Occurrence and Prognosis of Secondary Lung Cancer in Patients with Primary Nasal Cavity and Sinus Squamous Cell Carcinoma.

INTRODUCTION

There is an increasing focus on the burden of long-term survivors of secondary malignant neoplasms (SMNs) after the appearance of the primary tumor. Our goal was to describe the occurrence and prognosis of secondary lung cancer (SLC) in patients suffering from primary nasal cavity and sinus squamous cell carcinoma (NSSCC).

METHODS

Patients with NSSCC who reported to the Surveillance, Epidemiology and End Results (SEER) program between 1973 and 2017 were selected for our analysis. The Kaplan-Meier analysis was employed to predict the overall prevalence of SMNs and survival rates after the development of SMN. Standardized incidence ratios (SIRs) of SMNs have also been assessed after the development of the primary NSSCC.

RESULTS

A total of 5354 patients were diagnosed with NSSCC. The type and date of diagnosis of the first malignancy were included in the records. In total 419 patients were reported to have developed SMNs within a median duration of 36 months from the time of the primary to the secondary tumor diagnosis. The reported cumulative incidence of SMNs was 14% after 10 years from the primary tumor diagnosis and 32% after 20 years. Among the solid SMNs, secondary lung cancer was the most common malignancy, with cumulative incidences of 12.4% after 20 years. The SIR of SMNs after the primary NSSCC compared with that of the general population was 1.65 and the 5-year overall survival (OS) rate following SMNs was 30%. The SMN lung cancer exhibited a SIR of 3.21 and was associated with a short-term median survival of only 11 months.

CONCLUSIONS

NSSCC survivors are at a high risk of developing SMNs, relative to baseline individuals. Lung cancer is one of the most common SMNs, and it has a poor outcome.