Department of Thoracic Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, China.
Department of Medical Oncology, The First Affiliated Hospital of Nanchang University, Nanchang, China.
Medicine (Baltimore). 2023 Feb 10;102(6):e32772. doi: 10.1097/MD.0000000000032772.
With recent advances in treatment modalities, the survival time for patients with small cell lung cancer (SCLC) has increased, along with the likelihood of recurrence of a second primary tumor. However, patient treatment options and prognosis remain uncertain. This research evaluated the survival rates of patients with SCLC with a second malignancy, aiming to provide new insights and statistics on whether to proceed with more active therapy. SCLC patients were selected based on the Surveillance, Epidemiology, and End Results (SEER) database, updated on April 15, 2021. We defined those with SCLC followed by other cancers (1st of 2 or more primaries) in the sequence number as S-second primary malignant cancer (S-SPM). Those who had other cancers followed by SCLC (2nd of 2 or more primaries) were defined as OC-SCLC. We performed Kaplan-Meier survival analysis, life table analysis, univariate analysis, stratified analysis, and multiple regression analysis of patient data. We considered the difference statistically meaningful at P < .05. After selection, data for 88,448 participants from the SEER database was included in our analysis. The mean survival time for patients with S-SPM was 69.349 months (95% confidence interval [CI]: 65.939, 72.759), and the medium duration of survival was 34 months (95% CI: 29.900, 38.100). Univariate analysis showed that for overall survival, the hazard ratio (HR) of S-SPM was 0.367 (95% CI: 0.351, 0.383), which was 0.633 lower than that of patients with solitary SCLC and 0.606 lower than that of patients with OC-SCLC. For cancer-specific survival (CSS), the HR of S-SPM was 0.285 (95% CI: 0.271, 0.301), which was 0.715 lower than for patients with solitary SCLC and 0.608 lower than that for patients with OC-SCLC. Multiple regression analysis showed that the HR values of S-SPM were lower than those of patients with single SCLC and those with OC-SCLC, before and after adjustment for variables. Kaplan-Meier survival curves showed that patients with S-SPM had significantly better survival times than the other groups. The survival time and prognosis of patients with S-SPM were clearly superior to those with single SCLC and OC-SCLC.
随着治疗方式的不断进步，小细胞肺癌（SCLC）患者的生存时间延长，同时第二原发肿瘤复发的可能性也增加。然而，患者的治疗选择和预后仍然不确定。本研究评估了患有第二恶性肿瘤的 SCLC 患者的生存率，旨在提供新的见解和统计数据，以确定是否应采用更积极的治疗方法。SCLC 患者是根据监测、流行病学和最终结果（SEER）数据库选择的，该数据库于 2021 年 4 月 15 日更新。我们将 SCLC 之后出现其他癌症（两个或更多原发性癌症中的第一个）的患者定义为 S-第二原发性恶性肿瘤（S-SPM）。那些先患有其他癌症然后患有 SCLC（两个或更多原发性癌症中的第二个）的患者被定义为 OC-SCLC。我们对患者数据进行了 Kaplan-Meier 生存分析、寿命表分析、单变量分析、分层分析和多变量回归分析。我们认为 P <.05 时差异具有统计学意义。选择后，我们对 SEER 数据库中的 88448 名参与者的数据进行了分析。S-SPM 患者的平均生存时间为 69.349 个月（95%置信区间[CI]：65.939，72.759），中位生存时间为 34 个月（95%CI：29.900，38.100）。单变量分析显示，对于总生存期，S-SPM 的风险比（HR）为 0.367（95%CI：0.351，0.383），比单独患有 SCLC 的患者低 0.633，比患有 OC-SCLC 的患者低 0.606。对于癌症特异性生存期（CSS），S-SPM 的 HR 为 0.285（95%CI：0.271，0.301），比单独患有 SCLC 的患者低 0.715，比患有 OC-SCLC 的患者低 0.608。多变量回归分析显示，在调整变量之前和之后，S-SPM 的 HR 值均低于单独患有 SCLC 和 OC-SCLC 的患者。Kaplan-Meier 生存曲线显示，S-SPM 患者的生存时间明显长于其他组。S-SPM 患者的生存时间和预后明显优于单独患有 SCLC 和 OC-SCLC 的患者。
