The burdens of lung cancer involved multiple primary cancers and its occurring patterns-SEER Analysis between 1973 and 2006

Survival in non-small cell lung cancer patients with versus without prior cancer

Clinical trials on cancer treatments frequently exclude patients with prior cancer, but more evidence is needed to understand their possible effects on outcomes. This study analyzed the prognostic impact of prior cancer in newly diagnosed non-small cell lung cancer (NSCLC) patients while accounting for various patient and cancer characteristics. Using population-based cancer registry data linked with administrative claims data, this retrospective cohort study examined patients aged 15-84 years diagnosed with NSCLC between 2010 and 2015 in Japan. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of all-cause mortality in patients with versus without prior cancer. The analysis was stratified according to NSCLC stage and diagnostic time intervals between prior cancers and the index NSCLC. We analyzed 9103 patients (prior cancer: 1416 [15.6%]; no prior cancer: 7687 [84.4%]). Overall, prior cancer had a non-significant mortality HR of 1.07 (95% CI: 0.97-1.17). Furthermore, prior cancer had a significantly higher mortality hazard for diagnostic time intervals of 3 years (HR: 1.23, 95% CI: 1.06-1.43) and 5 years (1.18, 1.04-1.33), but not for longer intervals. However, prior cancer in patients with more advanced NSCLC did not show a higher mortality risk for any diagnostic time interval. Smoking-related prior cancers and prior cancers with poorer prognosis were associated with poorer survival. NSCLC patients with prior cancer do not have an invariably higher risk of mortality, and should be considered for inclusion in clinical trials depending on their cancer stage.

Epidemiology and Survival Outcomes of Lung Cancer: A Population-Based Study

Purpose

Lung cancer has been the top-ranking cause of cancer deaths in Taiwan for decades. Limited data were available in global cancer surveillance regarding lung cancer epidemiology in Taiwan, and previous reports are outdated.

Patients and Methods

This population-based cohort study extracted data of patients with lung cancer from the Taiwan National Health Insurance database and determined the lung cancer incidence and prevalence during 2002–2014. Histological subtypes were retrieved from the Taiwan Cancer Registry database; survival rates were gathered from the National Death Registry. Average annual percentage changes (APCs) of prevalence, incidence, and overall survival were estimated by joinpoint regression analysis.

Results

Age-standardized incidence of lung cancer increased from 45.04 per 100,000 person-years in 2002 to 49.86 per 100,000 person-years in 2014, with an average APC of 0.7 (95% CI = 0.3–1.1; 0.2 in males, 2.0 in females). Lung cancer was more prevalent in male patients, but this increase gradually slowed down. Socioeconomic analysis showed that lung cancer has higher prevalence in patients with higher income level and urban residency. Adenocarcinoma was the most abundant histological subtype in Taiwan (adenocarcinoma-to-squamous cell carcinoma ratio = 4.16 in 2014), with a 2.4-fold increase of incident cases during 2002–2014 (from 43.47% to 64.89% of all lung cancer cases). The 5-year survival rate of lung cancer patients in 2010 was 17.34% (12.60% in male, 25.40% in female), with an average APC of 9.3 (6.3 in male, 11.8 in female) during 2002–2010.

Conclusion

Average APCs of prevalence and incidence of lung cancer were 3.1 and 0.7, respectively, during 2002–2014 in Taiwan. The number of female patients and number of patients with adenocarcinoma have increased the most, with incident cases doubling in these years. Facing this fatal malignancy, it is imperative to improve risk stratification, encourage early surveillance, and develop effective therapeutics for lung cancer patients in Taiwan.

Clinical treatment of advanced synchronous triple primary malignancies: comprehensive treatment based on targeted therapy

The prevalence of cancer remains high. With the improvement of diagnosis and treatment level and the increase of cancer survivors after treatment, multiple primary tumors are more common than before. The diagnosis and treatment of synchronous multiple primary tumors is more complicated than that of single or metachronous multiple tumors, and patients also suffer more. Because of the different conditions of these patients, lack of large-scale clinical observation data, it is necessary for clinicians to make realistic decisions on the specific conditions of patients. It is a challenge for clinicians to apply the advances of modern medicine to the diagnosis and treatment of such patients so as to prolong their survival time and improve their quality of life. This report describes the survival of an advanced elderly patient with lung, prostate and bladder cancer after receiving targeted therapy-based comprehensive treatment.

The impact of pre-existing cancer on survival of prostate cancer patients: A population-based study

Prostate cancer (PCa) is the second most common malignant tumors for male patients worldwide. However, whether a history of pre-existing cancer cases may affect the survival of prostate cancer patients is still not fully understood.We identified patients diagnosed with PCa between 2000 and 2014 from the Surveillance, Epidemiology, and End Results (SEER) linked database. We further made propensity score matching and then compared all-cause and cancer-specific survival between patients with and those without a pre-existing cancer. Cox proportional hazards models and Kaplan-Meier analysis were used for survival comparison.A total of 153,255 patients with PCa were included for analysis, of whom 5939 had a history of pre-existing cancer, including hematologic and lymph (11%), intestine (19%), urinary system (36%), head and neck (9%), lung (5%), skin (12%), and others (8%). Patients with a pre-existing cancer had a worse prognosis compared with those without a pre-existing cancer [all-cause death: hazard ratio (HR) = 2.74, P < .001; cancer-special death: HR = 3.98, P < .001]. Importantly, cancers in urinary bladder prior to PCa had a most adverse impact on all-cause (HR = 5.00, P < .001) and cancer-specific death risk (HR = 10.45, P < .001). Time between the pre-existing cancer and PCa had a dose-dependent effect on survival of PCa patients, with a decreased death risk as the increase of the interval time.Pre-existing cancer has a negative impact on the prognosis of patients with PCa, which is most evident in the presence of a pre-existing urinary bladder cancer. Our results provide epidemiologic evidence with low between-group bias, large sample size, and long-term follow-up, highlighting the need for site-, and interval-time-based clinical management for patients with PCa who had a pre-existing cancer.