title: Risk factors for patients with multiple synchronous primary cancers involving oral and oropharyngeal subsites.
abstract: OBJECTIVE
  To evaluate risk factors and prognosis for multiple synchronous primary cancers (MSPCs) associated with head and neck squamous cell carcinoma.
  
  
  METHODS
  The retrospective study included 1623 patients.
  
  
  RESULTS
  The most common MSPC site involved was the head and neck region. The presence of multiple oral dysplastic lesions (P < .001) was the sole risk factor for the occurrence of MSPCs. A multivariate survival analysis showed that the pathologic grade (P = .003) was an independent predictive factor for the 5-year disease-specific survival of patients with MSPCs. A Kaplan-Meier analysis showed that the 5-year disease-specific survival of patients who developed MSPCs was worse than that of patients who did not develop MSPCs (P = .020).
  
  
  CONCLUSIONS
  MSPCs are a significant negative prognostic factor for patients with head and neck squamous cell carcinoma. However, a worse prognosis is predicted for patients with MSPCs with several features: a higher pathologic grade, a more aggressive growth pattern, male gender plus a tobacco or alcohol habit, and no multiple oral dysplastic lesions.
authors.affiliation: Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, China.
authors.forename: Zhien
authors.initials: Z
authors.lastname: Feng
authors.affiliation: Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, China.
authors.forename: Qiao Shi
authors.initials: QS
authors.lastname: Xu
authors.affiliation: Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, China.
authors.forename: Qi Fang
authors.initials: QF
authors.lastname: Niu
authors.affiliation: Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, China.
authors.forename: Li Zheng
authors.initials: LZ
authors.lastname: Qin
authors.affiliation: Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, China.
authors.forename: Jin Zhong
authors.initials: JZ
authors.lastname: Li
authors.affiliation: Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Su
authors.affiliation: Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, China.
authors.forename: Hua
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, China. Electronic address: Hanf1989@hotmail.com.
authors.forename: Zhengxue
authors.initials: Z
authors.lastname: Han
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis