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  EP1.16 - Treatment in the Real World - Support, Survivorship, Systems Research (ID 206)

  • Event: WCLC 2019
  • Type: E-Poster Viewing in the Exhibit Hall
  • Track: Treatment in the Real World - Support, Survivorship, Systems Research
  • Presentations: 1
  • Now Available
  • Moderators:
  • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall

  • 32264

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    EP1.16-21 - Frequencies and Prognosis of Non-Small Cell Lung Cancers Complicated with Synchronous/Metachronous Multiple Primary Cancers (Now Available) (ID 1653)

    08:00 - 18:00  |  Author(s): Masashi Ishihara
    • Abstract
    • Slides

    Background
    

    Recently, opportunities to diagnose multiple primary cancers have been increasing due to the progress of diagnostic technology, resulting in the difficulty in treatment decisions. Therefore, we examined the frequencies, background, and prognosis of non-small cell lung cancers (NSCLC) complicated with synchronous/metachronous multiple primary cancers.

    Method
    

    Between 2013 and 2017, we retrospectively examined the medical charts in patients with NSCLC who had never experienced cancers before. We classified such NSCLC patients into the following three groups: (1) single primary NSCLC group (SPN), showing no other cancers during the follow-up period, (2) synchronous NSCLC group (SN), showing other cancers diagnosed within 2 months from the first NSCLC diagnosis, and (3) metachronous NSCLC group (MN), showing other cancers diagnosed after 3 months or more from the first NSCLC diagnosis.

    Result
    

    Among 1350 cases enrolled, the frequencies of SPN, SN, and MN groups were 88.6% (1196 cases), 8.3% (112 cases), and 3.1% (42 cases), respectively. Background factors such as age, sex, performance status, smoking history, clinical stage, EGFR mutation, EML4-ALK fusion gene, ROS-1 gene, PD-L1 expression, and the number of affected cancers were adjusted using Cox proportional hazards model analysis. In SN group, NSCLC (32 cases), colon cancer (20 cases), and gastric cancer (12 cases) were commonly observed. Similarly, in MN group, NSCLC (17 cases), colon cancer (4 cases), and gastric cancer (4 cases) were commonly observed. The median survival times of SPN, SN, and MN groups were 24.0 months, 42.1 months, and not reached, respectively (p < 0.001). Regarding the prognostic factors, the hazard ratios [HR] of SN and MN groups toward SPN group were 0.98 (95% confidence interval [CI]; 0.71 to 1.36, p = 0.91) and 0.38 (95% CI; 0.22 to 0.66, p < 0.001), respectively. The other prognostic factors were 75 years old or older (HR; 1.46, 95% CI; 1.24 to 1.72, p < 0.001), male (HR; 1.56, 95% CI; 1.26 to 1.94, p < 0.001), performance status 3-4 (HR; 3.88, 95% CI; 3.09-4.82, p < 0.001), smoking history (HR; 1.44, 95% CI; 1.12 to 1.84, p = 0.01), and clinical stage IIIB-IV NSCLC (HR; 4.37, 95% CI; 3.62 to 5.30, p < 0.001).

    Conclusion
    

    In patients with NSCLC who had never experienced cancers before, synchronous/metachronous multiple primary cancers could be often observed. However, their coexistence might not adversely affect the prognosis of firstly diagnosed NSCLC.

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