Secondary primary lung cancer after esophageal cancer: a population-based study of 44,172 patients

Yadong Gao,Jianwei Qiu,Liugen Gu,Yanmei Yang,Haifeng Kang,Yong Zhang,Shenglai Zhang,Yan Zhang,Huimin Wang,Yi Zhang,Junbo Qian

doi:10.1080/00365521.2021.1994639

Abstract

Background The present study aimed to assess the survival, incidence, and characteristics of secondary primary lung cancer (SPLC) after esophageal cancer (EC-LC). Methods The patients with esophageal cancer (EC) who developed SPLC and patients with first primary lung cancer (LC-1) were retrospectively reviewed in the Surveillance, Epidemiology, and End Results 18 registries covering 2000–2016. Overall survival and characteristics were compared between patients with EC-LC and patients with LC-1. The independent relation between a history of EC and death was evaluated by calculating hazard ratios in multivariate Cox regression analysis propensity score-matching analysis, and multiple imputation for cases with missing information. Results In comparison with the general population, the patients with EC had a higher risk for developing secondary primary lung cancer (SIR =1.86, 95% confidence interval (CI): 1.69–2.05). A history of EC was found to be an independent risk factor of death for lung squamous carcinoma (LUSC) and lung adenocarcinoma (LUAD) patients in localized stage based on multivariate Cox regression analysis, propensity score-matching analysis and multiple imputation. Conclusions There is a significantly increased risk of secondary primary lung cancer in EC survivors and a history of EC adversely affects overall survival in individuals who subsequently develop localized LUSC and LUAD. Clinicians should moderately strengthen lung tissue protection during the management of EC patients.

Highlights

The present study aimed to assess the incidence, characteristics, and survival of secondary primary lung cancer after primary esophageal cancer (EC-Lung cancer (LC))
Of these cases with Esophageal cancer (EC) who were followed for a total of 85011.69 person-years at risk, 424 developed a secondary primary lung cancer (SPLC)
standardized incidence ratio (SIR) was utilized to evaluate the incidence of SPLC

Summary

Introduction

The present study aimed to assess the incidence, characteristics, and survival of secondary primary lung cancer after primary esophageal cancer (EC-LC). Esophageal cancer incidence rates in U.S have tended to decrease[2,3], the incidence rates of secondary primary malignancy (SPM) after EC have tended to increase because of increasing numbers of long-term cancer survivors[4]. Previous several population-based studies have demonstrated that patients with EC are at increased risk of developing SPM, with standardized incidence ratios (SIRs) range from 1.15 to 3.53 in comparison with the general population[5,6,7]. There have been several studies describing an increased incidence of secondary primary lung cancer (SPLC) in the EC population, which may be explained by the concept of “field cancerization”[5,6,7,8,9,10]. The object of the research using data from the Surveillance, Epidemiology, and End

Methods

Results

Discussion

Conclusion