{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T07:47:28Z","timestamp":1782460048212,"version":"3.54.5"},"reference-count":32,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp;amp; Neck"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Late detection of second primary tumors (SPTs) in survivors of oropharyngeal squamous cell carcinoma (OPSCC) remains a major clinical challenge, even during routine follow\u2010up. This study aimed to develop a predictive risk model and a nomogram to estimate the likelihood of SPT development in patients with OPSCC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The authors conducted a retrospective cohort study of 514 consecutive patients diagnosed with OPSCC between 2008 and 2018. Sociodemographic and clinical data were obtained from medical records. Bidirectional cause\u2010specific Cox regression analysis was used to identify independent risk factors for SPT development. A predictive nomogram was subsequently constructed based on the final model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the 514 patients, 51 (9.9%) developed SPTs, most commonly in the head and neck region, esophagus, or lungs. The cohort was predominantly male (88.7%) with a median age of 58\u2009years. Most tumors were p16\u2010negative (76.7%) and presented at advanced stages (III\u2013IV) in 74.9% of cases. The median time to SPT diagnosis was 34.6\u2009months. Independent risk factors for SPT included a history of smoking (HR\u2009=\u20094.5,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.14), primary tumors located in the soft palate, uvula, vallecula, posterior oropharyngeal wall, or unspecified oropharyngeal sites (HR\u2009=\u20092.17,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01), and advanced stage at diagnosis (HR\u2009=\u20092.19,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Non\u2010HPV\u2010related OPSCC subsites, smoking history, and advanced tumor stage were independently associated with a higher risk of SPT. These variables were incorporated into a nomogram designed to support individualized surveillance and facilitate earlier SPT detection in high\u2010risk patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hed.70347","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T06:09:00Z","timestamp":1781762940000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Smoking, Tumor Subsite, and Stage as Predictors of Second Primary Tumors in Oropharyngeal Squamous Cell Carcinoma (\n                    <scp>OPSCC<\/scp>\n                    ): A Retrospective Cohort Study"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6744-0209","authenticated-orcid":false,"given":"Fl\u00e1via Mince Azenha","family":"da Silva","sequence":"first","affiliation":[{"name":"Barretos Cancer Hospital, Educational &amp; Research Institute  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2800-0183","authenticated-orcid":false,"given":"Gabriel Riquieri","family":"Mortari","sequence":"additional","affiliation":[{"name":"Barretos Cancer Hospital, Educational &amp; Research Institute  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4065-954X","authenticated-orcid":false,"given":"Luisa Aguirre","family":"Buexm","sequence":"additional","affiliation":[{"name":"Barretos Cancer Hospital, Educational &amp; Research Institute  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4409-5403","authenticated-orcid":false,"given":"Raiany Santos","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Barretos Cancer Hospital, Educational &amp; Research Institute  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8217-3383","authenticated-orcid":false,"given":"Welinton Yoshio","family":"Hirai","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics Barretos Cancer Hospital  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7464-2490","authenticated-orcid":false,"given":"Caroline","family":"de Oliveira","sequence":"additional","affiliation":[{"name":"Faculdade de Ci\u00eancias da Saude de Barretos Dr Paulo Prata  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0884-5043","authenticated-orcid":false,"given":"J\u00falia Lopes","family":"Ferigatto","sequence":"additional","affiliation":[{"name":"Barretos Cancer Hospital, Educational &amp; Research Institute  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4109-9521","authenticated-orcid":false,"given":"Fabiana","family":"de Lima Vazquez","sequence":"additional","affiliation":[{"name":"Barretos Cancer Hospital, Center of Molecular Oncology Research and Prevention  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0108-6593","authenticated-orcid":false,"given":"Fabio Luiz","family":"Coracin","sequence":"additional","affiliation":[{"name":"Department of Dentistry Barretos Cancer Hospital  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5068-8208","authenticated-orcid":false,"given":"Leandro Luongo","family":"de Matos","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo Instituto do C\u00e2ncer do Estado de S\u00e3o Paulo (ICESP HCFMUSP). 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