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Second primary malignancy in patients with cholangiocarcinoma: a population-based study.
Liping Zhuang1,2, Xia Yan1,2, Zhiqiang Meng1,2
1Department of Integrative Oncology, Fudan University Shanghai Cancer Center, Shanghai, China, mengzhq@yeah.net.
Cancer Management and Research
|March 19, 2019
Summary
Patients with cholangiocarcinoma (CCA) have a higher risk of developing a second primary malignancy (SPM). However, the presence of SPM did not negatively impact their overall survival or disease-specific survival.
Area of Science:
- Oncology
- Epidemiology
- Cancer Research
Background:
- A population-based risk estimate for second primary malignancy (SPM) in cholangiocarcinoma (CCA) patients is currently lacking.
- Understanding this risk is crucial for patient management and surveillance strategies.
Purpose of the Study:
- To determine the overall and site-specific risk of SPM in CCA patients.
- To identify risk factors associated with SPM development.
- To evaluate the impact of SPM on overall survival (OS) and disease-specific survival (DSS) in CCA patients.
Main Methods:
- Utilized the Surveillance, Epidemiology, and End Results (SEER) database to identify CCA patients diagnosed between 1973 and 2015.
- Calculated standardized incidence ratios (SIR) to compare SPM risk in CCA patients to the general population.
- Employed logistic regression, Cox proportional hazards models, and nomogram methods to analyze risk factors and survival outcomes.
Main Results:
- CCA patients exhibited a significantly higher overall risk of SPM (SIR = 1.27).
- Elevated SPM risk was observed for specific sites including the transverse colon, intrahepatic bile duct, other biliary sites, and thyroid.
- Younger age, female sex, white ethnicity, and shorter latency periods were associated with increased SPM risk. Surgery for the first primary malignancy was linked to a decreased risk of SPM.
- Patients with SPM demonstrated better OS and DSS compared to those without SPM, with absence of SPM being an independent risk factor for poorer survival.
Conclusions:
- While CCA patients face an elevated risk of SPM, the presence of SPM did not adversely affect their OS and DSS.
- This finding may be attributed to the generally poorer prognosis of CCA, potentially masking the survival impact of SPMs.
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