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Favorable survival of patients with nasopharyngeal carcinoma associated with metachronous multiple primary cancers: A retrospective study

  • Authors:
    • Xin Huang
    • Ying Kong
    • Tianyu Wu
    • Zhen Meng
    • Min Kang
  • View Affiliations / Copyright

    Affiliations: Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021 P.R. China
    Copyright: © Huang et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY 4.0].
  • Article Number: 550
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    Published online on: September 23, 2025
       https://doi.org/10.3892/ol.2025.15296
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Abstract

Patients successfully treated for nasopharyngeal carcinoma (NPC) are at an increased risk of developing multiple primary cancers (MPCs), but the prognostic implications of synchronous (sMPC) vs. metachronous (mMPC) disease remain unclear. The present study aimed to compare the clinical characteristics and survival outcomes between patients with NPC with MPC, sMPC and mMPC, and to identify prognostic factors. Data from 306 patients with NPC‑related MPC admitted to the First Affiliated Hospital of Guangxi Medical University (Nanning, China) from 2012 to 2023 were retrospectively analyzed, with 35 cases of sMPC (diagnosed within 6 months of the detection of the primary cancer) and 271 cases of mMPC (diagnosed >6 months apart). The clinical characteristics, treatment details and survival outcomes of patients were compared using the χ2 test, Fisher's exact test, t‑test, Kaplan‑Meier method and multivariate Cox regression analysis. The results demonstrated that sMPC, compared with mMPC, was significantly associated with a higher proportion of other‑cancer‑first cases (37.1 vs. 11.8%; P<0.001), an older mean age (53.3±12.4 vs. 46.2±11.9 years; P=0.001), being a heavy smoker (11.4 vs. 3.0%; P=0.042) and advanced‑stage first cancers (80.0 vs. 53.5%; P=0.002). The median survival duration for the first cancer was significantly shorter in patients with sMPC compared with those with mMPC (41.3 vs. 160.3 months; P<0.001). Multivariate analysis identified mMPC [adjusted hazard ratio (HR), 0.21; P<0.001], an older age at first diagnosis (adjusted HR, 1.04; P<0.001), advanced tumor‑node‑metastasis (TNM) stage (adjusted HR, 2.8; P<0.001) and radiotherapy for first cancer (adjusted HR, 0.55; P=0.042) as independent prognostic factors. NPC with mMPC was associated with longer survival than NPC with sMPC. Therefore, age, TNM stage and radiotherapy were identified as key prognostic indicators. These findings highlight the need for tailored surveillance and treatment strategies to improve outcomes in this unique patient population.
View Figures

Figure 1

Median survival time of first cancer
in patients with MPCs. Patients with mMPC demonstrated
significantly improved OS compared with patients with sMPC, with
median overall survival rates of 160.3 (95% CI, 139.0–181.6) and
41.3 (95% CI, 37.7–44.9) months, respectively (P<0.001),
suggesting that patients with mMPC may have an improved prognosis
compared with patients with sMPC. MPC, multiple primary cancers;
sMPC, synchronous MPC; mMPC, metachronous MPC; CI, confidence
interval.

Figure 2

Median survival time of patients with
second cancer with MPCs. The median survival time of second cancer
did not differ significantly between the two groups (40.8 vs. 30.5
months; P=0.302). MPC, multiple primary cancers; sMPC, synchronous
MPC; mMPC, metachronous MPC.
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Copy and paste a formatted citation
Spandidos Publications style
Huang X, Kong Y, Wu T, Meng Z and Kang M: Favorable survival of patients with nasopharyngeal carcinoma associated with metachronous multiple primary cancers: A retrospective study. Oncol Lett 30: 550, 2025.
APA
Huang, X., Kong, Y., Wu, T., Meng, Z., & Kang, M. (2025). Favorable survival of patients with nasopharyngeal carcinoma associated with metachronous multiple primary cancers: A retrospective study. Oncology Letters, 30, 550. https://doi.org/10.3892/ol.2025.15296
MLA
Huang, X., Kong, Y., Wu, T., Meng, Z., Kang, M."Favorable survival of patients with nasopharyngeal carcinoma associated with metachronous multiple primary cancers: A retrospective study". Oncology Letters 30.6 (2025): 550.
Chicago
Huang, X., Kong, Y., Wu, T., Meng, Z., Kang, M."Favorable survival of patients with nasopharyngeal carcinoma associated with metachronous multiple primary cancers: A retrospective study". Oncology Letters 30, no. 6 (2025): 550. https://doi.org/10.3892/ol.2025.15296
Copy and paste a formatted citation
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Spandidos Publications style
Huang X, Kong Y, Wu T, Meng Z and Kang M: Favorable survival of patients with nasopharyngeal carcinoma associated with metachronous multiple primary cancers: A retrospective study. Oncol Lett 30: 550, 2025.
APA
Huang, X., Kong, Y., Wu, T., Meng, Z., & Kang, M. (2025). Favorable survival of patients with nasopharyngeal carcinoma associated with metachronous multiple primary cancers: A retrospective study. Oncology Letters, 30, 550. https://doi.org/10.3892/ol.2025.15296
MLA
Huang, X., Kong, Y., Wu, T., Meng, Z., Kang, M."Favorable survival of patients with nasopharyngeal carcinoma associated with metachronous multiple primary cancers: A retrospective study". Oncology Letters 30.6 (2025): 550.
Chicago
Huang, X., Kong, Y., Wu, T., Meng, Z., Kang, M."Favorable survival of patients with nasopharyngeal carcinoma associated with metachronous multiple primary cancers: A retrospective study". Oncology Letters 30, no. 6 (2025): 550. https://doi.org/10.3892/ol.2025.15296
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