Let us not underestimate the long-term risk of SPLC after surgical resection of NSCLC

Leroy, T.; Monnet, Élisabeth; Guerzider, Stéphane; Jacoulet, P.; Bari, Bernardino De; Falcoz, Pierre‐Emmanuel; Gainet-Brun, M.; Lahourcade, Jean; Alfreijat, F.; Almotlak, Hamadi; Adotévi, Olivier; Pernet, D.; Polio, J C; Desmarets, Maxime; Woronoff, Anne‐Sophie; Westeel, Virginie

doi:10.1016/j.lungcan.2019.09.001

Cited by 22 publications

(22 citation statements)

References 25 publications

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“…14 As primary analyses, we evaluated potential risk factors for SPLC focusing on smoking-related variables and clinical variables that have not previously been evaluated in the literature (i.e., body mass index [BMI], personal history of cancer, family history of lung cancer). [10][11][12][13] We also estimated the SPLC risk associated with meeting the 2013 USPSTF lung cancer screening criteria at IPLC diagnosis, as a composite smoking and age measure of individuals at particularly high risk of IPLC. We also conducted a set of confirmatory secondary analyses to evaluate the associations between SPLC and factors that were examined in previous studies (i.e., sex, race/ethnicity, education, IPLC therapies).…”

Section: Mec: Participants and Study Design (Discovery Cohort)mentioning

confidence: 99%

“…9 Previous studies have sought to identify SPLC risk factors, but these have been limited to single institutions or population-based registries comprising selected patient populations without validation in independent cohorts. [10][11][12][13] Furthermore, these studies have used different methodological designs or statistical approaches for identifying SPLC risk factors and, accordingly, have reached conflicting conclusions. For example, although tobacco smoking is an established risk factor for IPLC, the association between smoking and SPLC risk has been controversial, with some studies reporting a positive association 5,10 and others revealing not significant relationships.…”

Section: Introductionmentioning

confidence: 99%

“…For example, although tobacco smoking is an established risk factor for IPLC, the association between smoking and SPLC risk has been controversial, with some studies reporting a positive association 5,10 and others revealing not significant relationships. 11,12 Our group previously used a risk stratification approach to distinguish between patients with IPLC at high versus low risk of SPLC using the Surveillance, Epidemiology, and End Results database. 13 However, this cohort did not contain data on potentially important risk factors such as tobacco smoking.…”

Section: Introductionmentioning

confidence: 99%

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Tobacco Smoking and Risk of Second Primary Lung Cancer

Aredo

Luo

Gardner

et al. 2021

Journal of Thoracic Oncology

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Introduction: Lung cancer survivors are at high risk of developing a second primary lung cancer (SPLC). However, SPLC risk factors have not been established and the impact of tobacco smoking remains controversial. We examined the risk factors for SPLC across multiple epidemiologic cohorts and evaluated the impact of smoking cessation on reducing SPLC risk.Methods: We analyzed data from 7059 participants in the Multiethnic Cohort (MEC) diagnosed with an initial primary lung cancer (IPLC) between 1993 and 2017. Cause-specific proportional hazards models estimated SPLC risk. We conducted validation studies using the Prostate, Lung, *Corresponding author. Disclosure: Dr. Kurian reports receiving research funding to the institution from Myriad Genetics outside of the submitted work. Dr. Wakelee reports receiving personal consulting fees from Janssen, Daiichi Sankyo, Helsinn, Mirati, AstraZeneca, and Blueprint and grants to institution for clinical trial conduct from ACEA Biosciences, Arrys

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Section: Mec: Participants and Study Design (Discovery Cohort)mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Tobacco Smoking and Risk of Second Primary Lung Cancer

Aredo

Luo

Gardner

et al. 2021

Journal of Thoracic Oncology

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“…However, guidelines for SPLC screening are lacking. As IPLC survivors have a persistently high risk of SPLC [7,32], it is imperative to establish which factors may be predictive of SPLC for early identification and intervention. In particular, there is a need for a non-invasive, efficient approach for screening that may accompany the current standards for surveillance imaging.…”

