Olsen,
Finn Cilius Nielsen,
Elo Andersen,
Christian Grønhøj,
Christian von Buchwald
Affiliations
Lasse Andersen
Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, DK-2100 Copenhagen, Denmark
Kathrine Kronberg Jakobsen
Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, DK-2100 Copenhagen, Denmark
Amanda-Louise Fenger Carlander
Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, DK-2100 Copenhagen, Denmark
Martin Garset-Zamani
Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, DK-2100 Copenhagen, Denmark
Jeppe Friborg
Department of Oncology, Herlev Hospital, University of Copenhagen, DK-2730 Herlev, Denmark
Katalin Kiss
Department of Pathology, Rigshospitalet, University of Copenhagen, DK-2100 Copenhagen, Denmark
Rasmus L. Marvig
Center for Genomic Medicine, Rigshospitalet, University of Copenhagen, DK-2100 Copenhagen, Denmark
Caroline Olsen
Department of Pathology, Rigshospitalet, University of Copenhagen, DK-2100 Copenhagen, Denmark
Finn Cilius Nielsen
Center for Genomic Medicine, Rigshospitalet, University of Copenhagen, DK-2100 Copenhagen, Denmark
Elo Andersen
Department of Oncology, Herlev Hospital, University of Copenhagen, DK-2730 Herlev, Denmark
Christian Grønhøj
Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, DK-2100 Copenhagen, Denmark
Christian von Buchwald
Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, DK-2100 Copenhagen, Denmark
Second primary cancer (SPC) is the second most common cause of death among patients diagnosed with head and neck cancer. This study examined the risk of SPC following oropharyngeal squamous cell carcinoma (OPSCC) and the impact of human papillomavirus (HPV) on survival following SPC. The study was a population-based, retrospective study including all patients diagnosed with OPSCC in eastern Denmark from 2000–2020 who received curative intended treatment. The incidence rate ratio (IRR), age-adjusted incidence rates (AAIR), and hazard ratios (HR) were calculated. A total of 2584 patients with primary OPSCC were included (median follow-up time: 3.1 years), with 317 patients (12.3%) diagnosed with SPC. The risk of SPC was approximately five times the occurrence of cancer in the general population (IRR: 4.96). The median time to SPC after a primary OPSCC was 2.0 years (interquartile range (IQR) = 0.6–4.2 years). HPV-positive (HPV+) patients had a significantly longer median time to SPC, and a significant better survival compared to HPV-negative (HPV-) patients. SPC was most frequently found in lungs, head, and neck (LHN) for HPV- OPSCC patients and lungs followed by gender-specific (prostate, ovaries, or endometrium) for HPV+ OPSCC. There was a significant difference between the two groups when distributed between “within” or “outside” LHN. Patients with SPC outside LHN had a significant better overall survival. This knowledge should be considered during post-treatment surveillance and might guide targeted imaging.
