Li Shuai, Luo Yiyang, Hou Qi, Chu Huaqing, Zheng Hui
Department of Anesthesiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Hysteroscopic Center, Fuxing Hospital, Capital Medical University, Beijing, China.
Transl Cancer Res. 2020 Nov;9(11):7001-7011. doi: 10.21037/tcr-20-1105.
With the expanding population of cancer survivors, screening for second primary malignancy (SPM) is one issue concerning survivorship care. This study aimed to evaluate the potential risk of developing SPMs and determine the features of SPMs among patients after the diagnosis of gastric cancer (GC).
We identified 33,705 GC patients from the Surveillance, Epidemiology, and End Results Program (SEER) database. The standardized incidence ratios (SIRs) were calculated to estimate the risk of SPMs. The SIRs were stratified by age, race, stage, and latency period since GC diagnosis.
A total of 2,018 among 33,705 GC patients developed SPMs. Compared with the general population, these GC survivors had higher risks of developing second malignancies of the esophagus, stomach, small intestine, colon, pancreas, and thyroid. Conversely, these GC survivors had lower chances of developing prostate and female breast cancer.
In stratified analyses, we identified the features associated with a higher risk of developing SPMs, including age between 20 and 39 years, latency between 60 and 119 months, localized stage, and American Indian/Alaska Native ethnicity. Hence, GC survivors are at a higher risk of developing SPMs than the general population. Careful attention and continuous surveillance should be used when treating these patients.
随着癌症幸存者数量的不断增加，筛查第二原发性恶性肿瘤（SPM）是生存护理中一个备受关注的问题。本研究旨在评估胃癌（GC）患者发生SPM的潜在风险，并确定SPM的特征。
我们从监测、流行病学和最终结果计划（SEER）数据库中识别出33705例GC患者。计算标准化发病比（SIR）以估计SPM的风险。SIR按年龄、种族、分期以及自GC诊断后的潜伏期进行分层。
33705例GC患者中共有2018例发生了SPM。与一般人群相比，这些GC幸存者发生食管、胃、小肠、结肠、胰腺和甲状腺第二恶性肿瘤的风险更高。相反，这些GC幸存者发生前列腺癌和女性乳腺癌的几率较低。
在分层分析中，我们确定了与发生SPM风险较高相关的特征，包括年龄在20至39岁之间、潜伏期在60至119个月之间、局限性分期以及美洲印第安人/阿拉斯加原住民种族。因此，GC幸存者发生SPM的风险高于一般人群。在治疗这些患者时应予以密切关注并持续监测。
