Dataset Information

Secondary primary malignancy risk among patients with esophageal cancer in Taiwan: a nationwide population-based study.

ABSTRACT:

Background

To evaluate the risk and sites of metachronous secondary primary malignancies (SPMs) among patients with esophageal cancer.

Methods

Newly diagnosed esophageal cancer patients between 1997 and 2011 were recruited. To avoid surveillance bias, SPMs that developed within one year were excluded. Standardized incidence ratios (SIRs) of metachronous SPMs in these patients were calculated by comparing to the cancer incidence in the general population. Risk factors for SPM development, included age, sex, comorbidities and cancer-related treatments, were estimated by Cox proportional hazards models.

Results

During the 15-year study period, 870 SPMs developed among 18,026 esophageal cancer patients, with a follow-up of 27,056 person-years. The SIR for all cancers was 3.53. The SIR of follow-up period ? 10 years was 3.56; 5-10 years, 3.14; and 1-5 years, 3.06. The cancer SIRs of head and neck (15.83), stomach (3.30), lung and mediastinum (2.10), kidney (2.24) and leukemia (2.72), were significantly increased. Multivariate analysis showed that age ? 60 years (hazard ratio [HR] 0.74), being male (HR 1.46) and liver cirrhosis (HR 1.46) were independent factors. According to the treatments, major surgery (HR 1.24) increased the risk, but chemotherapy was nearly significant.

Conclusions

Patients with esophageal cancer were at increased risk of developing metachronous SPMs. The SIR remained high in follow-up > 10 years, so that close monitoring may be needed for early detection of SPM among these esophageal cancer patients.

SUBMITTER: Chen SC

PROVIDER: S-EPMC4312084 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

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Publications

Secondary primary malignancy risk among patients with esophageal cancer in Taiwan: a nationwide population-based study.

Chen San-Chi SC Teng Chung-Jen CJ Hu Yu-Wen YW Yeh Chiu-Mei CM Hung Man-Hsin MH Hu Li-Yu LY Ku Fan-Chen FC Tzeng Cheng-Hwai CH Chiou Tzeon-Jye TJ Chen Tzeng-Ji TJ Liu Chia-Jen CJ

PloS one 20150130 1

<h4>Background</h4>To evaluate the risk and sites of metachronous secondary primary malignancies (SPMs) among patients with esophageal cancer.<h4>Methods</h4>Newly diagnosed esophageal cancer patients between 1997 and 2011 were recruited. To avoid surveillance bias, SPMs that developed within one year were excluded. Standardized incidence ratios (SIRs) of metachronous SPMs in these patients were calculated by comparing to the cancer incidence in the general population. Risk factors for SPM devel ...[more]

PMID: 25635388

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Project description:BackgroundTuberculosis (TB) presents a global threat in the world and the lung is the frequent site of metastatic focus. A previous study demonstrated that TB might increase primary lung cancer risk by two-fold for more than 20 years after the TB diagnosis. However, no large-scale study has evaluated the risk of TB and secondary lung cancer. Thus, we evaluated the risk of secondary lung cancer in patients with or without tuberculosis (TB) using a nationwide population-based dataset.MethodsIn a cohort study of 1,936,512 individuals, we selected 6934 patients among patients with primary cancer and TB infection, based on the International Classification of Disease (ICD-p-CM) codes 010-011 from 2000 to 2015. The control cohort comprised 13,868 randomly selected, propensity-matched patients (by age, gender, and index date) without TB exposure. Using this adjusted date, a possible association between TB and the risk of developing secondary lung cancer was estimated using a Cox proportional hazards regression model.ResultsDuring the follow-up period, secondary lung cancer was diagnosed in 761 (10.97%) patients with TB and 1263 (9.11%) patients without TB. After adjusting for covariates, the risk of secondary lung cancer was 1.67 times greater among primary cancer in the cohort with TB than in the cohort without TB. Stratification revealed that every comorbidity (including diabetes, hypertension, cirrhosis, congestive heart failure, cardiovascular accident, chronic kidney disease, chronic obstructive pulmonary disease) significantly increased the risk of secondary lung cancer when comparing the TB cohort with the non-TB cohort. Moreover, the primary cancer types (including head and neck, colorectal cancer, soft tissue sarcoma, breast, kidney, and thyroid cancer) had a more significant risk of becoming secondary lung cancer.ConclusionA significant association exists between TB and the subsequent risk for metastasis among primary cancers and comorbidities. Therefore, TB patients should be evaluated for the subsequent risk of secondary lung cancer.

Dataset Information

Secondary primary malignancy risk among patients with esophageal cancer in Taiwan: a nationwide population-based study.

Background

Methods

Results

Conclusions

Publications

Secondary primary malignancy risk among patients with esophageal cancer in Taiwan: a nationwide population-based study.

Similar Datasets

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