调查早期头颈鳞状细胞癌 (HNSCC) 治疗方式与第二原发恶性肿瘤风险的关联。2000 年至 2020 年早期（I-II 期，第七版 TNM 分期手册）HNSCC 5 年幸存者数据从监测、流行病学和最终结果 (SEER) 数据库中提取。使用标准化发病率和超额绝对风险来评估外部第二原发恶性肿瘤（SPM）的发展。估计相对风险以比较组内的 SPM 风险。 Fine-Gray 模型估计了第二原发恶性肿瘤的累积发病率。总体而言，共招募了 8957 名早期 HNSCC 的 5 年幸存者。接受根治性放射治疗的患者的生存率低于手术患者。手术与较低的第二原发恶性肿瘤风险相关（RR = 0.89，95% CI 0.80-0.99），尤其是口咽鳞状细胞癌（RR = 0.56，95% CI 0.39-0.82）。基于临床特征的亚组之间第二原发恶性肿瘤的风险差异不显着。治疗方式并没有显着影响每个亚组内第二原发恶性肿瘤的风险。与根治性放疗相比，5年幸存者中手术可以提高生存率并降低第二原发恶性肿瘤的风险。第二原发恶性肿瘤的发病率和部位因原发部位而异，强调了有针对性的长期监测的重要性。© 2024 John Wiley

Investigating treatment modalities' association with second primary malignancy risk in early-stage head and neck squamous cell carcinoma (HNSCC).Data of 5-year survivors of early-stage (stages I-II, seventh TNM staging manual) HNSCC from 2000 to 2020 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Standardized incidence ratio and excess absolute risk were used to assess second primary malignancy (SPM) development externally. Relative risk was estimated to compare SPM risk within groups. Fine-Gray's model estimated cumulative incidence of second primary malignancy.Overall, 8957 5-year survivors with early-stage HNSCC were enrolled. Patients receiving definitive radiotherapy had poorer survival than surgery patients. Surgery correlated with lower risk of second primary malignancy (RR = 0.89, 95% CI 0.80-0.99), especially for oropharyngeal squamous cell carcinoma (RR = 0.56, 95% CI 0.39-0.82). Differences in the risk of second primary malignancy among subgroups based on clinical characteristics were not significant. Treatment modalities did not significantly affect risk of second primary malignancy within each subgroup.Surgery led to better survival and lower risk of second primary malignancy compared to definitive radiotherapy in 5-year survivors. Incidence and sites of second primary malignancy varied by primary sites, emphasizing targeted long-term surveillance's importance.© 2024 John Wiley & Sons Ltd.