Abstract
ObjectivesTo investigate the characteristics and survival of lung cancer patients with additional malignant primary cancers.MethodsRecords of lung cancer patients newly diagnosed in Shanghai Pulmonary Hospital between January 2000 and January 2010 were retrospectively reviewed. Patients with second primary lung cancer and those with lung cancer only were included for detailed analysis.ResultsOf 27642 newly diagnosed lung cancer patients, 283 patients (1.02%) suffered previous additional primary cancers. Compared with single primary lung cancer, patients with secondary lung cancer associated other primary cancers were more often women (female to male ratio 1:1.72 vs 1:2.58, P = 0.018), older (64.2 vs 60.5 years old, P<0.001), more squamous cell type (30.7% vs 20.5%, P = 0.004), less small cell (3.9% vs 15.5%, P<0.001) type, at earlier stages (17.7% vs 11.0% for stage I, P = 0.014), and more frequently with family history of cancers (7.8% vs 3.9%, P = 0.038). The most common previous primary cancers observed were colorectal (22.0%), breast (18.4%), gastric (14.4%) and larynx cancers (11.9%). Approximately 42.9% of patients were diagnosed with lung cancer 2 to 6 years after diagnosis of initial primary cancers. The survival of patients with secondary lung cancer associated other malignancies was not significantly different from those with single lung cancer (P = 0.491), while synchronous multiple primary malignancies showed worse prognosis compared with those with metachronous ones or single lung cancer (p = 0.012).ConclusionThe possibility of second primary lung cancer should always be considered during the follow-up of related cancer types, especially those with family history of cancers. Patients with secondary lung cancer associated other primary malignancies have non-inferior survival than those with single lung cancer.
Highlights
Multiple primary malignancies (MPMs) are defined as the formation of more than one different tumors in the same or different organs synchronously or metachronously
Compared with single primary lung cancer, patients with secondary lung cancer associated other primary cancers were more often women, older (64.2 vs 60.5 years old, P
The possibility of second primary lung cancer should always be considered during the follow-up of related cancer types, especially those with family history of cancers
Summary
Multiple primary malignancies (MPMs) are defined as the formation of more than one different tumors in the same or different organs synchronously or metachronously. Detection and improved treatments contribute to significantly prolonged survival time of cancer patients and allow more cancer patients to live long enough to develop subsequent primary cancers[1,2,3]. Investigation of MPMs may help us further understand risk factors for second primary cancers. Prolonged survival of cancer patients makes it possible to develop second primary lung cancer. Even though there is adequate published data describing the clinical characteristics of patients with MPMs, reports about lung cancer as a second primary cancer are rare.
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