涉及肺癌的双原发癌患者的临床病理特征、预后因素分析和生存列线图。

Clinicopathological features, prognostic factor analysis, and survival nomogram of patients with double primary cancers involving lung cancer.

机构信息

Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, China.

Hematology Laboratory, Shengjing Hospital of China Medical University, Shenyang, China.

出版信息

Cancer Med. 2024 May;13(10):e7296. doi: 10.1002/cam4.7296.

DOI:10.1002/cam4.7296

PMID:38770671

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11106682/

Abstract

BACKGROUND

Although the incidence of double primary cancers (DPCs) involving lung cancer is rising, they have not been studied sufficiently. This study retrospectively analyzed the clinicopathological and prognostic characteristics of DPC patients with lung cancer and developed a survival nomogram to predict the individual OS rates.

METHODS

We included 103 DPC patients with lung cancer from Shengjing Hospital between 2016 and 2021. Based on the 6-month cancer occurrence interval, the cases were categorized as synchronous DPCs (sDPCs) or metachronous DPCs (mDPCs). Furthermore, the mDPCs were subdivided based on whether the lung cancer occurred first (LCF cohort) or the other cancer occurred first (OCF cohort).

RESULTS

Among the patients, 35 (33.98%) and 68 (66.02%) had sDPCs and mDPCs, respectively. In the mDPCs cohort, 18 (26.47%) belonged to the LCF cohort and 50 (73.53%) to the OCF cohort. The most frequent primary cancer sites were the breast (27.18%), colorectum (22.33%), and urinary system (18.45%). Independent risk factors for progression-free survival were Stage IV lung cancer (p = 0.008) and failure to undergo radical lung cancer surgery (p = 0.028). The risk factors for OS included squamous carcinoma (p = 0.048), Stage IV lung cancer (p = 0.001), single cancer resection plus drug therapy (p < 0.001), drug therapy alone (p = 0.002), failure to undergo radical lung cancer surgery (p = 0.014), and chemotherapy (p = 0.042). The median OS was 37 months, with 3- and 5-year rates of 50.9% and 35.9%, respectively.

CONCLUSION

DPCs involving lung cancer account for 1.11% of cases. The breast, colorectum, and urinary system were the most common extra-pulmonary sites, and mDPCs were more frequent than sDPCs. Radical lung cancer surgery significantly affects prognosis, and drug therapy alone may be preferable when only one tumor is operable. The developed nomogram can accurately predict individual 3-year and 5-year OS rates.

摘要

背景

尽管涉及肺癌的双原发癌（DPC）的发病率正在上升，但它们尚未得到充分研究。本研究回顾性分析了肺癌合并 DPC 患者的临床病理和预后特征，并建立了一个生存列线图来预测个体 OS 率。

方法

我们纳入了 2016 年至 2021 年期间在盛京医院就诊的 103 例肺癌合并 DPC 患者。根据 6 个月的癌症发生间隔，将病例分为同步性 DPC（sDPC）或异时性 DPC（mDPC）。此外，根据肺癌是否先发生（LCF 队列）或其他癌症先发生（OCF 队列）将 mDPC 进一步细分。

结果

患者中，35 例（33.98%）为 sDPC，68 例（66.02%）为 mDPC。在 mDPC 队列中，18 例（26.47%）属于 LCF 队列，50 例（73.53%）属于 OCF 队列。最常见的原发性癌症部位是乳房（27.18%）、结直肠（22.33%）和泌尿系统（18.45%）。无进展生存期的独立危险因素包括Ⅳ期肺癌（p=0.008）和未能行根治性肺癌手术（p=0.028）。OS 的危险因素包括鳞癌（p=0.048）、Ⅳ期肺癌（p=0.001）、单一癌症切除加药物治疗（p<0.001）、单纯药物治疗（p=0.002）、未能行根治性肺癌手术（p=0.014）和化疗（p=0.042）。中位 OS 为 37 个月，3 年和 5 年的生存率分别为 50.9%和 35.9%。