Section: Discussionmentioning

confidence: 99%

Metabolomic profiling for second primary lung cancer: A pilot case-control study

Aredo

Purington

et al. 2021

Lung Cancer

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Lung cancer survivors have a high risk of developing a second primary lung cancer (SPLC). While national screening guidelines have been established for initial primary lung cancer (IPLC), no consensus guidelines exist for SPLC. Furthermore, the factors that contribute to SPLC risk have not been established. This study examines the potential for using serum metabolomics to identify metabolite biomarkers that differ between SPLC cases and IPLC controls. Material and methods: In this pilot case-control study, we applied an untargeted metabolomics approach based on ultrahigh performance liquid chromatography-tandem mass spectroscopy (UPLC-MS/MS) to serum samples of 82 SPLC cases and 82 frequency matched IPLC controls enrolled in the Boston Lung Cancer Study. Random forest and unconditional logistic regression models identified metabolites associated with SPLC. Candidate metabolites were integrated into a SPLC risk prediction model and the model performance was evaluated through a risk stratification approach. Results: The untargeted analysis detected 1008 named and 316 unnamed metabolites among all study participants. Metabolites that were significantly associated with SPLC (False Discovery Rate q-value < 0.2) included 5methylthioadenosine (odds ratio [OR] = 2.04, 95 % confidence interval [CI] 1.39-3.01; P = 2.8 × 10 − 4) and phenylacetylglutamine (OR = 2.65, 95 % CI 1.56-4.51; P = 3.2 × 10 − 4), each exhibiting approximately 1.5-fold increased levels among SPLC cases versus IPLC controls. In stratifying the study participants across quartiles of estimated SPLC risk, the risk prediction model identified a significantly higher proportion of SPLC cases in the fourth compared to the first quartile (68.3 % versus 39.0 %; P = 0.044). Conclusion: SPLC cases may have distinct metabolomic profiles compared to those in IPLC patients without SPLC. A risk stratification approach integrating metabolomics may be useful for distinguishing patients based on SPLC risk. Prospective validation studies are needed to further evaluate the potential for leveraging metabolomics in SPLC surveillance and screening.

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“…Surgical trauma induces systemic inflammation via the release of inflammatory cytokines [26] and such inflammation may accelerate the proliferation of dormant tumor cells and play a role in determining cancer susceptibility. Receiving postoperative radiotherapy may further increase the risk of SPCs [27].…”

Section: Discussionmentioning

confidence: 99%

Life-long follow-up of second primary lung and extra-pulmonary cancer in lung cancer patients is needed

Ma¹,

Qin²,

Zhang³

et al. 2020

J. Cancer

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Background: Lung cancer (LC) patients are at high risk of developing second primary cancer (SPC). This study aimed to explore the risk factors associated with SPC and provide an individualized risk prediction model for LC patients. Methods: Initial primary lung cancer (IPLC) patients diagnosed between 1998 and 2011 were identified from the Surveillance, Epidemiology, and End Results (SEER) database. A Fine-Gray multivariate competing-risk model was used to estimate the risk of SPC, and the model was assessed regarding discrimination and calibration. A nomogram was designed for clinical convenience to predict the 3-, 5-, and 10-year probabilities of developing SPCs. Results: A total of 142,491 IPLC patients were considered in this study and 14,374(10.01%) developed SPC within a maximum study period of approximately 19 years. Seven independent prognostic factors were identified according to the competing-risk model, and the SEER summary stage and surgery were the strongest predictors. The model was well calibrated and had good discrimination ability(C-index = 0.746). Conclusions: LC survivors had an increased risk of SPC and factors associated with good prognosis often predicted SPC. Consideration should be given to increasing the duration of routine follow-up even after 10 years of initial diagnosis for those at the highest risk and site-specific follow-up strategy is also required.

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Let us not underestimate the long-term risk of SPLC after surgical resection of NSCLC

Cited by 22 publications

References 25 publications

Tobacco Smoking and Risk of Second Primary Lung Cancer

Tobacco Smoking and Risk of Second Primary Lung Cancer

Metabolomic profiling for second primary lung cancer: A pilot case-control study

Life-long follow-up of second primary lung and extra-pulmonary cancer in lung cancer patients is needed

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