SAN DIEGO (EGMN) – Most patients with multiple primary malignancies that are potentially related to human papillomavirus present with cervical cancer, and later develop head and neck squamous cell cancer or anal cancer, results from a long-term, single-center study suggest.

“In head and neck squamous cell cancers, the presence of HPV is correlated with improved patient outcomes,” researchers led by Dr. Heath D. Skinner wrote in an abstract presented in a poster session at the annual meeting of the American Society for Radiation Oncology. “However, it is unknown whether the development of one potentially HPV-related cancer affects the development of another and how the disease factors and outcomes are related.”

Based on the available literature, this patient population has a two- to fourfold increased risk over the general population for the development of a second potentially HPV-related malignancy, said Dr. Skinner of the University of Texas M.D. Anderson Cancer Center in Houston. He and his associates reviewed the charts of 143 patients with multiple cancers who were treated at the center in 1949-2008. Patients with in situ and non–squamous cell carcinoma malignancies were excluded from the analysis, with the exception of cervical adenocarcinoma.

Of the 301 cancers, the most common was head and neck (115), followed by cancer of the cervix (104), anus (49), vulva (21), vagina (8) and penis (4). The median follow-up from diagnosis of the first and second tumor was 16 years and 3 years, respectively.

The median age of patients at first and second diagnosis was 45 and 60 years, respectively, with a median duration between diagnoses of 11 years. Cervical cancer was the most common initial diagnosis (62%); head and neck squamous cell cancer was the most common second diagnosis (58%).

Dr. Skinner and his associates also found that patients with head and neck squamous cell cancer as the first diagnosis were most likely to develop subsequent cervical cancer.

“There is a significant difference in the timeline of the development of a second potentially HPV-related malignancy based on the primary site,” the researchers noted. “Patients with cervix cancer have a much longer latency to a second primary than do patients with head and neck squamous cell cancer, anal [cancer], or other gynecologic malignancies.”

Next, the researchers plan to investigate the actual HPV positivity of these tumors and identify whether a single viral genotype is responsible for multiple tumors in an individual patient.

The researchers stated that they have no relevant financial conflicts to disclose.

Copyright (c) 2010 Elsevier Global Medical News. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

圣地亚哥(EGMN)——在美国放射肿瘤学会2010年年会的墙报交流中，一项长期单中心研究表明，在可能与人乳头状瘤病毒(HPV)相关的多发性原发恶性肿瘤患者中，大多都先表现为宫颈癌，然后再出现头颈鳞状细胞癌或肛门癌。

基于现有文献，这个患者人群出现第二种可能与HPV相关的恶性肿瘤的风险比一般人群要高2~4倍。研究者对1949~2008年美国德克萨斯大学安德森肿瘤中心收治的143例多发性癌症患者的病历资料进行了回顾性分析。原位癌和非鳞状细胞癌患者被排除在分析之外，但宫颈腺癌例外。

在这301例癌症病例中，最常见的是头颈癌(115例)，其次是宫颈癌(104例)、肛门癌(49例)、会阴癌 (21例)、阴道癌 (8例)以及阴茎癌 (4例)。第一种和第二种癌症确诊后的中位随访时间分别为16年和3年。第一种和第二种癌症确诊时患者的中位年龄分别为45岁和60岁，两次确诊之间的中位间隔期为11年。宫颈癌是最常见的第一种诊断(62%)；头颈鳞状细胞癌则是最常见的第二种诊断(58%)。研究者还发现，第一种诊断是头颈鳞状细胞癌的患者之后出现宫颈癌的几率很大。与头颈鳞状细胞癌、肛门癌或其他妇科恶性肿瘤相比，宫颈癌患者在出现第二种原发癌之前的潜伏期要长得多。

研究者指出：“对于头颈鳞状细胞癌患者，HPV阳性与预后良好相关。不过，目前尚不清楚某一种可能与HPV相关的癌症发病是否会影响到另一种癌症的发病，也不清楚疾病因素与预后之间是如何关联起来的。”

研究者声明无相关经济利益冲突。

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