Multiple independent primary cancers do not adversely affect survival of the lung cancer patient

Aguiló, Rafael; Macià, Francesc; Porta, Miquel; Casamitjana, Montserrat; Minguella, Joan; Novoa, Ana M.

doi:10.1016/j.ejcts.2008.08.004

Cited by 58 publications

(45 citation statements)

References 18 publications

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“…This histologic distribution resembles that reported in other series of prior malignancy among lung cancer patients (22)(23)(24)(25)39). The high prevalence of prostate cancer in the cohort reflects its overall prevalence in the general population (43).…”

Section: Articlesupporting

confidence: 60%

“…In a single-center series of 1914 lung cancer patients, of whom 228 (12%) had a history of at least one previous malignancy, no survival detriment was observed in the group with prior cancer (HR = 0.84, 95% CI = 0.70 to 1.01) (22). A number of smaller studies reported similar trends (24,26,27,39).…”

Section: Articlementioning

confidence: 48%

“…Earlier studies investigating the impact of a prior cancer diagnosis on lung cancer outcomes yielded conflicting findings and primarily focused on resected, early-stage lung cancer (22)(23)(24)(25)(26)(27)39). In a single-center series of 1914 lung cancer patients, of whom 228 (12%) had a history of at least one previous malignancy, no survival detriment was observed in the group with prior cancer (HR = 0.84, 95% CI = 0.70 to 1.01) (22).…”

Section: Articlementioning

confidence: 99%

“…Indeed, in an earlier study, we determined that for some lung cancer clinical trials, up to 18% of patients may be excluded for this reason alone (20 article treatments improve and the number of survivors grows, this proportion will likely increase (22,. Compared with other common exclusion criteria, prior cancer may be one of the most substantial factors limiting accrual.…”

Section: Articlementioning

confidence: 99%

“…However, studies evaluating the impact of prior cancer on lung cancer outcomes yield conflicting results, are predominantly small, single-center series, and primarily focus on resected, early-stage tumors (22)(23)(24)(25)(26)(27). We therefore determined the prevalence and prognostic impact of prior cancers among patients with advanced lung cancer using a large, representative, population-based, clinically detailed dataset.…”

mentioning

confidence: 99%

See 4 more Smart Citations

Effect of Prior Cancer on Outcomes in Advanced Lung Cancer: Implications for Clinical Trial Eligibility and Accrual

Gerber

Laccetti

Liu

et al. 2014

International Journal of Radiation Oncology*Biology*Physics

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Section: Articlesupporting

confidence: 60%

Section: Articlementioning

confidence: 48%

Section: Articlementioning

confidence: 99%

Section: Articlementioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Effect of Prior Cancer on Outcomes in Advanced Lung Cancer: Implications for Clinical Trial Eligibility and Accrual

Gerber

Laccetti

Liu

et al. 2014

International Journal of Radiation Oncology*Biology*Physics

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Estimating lead‐time bias in lung cancer diagnosis of patients with previous cancers

Heitjan

Gerber

et al. 2018

Statistics in Medicine

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Surprisingly, survival from a diagnosis of lung cancer has been found to be longer for those who experienced a previous cancer than for those with no previous cancer. A possible explanation is lead-time bias, which, by advancing the time of diagnosis, apparently extends survival among those with a previous cancer even when they enjoy no real clinical advantage. We propose a discrete parametric model to jointly describe survival in a no-previous-cancer group (where, by definition, lead-time bias cannot exist) and in a previous-cancer group (where lead-time bias is possible). We model the lead time with a negative binomial distribution and the post-lead-time survival with a linear spline on the logit hazard scale, which allows for survival to differ between groups even in the absence of bias; we denote our model Logit-Spline/Negative Binomial. We fit Logit-Spline/Negative Binomial to a propensity-score matched subset of the Surveillance, Epidemiology, and End Results-Medicare linked data set, conducting sensitivity analyses to assess the effects of key assumptions. With lung cancer-specific death as the end point, the estimated mean lead time is roughly 11 months for stage I&II patients; with overall survival, it is roughly 3.4 months in stage I&II. For patients with higher-stage lung cancers, the mean lead time is 1 month or less for both outcomes. Accounting for lead-time bias reduces the survival advantage of the previous-cancer group when one exists, but it does not nullify it in all cases.

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The role of 18F-FDG PET in the differentiation between lung metastases and synchronous second primary lung tumours

Dijkman

Schuurbiers

Vriens

et al. 2010

Eur J Nucl Med Mol Imaging

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PurposeIn lung cancer patients with multiple lesions, the differentiation between metastases and second primary tumours has significant therapeutic and prognostic implications. The aim of this retrospective study was to investigate the potential of 18F-FDG PET to discriminate metastatic disease from second primary lung tumours.MethodsOf 1,396 patients evaluated by the thoracic oncology group between January 2004 and April 2009 at the Radboud University Nijmegen Medical Centre, patients with a synchronous second primary lung cancer were selected. Patients with metastatic disease involving the lungs served as the control group. Maximum standardized uptake values (SUVs) measured with 18F-FDG PET were determined for two tumours in each patient. The relative difference between the SUVs of these tumours (∆SUV) was determined and compared between the second primary group and metastatic disease group. Receiver-operating characteristic (ROC) curve analysis was performed to determine the sensitivity and specificity of the ∆SUV for an optimal cut-off value.ResultsA total of 37 patients (21 metastatic disease, 16 second primary cancer) were included for analysis. The ∆SUV was significantly higher in patients with second primary cancer than in those with metastatic disease (58 vs 28%, respectively, p < 0.001). The area under the ROC curve was 0.81 and the odds ratio for the optimal cut-off was 18.4.ConclusionSUVs from 18F-FDG PET images can be helpful in differentiating metastatic disease from second primary tumours in patients with synchronous pulmonary lesions. Further studies are warranted to confirm the consistency of these results.

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Multiple independent primary cancers do not adversely affect survival of the lung cancer patient

Cited by 58 publications

References 18 publications

Effect of Prior Cancer on Outcomes in Advanced Lung Cancer: Implications for Clinical Trial Eligibility and Accrual

Effect of Prior Cancer on Outcomes in Advanced Lung Cancer: Implications for Clinical Trial Eligibility and Accrual

Estimating lead‐time bias in lung cancer diagnosis of patients with previous cancers

The role of 18F-FDG PET in the differentiation between lung metastases and synchronous second primary lung tumours

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