接受手术治疗的胰腺癌患者中的多原发性肿瘤：一项基于监测、流行病学和最终结果（SEER）数据库的人群研究

Multiple primary tumors in patients with surgically treated pancreatic cancer: a SEER population-based study.

作者信息

Zhang Minghao, Li Nana, Ma Kuanjie, Wang Lin, Cai Yurong, Liu Zhen

机构信息

The Key Laboratory of Advanced Textile Materials and Manufacturing Technology of Ministry of Education, National Engineering Lab for Textile Fiber Materials and Processing Technology, School of Materials Science and Engineering, Zhejiang Sci-Tech University, Hangzhou, China.

Department of Medical Oncology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.

出版信息

J Gastrointest Oncol. 2024 Apr 30;15(2):747-754. doi: 10.21037/jgo-24-13. Epub 2024 Apr 28.

DOI:10.21037/jgo-24-13

PMID:38756627

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11094503/

Abstract

BACKGROUND

With improving survival after pancreatic cancer (PC) resection, questions emerge concerning risk and patterns of metachronous tumors. We aimed to determine the incidence of multiple primary cancers among postoperative PC survivors.

METHODS

Patients undergoing PC surgery from 1975 to 2020 were identified in the Surveillance, Epidemiology, and End Results (SEER) registry. Standardized incidence ratios (SIRs) compared observed-to-expected cancers based on U.S. population rates. Cumulative incidence of secondary tumors was analyzed with Cox regression and cancer-specific survival with Kaplan-Meier curves.

RESULTS

Of 6,100 resected PC patients, 267 (4.38%) developed multiple cancers over 6.2 years median follow-up period. Subsequent malignancies showed a rising cumulative incidence extending beyond 5 years. Lung cancer was the predominant second primary in both males (n=36, SIR 1.87) and females (n=32, SIR 2.17). Prostate (n=33) and breast (n=25) cancers were also common. Risk varied by latency period and gender.

CONCLUSIONS

Postoperative PC patients face a measurable risk for secondary cancers. Enhanced long-term surveillance has the potential to improve early detection and outcomes in this survivor population. Our data provides real-world evidence which could help inform surveillance guidelines in the future.

摘要

背景

随着胰腺癌（PC）切除术后生存率的提高，关于异时性肿瘤的风险和模式出现了一些问题。我们旨在确定PC术后幸存者中多原发性癌症的发生率。

方法

在监测、流行病学和最终结果（SEER）登记处识别出1975年至2020年接受PC手术的患者。标准化发病率（SIR）根据美国人口发病率比较观察到的癌症与预期癌症。用Cox回归分析继发性肿瘤的累积发病率，用Kaplan-Meier曲线分析癌症特异性生存率。

结果

在6100例接受PC切除的患者中，267例（4.38%）在中位随访期6.2年期间发生了多种癌症。随后的恶性肿瘤累积发病率呈上升趋势，持续超过5年。肺癌是男性（n = 36，SIR 1.87）和女性（n = 32，SIR 2.17）中最主要的第二原发性癌症。前列腺癌（n = 33）和乳腺癌（n = 25）也很常见。风险因潜伏期和性别而异。