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Analysis of second primary lung cancers in the SEER database
Amrit Bhaskarla1, Paul C Tang, Terry Mashtare
1Department of Thoracic Surgery, Roswell Park Cancer Institute, Buffalo, New York 14263, USA.
The Journal of Surgical Research
|April 20, 2010
Summary
Second primary lung cancer is rare, affecting 1.5% of patients. Synchronous non-small-cell lung cancers (NSCLCs) show better outcomes than metachronous or stage IV NSCLC, warranting stage-specific treatment.
Area of Science:
- Oncology
- Pulmonary Medicine
- Cancer Epidemiology
Background:
- Examining outcomes of second primary lung cancers using the Surveillance Epidemiology and End Results (SEER) database.
- Investigating synchronous second non-small-cell lung cancers (NSCLCs) classified as stage IVA (M1A) per TNM staging.
Purpose of the Study:
- To analyze the incidence and survival outcomes of second primary lung cancers.
- To compare outcomes of synchronous versus metachronous NSCLCs and stage IV NSCLC.
Main Methods:
- Retrospective analysis of patients with at least two primary lung cancers from the SEER database.
- Comparison of overall survival between synchronous, metachronous, and stage IV NSCLC cohorts.
- Multivariable adjustment for prognostic factors including age, race, gender, and cancer stage/histology.
Main Results:
- Second primary lung cancer incidence was 1.5%, associated with younger age, female gender, earlier stage, and white race.
- Median survival for synchronous NSCLCs (29 months) was significantly better than metachronous NSCLCs (22 months) (P < 0.01).
- Adjusted analysis showed no significant survival difference between synchronous and metachronous NSCLCs, but both were superior to stage IV NSCLC (4 months median survival).
Conclusions:
- The incidence of second primary lung cancer is lower than previously reported.
- Favorable prognostic factors are associated with developing a second primary lung cancer.
- Synchronous NSCLCs have better outcomes than stage IV (M1a) designation and should receive stage-specific multi-modality therapy.
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