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Zhengrui Xiao
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MA14 - Survivorship, Socioeconomic and End-of-Life Considerations (ID 915)
- Event: WCLC 2018
- Type: Mini Oral Abstract Session
- Track: Treatment in the Real World - Support, Survivorship, Systems Research
- Presentations: 1
- Moderators:
- Coordinates: 9/25/2018, 10:30 - 12:00, Room 205 BD
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MA14.09 - Mortality of Lung Cancer as a Second Primary Malignancy among Cancer Survivors: A Study of Surveillance, Epidemiology, and End Results Database (ID 11862)
11:30 - 11:35 | Author(s): Zhengrui Xiao
- Abstract
- Presentation
Background
Cancer survivors are at increased risk of developing a second primary malignancy, including lung cancer. However, the prognosis of lung cancer as a second primary malignancy (lung-2) remains largely unknown.
a9ded1e5ce5d75814730bb4caaf49419 Method
Primary lung cancer patients diagnosed from 1988 to 2014 in the SEER program were included. Lung-2 was ascertained by a previous diagnosis of primary malignancy in SEER. Hazard ratios (HRs) of overall and lung cancer specific mortality were estimated among patients with lung-2 compared to lung-1.
4c3880bb027f159e801041b1021e88e8 Result
679,541(88.8%) and 85,758 (11.2%) patients were identified as lung-1 and lung-2, respectively. The median time from first primary malignancy to lung-2 diagnosis was 4.8 years. Compared to lung-1, patients with lung-2 were more likely to be diagnosed at localized stage, with smaller primary tumor, and treated with surgery. Lung-2 patients were at lower risk of lung cancer specific mortality in the first five years (HR 0.77, 95% CI 0.76 - 0.78 at < 1 year; HR 0.87, 95% CI 0.86 - 0.89 from 1 to < 5 years) but at higher risk thereafter. Patients with lung-2 were associated with reduced risk of overall mortality during the first year after diagnosis (HR 0.91, 95% CI 0.91 - 0.92), but with significantly increased risks thereafter.
Table Hazard ratios (HRs) of overall and lung cancer specific mortality among patients with lung-2
N (%) of patients
From 0 to <1 year after diagnosis
From 1 year to < 5 years after diagnosis
From 5 years to 10 years of follow-up after diagnosis
N (IR)
HR (95% CI) *
N (IR)
HR (95% CI)*
N (IR)
HR (95% CI)*
Overall mortality
First primary lung cancer
679,541
383,208 (99.9)
1.00
135,513 (29.3)
1.00
16,821 (9.8)
1.00
Second primary lung cancer
85,758
44,288 (84.1)
0.91 (0.91-0.92)
20,073 (29.4)
1.10 (1.08-1.12)
3,133 (14.6)
1.32 (1.27-1.37)
Lung cancer specific mortality
First primary lung cancer
679,541
325,633 (84.9)
1.00
111,348 (24.1)
1.00
8,147 (4.7)
1.00
Second primary lung cancer
85,758
31,247 (59.3)
0.77 (0.76-0.78)
12,485 (18.3)
0.87 (0.86-0.89)
1,158 (5.4)
1.10 (1.03-1.17)
N, number of deaths; IR, incidence rate per 100 person-years
* HR was adjusted for age and calendar period at diagnosis, sex, race, cohabitation status, percentile of cost of living and high-school education in county of residence, tumor stage, histology, tumor grade, surgery, radiation therapy, and chemotherapy.
Lung-2 is associated with favorable lung cancer specific and overall survival within early period of diagnosis. Inferior overall survival afterwards cannot be attributed to aggressiveness of lung-2, highlighting the importance of managing first malignancy and comorbidities.
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