Effect of second primary cancer on the prognosis of patients with non-small cell lung cancer

Abstract

Background: Second primary cancer (SPC) is not a rare event for patients with non-small cell lung cancer (NSCLC), especially for those who survive for a longer period of time. This study was aimed to explore the effects of SPC on the survival of NSLCL patients. Methods: A total of 241,805 patients with primary NSCLC were identified between 2004 and 2014 from the Surveillance, Epidemiology, and End Results (SEER) database. The incidence of SPC and its effect on the overall survival (OS) and lung cancer-specific survival (LCSS) was explored and analyzed using Cox regression model with SPC being treated as a time-dependent covariate. Results: The incidence of SPCs after the diagnosis of NSCLC was 6.4%, with the second primary lung cancer being the most common one (45.1%). About half of the SPCs (50.7%) occurred during the first year after the diagnosis of NSCLC. It seemed that patients who developed SPC late in the follow-up period tended to have poor prognosis. Multivariable analysis with Cox regression showed that the occurrence of SPC was a poor prognostic factor for patients with NSCLC [hazard ratio (HR), 1.298; 95% confidence interval (CI), 1.270-1.326; P=0.000], and it increased the risk of LCSS (versus no SPC, HR, 1.094; 95% CI, 1.066-1.123; P=0.000). Conclusions: The occurrence of SPC after the diagnosis of NSCLC was not a rare event, and it indicated a poorer prognosis compared with patients without it. During the follow-up, attention should be paid to the screening of SPC especially the second primary lung cancer, and a rational surveillance policy should be formed and implemented.

Role of chemotherapy for survival in patients with second primary non‐small cell lung cancer

“…In another study, among patients who underwent resection of stage I non‐small cell lung cancer (NSCLC) of initial primary lung cancer, the incidence of second primary lung cancer has been reported to be 12% 5 . Another recent study also supported the finding that there is a relatively high risk of occurrence of second primary lung cancer among initial primary lung cancer patients 6 . The relatively high incidence of second primary lung cancer is not the only challenge for treatment.…”

Prognostic study for survival outcome following the treatment of second primary lung cancer in patients with previously resected non‐small cell lung cancer

“…It has also been reported that SPLC was observed in 1.5% of patients with lung cancer in the Surveillance, Epidemiology, and End Results (SEER) database 3 . Patients who have previously undergone surgical resection of initial lung cancer are reported to be at a higher risk of developing SPLC 4 . However, the increase in SPLC patients has brought new challenges and discussions to clinical management, including resectability evaluation, surgical procedure selection, follow‐up advice and prognosis prediction.…”

“…3 Patients who have previously undergone surgical resection of initial lung cancer are reported to be at a higher risk of developing SPLC. 4 However, the increase in SPLC patients has brought new challenges and discussions to clinical management, including resectability evaluation, surgical procedure selection, follow-up advice and prognosis prediction. It is inappropriate to treat SPLC as initial primary lung cancer (IPLC), although some similarities between them are shared.…”

Risk of second primary malignancy in adults with pulmonary high-grade neuroendocrine carcinoma (HGNEC)

“…According to research done by Wu and coworkers, the incidence of SPMs among patients with non-small cell lung cancer is about 6.4%. Furthermore, their findings indicated that 50.7% of SPMs occurred during the first year after the diagnosis of non-small cell lung cancer [5]. However, the risk of SPMs following a diagnosis of lung HGNEC remains unclear.…”