Prior cancer does not adversely affect survival in locally advanced lung cancer: A national SEER-medicare analysis
| Autor: | Ethan A. Halm, David E. Gerber, Lei Xuan, Andrew L. Laccetti, Sandi L. Pruitt |
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| Rok vydání: | 2016 |
| Předmět: |
Pulmonary and Respiratory Medicine
Oncology Male Cancer Research medicine.medical_specialty Lung Neoplasms Population Medicare Article 03 medical and health sciences 0302 clinical medicine Internal medicine Cause of Death Epidemiology Epidemiology of cancer medicine Prevalence Humans 030212 general & internal medicine Lung cancer education Aged Neoplasm Staging Proportional Hazards Models Aged 80 and over education.field_of_study business.industry Proportional hazards model Hazard ratio Cancer Neoplasms Second Primary medicine.disease Prognosis United States Clinical trial 030220 oncology & carcinogenesis Female business SEER Program |
| Zdroj: | Lung cancer (Amsterdam, Netherlands). 98 |
| ISSN: | 1872-8332 |
| Popis: | Introduction Management of locally advanced non-small cell lung cancer is among the most highly contested areas in thoracic oncology. In this population, a history of prior cancer frequently results in exclusion from clinical trials and may influence therapeutic decisions. We therefore determined prevalence and prognostic impact of prior cancer among these patients. Materials and methods We identified patients>65years of age diagnosed 1992–2009 with locally advanced lung cancer in the Surveillance, Epidemiology, and End Results-Medicare linked dataset. We characterized prior cancer by prevalence, type, stage, and timing. We compared all-cause and lung cancer-specific survival between patients with and without prior cancer using propensity score-adjusted Cox regression. Results 51,542 locally advanced lung cancer patients were included; 15.8% had a history of prior cancer. Prostate (25%), gastrointestinal (17%), breast (16%), and other genitourinary (15%) were the most common types of prior cancer, and 76% percent of prior cancers were localized or in situ stage. Approximately half (54%) of prior cancers were diagnosed within 5 years of the index lung cancer date. Patients with prior cancer had similar (propensity-score adjusted hazard ratio [HR] 0.96; 95% CI, 0.94–0.99; P =0.005) and improved lung cancer-specific (HR 0.84; 95% CI, 0.81–0.86; P Conclusions For patients with locally advanced lung cancer, prior cancer does not adversely impact clinical outcomes. Patients with locally advanced lung cancer and a history of prior cancer should not be excluded from clinical trials, and should be offered aggressive, potentially curative therapies if otherwise appropriate. |
| Databáze: | OpenAIRE |
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