Abdel-Rahman Omar, Cheung Winson Y
a Clinical Oncology Department, Faculty of Medicine , Ain Shams University , Cairo , Egypt.
b Department of Oncology , University of Calgary, Tom Baker Cancer Centre , Calgary , Alberta , Canada.
Curr Med Res Opin. 2017 Nov;33(11):2009-2017. doi: 10.1080/03007995.2017.1333953. Epub 2017 Jun 7.
Population-based data on the development of subsequent thoracic cancers following the initial diagnosis of lung cancer are scarce. We evaluated this clinical scenario in lung cancer patients registered within the Surveillance, Epidemiology and End Results (SEER) database.
The SEER database (1988-2013) was queried using the SEER*Stat program to determine the clinico-pathological features of lung cancer patients who develop subsequent thoracic cancers as well as the characteristics of these subsequent cancers. Associations were ascertained with chi-squared tests and survival analysis was performed using Kaplan-Meier methods. Standardized incidence ratios (SIRs) were calculated to determine the risk of each type of subsequent cancer.
A total of 223,274 lung cancer patients were identified and included in the current study. In this cohort, 6387 patients developed subsequent thoracic cancers. The following were associated with a higher likelihood of second cancers: female gender, younger age, white race, adenocarcinoma histology, married, lower AJCC stage, earlier year of diagnosis and local treatment with surgery rather than radiotherapy (p < .0001 for all parameters). In the subset of patients with subsequent thoracic cancers, survival was best for patients with second primary breast cancer followed by patients with lung or esophageal cancer (p < .0001). SIR analyses showed an excess risk for the development of esophageal cancer and second primary lung cancer following an initial diagnosis of lung cancer. This risk persists regardless of gender or receipt of radiotherapy (p < .05 for all scenarios).
There is an excess risk for the development of esophageal cancer and second primary lung cancer following an initial lung cancer diagnosis. This risk is present irrespective of gender or receipt of radiotherapy.
关于肺癌初次诊断后后续胸段癌症发生情况的基于人群的数据稀缺。我们在监测、流行病学和最终结果（SEER）数据库中登记的肺癌患者中评估了这种临床情况。
使用SEER*Stat程序查询SEER数据库（1988 - 2013年），以确定发生后续胸段癌症的肺癌患者的临床病理特征以及这些后续癌症的特征。通过卡方检验确定关联，并使用Kaplan - Meier方法进行生存分析。计算标准化发病比（SIR）以确定每种后续癌症的风险。
共识别出223274例肺癌患者并纳入本研究。在该队列中，6387例患者发生了后续胸段癌症。以下因素与发生第二原发癌的可能性较高相关：女性、年龄较小、白种人、腺癌组织学类型、已婚、美国癌症联合委员会（AJCC）分期较低、诊断年份较早以及采用手术而非放疗的局部治疗（所有参数p < 0.0001）。在发生后续胸段癌症的患者亚组中，第二原发性乳腺癌患者的生存率最佳，其次是肺癌或食管癌患者（p < 0.0001）。SIR分析显示，肺癌初次诊断后发生食管癌和第二原发性肺癌的风险增加。无论性别或是否接受放疗，这种风险都持续存在（所有情况p < 0.05）。
肺癌初次诊断后发生食管癌和第二原发性肺癌的风险增加。无论性别或是否接受放疗，这种风险都存在。
