Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China.
Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, Guangdong, China.
Int J Cancer. 2018 Oct 1;143(7):1569-1577. doi: 10.1002/ijc.31543. Epub 2018 May 7.
The population of cancer survivors with prior cancer is rapidly growing. Whether a prior cancer diagnosis interferes with outcome is unknown. We conducted a pan-cancer analysis to determine the impact of prior cancer history for patients newly diagnosed with cancer. We identified 20 types of primary solid tumors between 2004 and 2008 in the Surveillance, Epidemiology, and End Results database. Demographic and clinicopathologic variables were compared by χ test and t-test as appropriate. The propensity score-adjusted Kaplan-Meier method and Cox proportional hazards models were used to evaluate the impact of prior cancer on overall survival (OS). Among 1,557,663 eligible patients, 261,474 (16.79%) had a history of prior cancer. More than 65% of prior cancers were diagnosed within 5 years. We classified 20 cancer sites into two groups (PCI and PCS) according to the different impacts of prior cancer on OS. PCI patients with a prior cancer history, which involved the colon and rectum, bone and soft tissues, melanoma, breast, cervix uteri, corpus and uterus, prostate, urinary bladder, kidney and renal pelvis, eye and orbits, thyroid, had inferior OS. The PCS patients (nasopharynx, esophagus, stomach, liver, gallbladder, pancreas, lung, ovary and brain) with a prior cancer history showed similar OS to that of patients without prior cancer. Our pan-cancer study presents the landscape for the survival impact of prior cancer across 20 cancer types. Compared to the patients without prior cancer, the PCI group had inferior OS, while the PCS group had similar OS. Further studies are still needed.
患有既往癌症的癌症幸存者人数正在迅速增加。既往癌症诊断是否会影响预后尚不清楚。我们进行了泛癌分析，以确定新发癌症患者既往癌症史的影响。我们在监测、流行病学和最终结果数据库中确定了 2004 年至 2008 年间 20 种原发性实体肿瘤。通过 χ 检验和 t 检验比较人口统计学和临床病理变量。倾向评分调整的 Kaplan-Meier 法和 Cox 比例风险模型用于评估既往癌症对总生存期（OS）的影响。在 1557663 名合格患者中，261474 名（16.79%）有既往癌症史。超过 65%的既往癌症是在 5 年内诊断的。我们根据既往癌症对 OS 的不同影响将 20 个癌症部位分为两组（PCI 和 PCS）。患有既往癌症史的 PCI 患者，涉及结肠和直肠、骨和软组织、黑色素瘤、乳房、子宫颈、子宫体和子宫、前列腺、膀胱、肾脏和肾盂、眼睛和眼眶、甲状腺，其 OS 较差。既往癌症史的 PCS 患者（鼻咽、食管、胃、肝、胆囊、胰腺、肺、卵巢和脑）与无既往癌症史的患者 OS 相似。我们的泛癌研究展示了 20 种癌症类型中既往癌症对生存影响的全景。与无既往癌症的患者相比，PCI 组的 OS 较差，而 PCS 组的 OS 相似。仍需要进一步研究。
