TP53 and head and neck squamous cell carcinoma: Compared with SCCHN patients with the p53 72Arg/Arg genotype, there was a significantly greater risk of SPM associated with the p53 72Arg/Pro genotype (hazard ratio [HR], 1.75; 95% CI, 1.17–2.61) and combined p53 72Arg/Pro þ Pro/Pro (HR, 1.58; 95% CI, 1.07–2.34).[25] Although the relationship between P53 gene and multiple primary cancers is still unclear, the immunohistochemistry of the 3 biopsies of this patient in our case all showed positive P53, suggesting that it may also be related to multiple primary cancers.