{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:17:42Z","timestamp":1787066262868,"version":"build-2736575974"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2013,7,2]],"date-time":"2013-07-02T00:00:00Z","timestamp":1372723200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2013,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Second primary malignancies (SPMs) are common in patients with head and neck squamous cell carcinoma (HNSCC) and have a negative impact on their survival. This study aimed to evaluate risk factors for SPM occurrence and cause\u2010specific mortality in Asian HNSCC patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>A retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>University teaching hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Subjects<\/jats:title>\n                    <jats:p>Nine hundred and thirty\u2010seven patients without previous cancer history who were treated between 2000 and 2009 and followed for at least 2 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Confirmation of SPMs was performed by histopathology. The cumulative probability of a SPM among survivors of index HNSCC was calculated using a competing risk model. Univariate and multivariate analyses were utilized to determine factors predictive of SPM occurrence and cause\u2010specific mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 937 patients, cumulative incidence of SPMs was 7.2% at 0 to 6\u00a0months (synchronous), 17.9% at 5 years, and 23.1% at 10 years after index tumor diagnosis. In multivariate analyses, old age (&gt;60 years) (\n                      <jats:italic>P<\/jats:italic>\n                      =. 002), hypopharyngeal index tumor site (\n                      <jats:italic>P<\/jats:italic>\n                      =. 001), and heavy drinker (\n                      <jats:italic>P<\/jats:italic>\n                      =. 001) were independently associated with the development of SPMs, and hypopharyngeal index tumor site were independent variables for SPM\u2010specific survival (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;. 001). Cumulative incidence function of SPM\u2010specific mortality according to index tumor sites was significantly higher in the hypopharynx than other sites (\n                      <jats:italic>P<\/jats:italic>\n                      =. 011).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Elderly patients, hypopharyngeal index cancer patients, or heavy drinkers may require careful surveillance for the development of SPMs. Our results may help identify and properly manage Asian patients at high risk of SPMs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0194599813496373","type":"journal-article","created":{"date-parts":[[2013,7,2]],"date-time":"2013-07-02T21:55:38Z","timestamp":1372802138000},"page":"579-586","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":86,"title":["Second Cancer Incidence, Risk Factor, and Specific Mortality in Head and Neck Squamous Cell Carcinoma"],"prefix":"10.1002","volume":"149","author":[{"given":"Dong Hwan","family":"Lee","sequence":"first","affiliation":[{"name":"Departments of Otolaryngology Asan Medical Center University of Ulsan College of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jong\u2010Lyel","family":"Roh","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology Asan Medical Center University of Ulsan College of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seunghee","family":"Baek","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology and Biostatistics Asan Medical Center University of Ulsan College of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae Hoon","family":"Jung","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology Asan Medical Center University of Ulsan College of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung\u2010Ho","family":"Choi","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology Asan Medical Center University of Ulsan College of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soon Yuhl","family":"Nam","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology Asan Medical Center University of Ulsan College of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang Yoon","family":"Kim","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology Asan Medical Center University of Ulsan College of Medicine Seoul Republic of Korea"},{"name":"Biomedical Research Institute Korea Institute of Science and Technology Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,7,2]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19950315)75:6<1343::AID-CNCR2820750617>3.0.CO;2-T"},{"key":"e_1_2_8_3_1","first-page":"1358","article-title":"Multiple primary malignant tumors: a survey of the literature and a statistical study","volume":"16","author":"Warren S","year":"1932","journal-title":"Am J Cancer"},{"key":"e_1_2_8_4_1","first-page":"9","volume-title":"New Malignancies among Cancer Survivors: SEER Cancer Registries, 1937\u20102000","author":"Curtis RE","year":"2006"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2001.19.5.1358"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e318172ef9a"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19941001)74:7<1933::AID-CNCR2820740718>3.0.CO;2-X"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(81)90938-7"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0347(199905)21:3<204::AID-HED4>3.0.CO;2-7"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.10444"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.2930400208"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.3109\/02841869309093596"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.31.8311"},{"key":"e_1_2_8_14_1","first-page":"21","volume-title":"AJCC Cancer Staging Manual","author":"Greene FL"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djk179"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6602102"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.12.9866"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(195309)6:5<963::AID-CNCR2820060515>3.0.CO;2-Q"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.23798"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(20000215)88:4<884::AID-CNCR20>3.0.CO;2-S"},{"key":"e_1_2_8_21_1","first-page":"675","article-title":"Ethnic differences in the biological consequences of alcohol abuse: a comparison between south Asian and European males","volume":"30","author":"Wickramasinghe SN","year":"1995","journal-title":"Alcohol"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1084\/jem.194.5.571"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/carcin\/22.3.433"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-08-0347"},{"key":"e_1_2_8_25_1","volume-title":"Cancer incidence, mortality and survival by site for 14 regions of the world","author":"Mathers CD","year":"2001"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.20107"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa055531"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1011191720336"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.01.4340"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-009-1064-6"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.134.11.1191"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599813496373","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1177\/0194599813496373","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599813496373","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T09:37:33Z","timestamp":1760953053000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1177\/0194599813496373"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,7,2]]},"references-count":30,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2013,10]]}},"alternative-id":["10.1177\/0194599813496373"],"URL":"https:\/\/doi.org\/10.1177\/0194599813496373","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,7,2]]},"assertion":[{"value":"2013-05-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-06-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-07-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}