{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T23:52:22Z","timestamp":1776383542693,"version":"3.51.2"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,3,30]],"date-time":"2023-03-30T00:00:00Z","timestamp":1680134400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81772878"],"award-info":[{"award-number":["81772878"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82003178"],"award-info":[{"award-number":["82003178"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>A high risk of developing second primary malignancy (SPM) has been reported among head and neck cancer patients. Here, we aimed to statistically quantify the impact of SPM development on the survival of head and neck cancer patients. Our study was conducted using the Surveillance, Epidemiology and End Results database to collect the data of 48\u2009316 patients who received curative surgical resection for initial primary head and neck squamous cell carcinoma (IP\u2010HNSCC) in 1975 to 2019. SPM diagnosis was treated as a time\u2010varying covariate and multivariable Cox regression analysis was conducted to estimate the association between SPM development and survival, overall or by the subsite of IP\u2010HNSCC. Of the included patients, 11\u2009238 patients (23.3%) developed SPM during the follow\u2010up period. A significant reduction in survival was observed among patients with SPM (hazard ratio [HR] for overall survival, 3.30; 95% confidence interval [CI]: 3.20\u20103.41). The impact of SPM development on reduced survival was more significant in patients with localized IP\u2010HNSCC vs regional IP\u2010HNSCC (HR<jats:sub>OS<\/jats:sub>, 3.41; 95% CI: 3.24\u20103.6 vs HR<jats:sub>OS<\/jats:sub>, 3.18; 95% CI: 3.05\u20103.31; <jats:italic>P<\/jats:italic> for interaction &lt;.001). The survival impact of SPM development was more evident in younger patients than in older patients. SPM in lung and bronchus was associated with the most pronounced reduction in survival, overall and across all subsites of HNSCC. Our results indicated that SPM development led to a significant reduction in survival. A greater survival benefit may be achieved through intensive surveillance for SPM in lung and bronchus targeting younger patients and those with localized HNSCC.<\/jats:p>","DOI":"10.1002\/ijc.34520","type":"journal-article","created":{"date-parts":[[2023,3,22]],"date-time":"2023-03-22T13:39:12Z","timestamp":1679492352000},"page":"94-102","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Time\u2010varying association of second primary malignancy and long\u2010term survival outcomes in patients with head and neck cancer"],"prefix":"10.1002","volume":"153","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3543-9668","authenticated-orcid":false,"given":"Xiaoke","family":"Zhu","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, Shanghai Key Clinical Disciplines of otorhinolaryngology, Eye Ear Nose &amp; Throat Hospital Fudan University  Shanghai People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5625-8324","authenticated-orcid":false,"given":"Yu","family":"Heng","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Shanghai Key Clinical Disciplines of otorhinolaryngology, Eye Ear Nose &amp; Throat Hospital Fudan University  Shanghai People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jian","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Shanghai Key Clinical Disciplines of otorhinolaryngology, Eye Ear Nose &amp; Throat Hospital Fudan University  Shanghai People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanqing","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Shanghai Key Clinical Disciplines of otorhinolaryngology, Eye Ear Nose &amp; Throat Hospital Fudan University  Shanghai People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liang","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Shanghai Key Clinical Disciplines of otorhinolaryngology, Eye Ear Nose &amp; Throat Hospital Fudan University  Shanghai People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Shanghai Key Clinical Disciplines of otorhinolaryngology, Eye Ear Nose &amp; Throat Hospital Fudan University  Shanghai People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pengyu","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Shanghai Key Clinical Disciplines of otorhinolaryngology, Eye Ear Nose &amp; Throat Hospital Fudan University  Shanghai People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Tao","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Shanghai Key Clinical Disciplines of otorhinolaryngology, Eye Ear Nose &amp; Throat Hospital Fudan University  Shanghai People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,3,30]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(21)01550\u20106"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2009\u20100289"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.22851"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.33888"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.23798"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/odi.13681"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2021.2776"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.2147\/IJGM.S339595"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/86.2.131"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.3442"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.31.8311"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.20272"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2018.0501"},{"issue":"5","key":"e_1_2_10_15_1","first-page":"1362","article-title":"General 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