Oropharyngeal and Oral Cancer in Lung Cancer Patients: Do They Present a Worse Prognosis than Isolated Lung Cancer Patients?

TL;DR

This study compares survival rates of lung cancer patients with and without a history of oropharyngeal and oral cancer, finding worse long-term outcomes for those with multiple cancers.

Contribution

The study provides new evidence on the long-term survival differences between lung cancer patients with and without a history of oropharyngeal and oral cancer.

Findings

At 60 months, no significant survival difference was observed between the two groups.

At 120 months, lung cancer patients with a history of OAOC had significantly worse survival rates.

Disease-free survival showed a non-significant trend toward worse outcomes in OAOC patients.

Abstract

The incidence of Multiple Primary Cancers has increased in the past decade. Each cancer has its own prognosis, and this plays a vital role in patient management and clinical decision-making. In case of Multiple Primary Cancers, the estimation of their incidence and survival rate are not as simple as in the cases of single primary cancers, since two or more malignancies play part. The objective of this study is to draw a comparison between the survival rates of patients diagnosed with bronchogenic carcinoma who underwent radical surgical treatment and those who underwent the same treatment while having a personal history of oropharyngeal and oral cancer (OAOC). The hypothesis of the researchers is that patients diagnosed with bronchogenic carcinoma have a reduced survival rate if they also have an associated primary OAOC.

Background/objectives: Second primary lung cancer frequently manifests in individuals who have survived head and neck cancer, with this occurrence often being attributed to shared risk factors. The objective of the present study is to compare the prognosis, in terms of survival rate, of patients who presented isolated bronchogenic carcinoma (BC) with that of patients who presented with a personal history of BC and associated oropharyngeal and oral cancer (OAOC). Methods: A retrospective longitudinal study was conducted, including all consecutive patients who underwent surgical resection with curative intent for BC in Hospital Clínico San Carlos (HCSC), Madrid, Spain, between December 1989 and December 2024. The survival rate was calculated and compared in two groups of patients: Group 1: 1594 patients with isolated BC and Group 2: 97 patients with BC and OAOC. Results: Group 2 did not show a significant difference in their 60-month survival rate in comparison to Group 1 (HR = 1.23, CI 95% 0.9–1.6) p = 0.14. But when comparing the 120-month survival rate, Group 1 showed a significantly higher survival rate (36.4%, CI 95% 33.9–39%) compared to Group 2, (25.54%, CI 95% 17.78–36.7%) HR= 1.28 (CI 95% 1–1.6), p = 0.04. Disease-free survival showed a non-significant trend of greater severity among patients with a previous history of OAOC. Conclusions: Lung cancer patients who presented with OAOC had worse overall survival compared to patients who presented with isolated lung cancer, and a significant difference was observed at 120 months of follow-up.

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