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Müller M, Li J, Giger R, Elicin O. Head and neck cancer with synchronous nodules of the lung as a diagnostic and therapeutic challenge - A systematic review. Oral Oncol 2023; 145:106529. [PMID: 37506514 DOI: 10.1016/j.oraloncology.2023.106529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 07/30/2023]
Abstract
Head and neck squamous cell carcinoma (HNSCC) often presents with synchronous nodules of the lung (sNL), which may be benign nodules, second primary malignancies or metastases of HNSCC. We sought to gain an insight into the incidence of sNL and synchronous second primary of the lung (sSPML) in HNSCC patients and current opinions on useful diagnostic and therapeutic approaches. We conducted a systematic search of the PubMed database for articles that reported the simultaneous detection of HNSCC and sNL/sPML, within the timeframe of diagnosis and staging. Only studies involving humans were included, without restrictions for sex, age, ethnicity, or smoking history. All articles were categorised according to the Oxford Centre of Evidence-Based Medicine levels and their data collected. Data from 24 studies were analysed. Amongst HNSCC, the mean overall incidence rate of sNL and sSPML was 11.4% (range: 1.3-27%) and 2.95% (range: 0.4-7.4%), respectively. The possibility of a sNL to be a sSPML cannot be ignored (mean: 35.2%). Studies investigating smoking habits showed that the majority (98-100%) of HNSCC patients with sSPML were previous or active smokers. Detection of human papillomavirus through DNA analysis, p16 immunohistochemistry, and identification of clonal evolution were useful in differentiating metastasis from sSPML. 18FDG-PET scan was the most reliable method to diagnose sSPML (sensitivity: 95%; specificity: 96%; positive predictive value: 80%). With early sSPML detection and curative treatment, the 5-year overall survival rate is 34-47%. However, the proposed advantage of early detection warrants further evidence-based justification.
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Affiliation(s)
- Marc Müller
- HMS Hospital, Ear Nose and Throat Department, Mirdif, Dubai, United Arab Emirates; Freie Universität Liechtenstein, Triesen, Liechtenstein
| | - Jinji Li
- HMS Hospital, Ear Nose and Throat Department, Mirdif, Dubai, United Arab Emirates
| | - Roland Giger
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Olgun Elicin
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
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Zhang C, Tang X, Liu W, Zheng K, Li X, Ma N, Zhao J. Impact of previous extra-pulmonary malignancies on surgical outcomes of sequential primary non-small cell lung cancer. Heliyon 2023; 9:e17898. [PMID: 37519717 PMCID: PMC10372209 DOI: 10.1016/j.heliyon.2023.e17898] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 06/27/2023] [Accepted: 06/30/2023] [Indexed: 08/01/2023] Open
Abstract
Reduced cancer deaths have led to an increase in the number of cancer survivors and the risk of the second primary tumor. This study explored the surgical outcomes of patients with non-small cell lung cancer as the second primary tumor and the impact of previous extra-pulmonary malignancies. Patients' data were obtained from Surveillance, Epidemiology and End Results database. The patients were divided into lung surgery and non-surgery groups. Propensity-score matching was used to balance potential confounders. Kaplan-Meier curves were generated to test the overall survival and lung-cancer-specific survival. Cox regression analysis was performed to calculate death risk. In total 3054 lung surgery and 1094 non-surgery patients with stage I-II non-small cell lung cancer as the second primary tumor were included. The surgery group showed longer overall survival (68 vs. 22 months) and lung cancer-specific survival (not reached vs. 37 months) than those of non-surgery groups (both P < 0.001). Patients with previous hormone-dependent malignancies had similar survival rates (overall survival: 22 vs. 20 months, P = 0.666; lung cancer-specific survival: 38 vs. 37 months, P = 0.292) as those with non-hormone dependent malignancies in the non-surgery group. Significantly longer overall survival (90 vs. 60 months, P = 0.001) was observed in patients with hormone-dependent malignancies in the surgery group; however, there was no difference in lung cancer-specific survival (P = 0.225). Competing risk analysis showed that for patients undergoing lung surgery, there was higher previous malignancy-induced mortality in patients with non-hormone dependent malignancies than in patients with hormone-dependent malignancies. However, there was no difference in lung cancer-induced mortality between the two groups. Patients who underwent lobectomy showed longer survival than those who underwent pneumonectomy and other resection types (89, 27.5 and 65 months, P < 0.001). In summary, lung surgery is beneficial for patients with stage I-II non-small cell lung cancer as the second primary tumor after hormone-dependent malignancy resection.
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Affiliation(s)
- Chenxi Zhang
- Department of Thoracic Surgery, Tangdu Hospital, Air Force Medical University. No.569, Xinsi Road, Xi'an, Shaanxi, 710038, China
- Department of Cardio-thoracic Surgery, 900 Hospital of PLA, Fuzhou, Fujian, 350001, China
| | - Xiyang Tang
- Department of Thoracic Surgery, Tangdu Hospital, Air Force Medical University. No.569, Xinsi Road, Xi'an, Shaanxi, 710038, China
| | - Wenhao Liu
- Department of Cardio-thoracic Surgery, 900 Hospital of PLA, Fuzhou, Fujian, 350001, China
| | - Kaifu Zheng
- Department of Thoracic Surgery, Tangdu Hospital, Air Force Medical University. No.569, Xinsi Road, Xi'an, Shaanxi, 710038, China
| | - Xiaofei Li
- Department of Thoracic Surgery, Chest Hospital, Xi'an International Medical Center, No.777, Xitai Road, Xi'an, Shaanxi, 710100, China
| | - Nan Ma
- Department of Ophthalmology, Tangdu Hospital, Air Force Medical University, No.569, Xinsi Road, Xi'an, Shaanxi, 710038, China
| | - Jinbo Zhao
- Department of Thoracic Surgery, Tangdu Hospital, Air Force Medical University. No.569, Xinsi Road, Xi'an, Shaanxi, 710038, China
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Budnik J, DeNunzio NJ, Singh DP, Milano MT. 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. Clin Lung Cancer 2020; 21:195-203. [DOI: 10.1016/j.cllc.2019.02.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 02/16/2019] [Accepted: 02/18/2019] [Indexed: 10/27/2022]
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