Overall survival analysis of double primary cancer patients with esophageal cancer as the first primary cancer

doi:10.3877/cma.j.issn.2095-2015.2021.03.005

Abstract

Abstract:

Objective

To investigate the prognostic factors of double primary cancer patients with esophageal cancer as the first primary cancer.

Methods

Using the National Cancer Institute SEER database, clinical data of patients with double primary cancer with esophageal cancer as the first primary cancer diagnosed by histopathology from 2004 to 2013 were identified and collected.Kaplan-Meier survival analysis and log-rank testing were applied to compare survival curves.The Cox proportional hazard model was used to analyze the independent prognostic factors.

Results

Clinical data of 540 patients were collected, including 256 patients with synchronous primary cancer(SPC)and 284 patients with metachronous primary cancer(MPC). In the SPC group, 25.4% of the patients had local esophageal cancer and 32.8% had regional esophageal cancer.In the MPC group, local and regional esophageal cancer accounted for 43.7% and 39.8%, respectively.The survival rate of patients in the MPC group was significantly higher than that in the SPC group(P<0.001). Surgical treatment for the first and second primary cancers was beneficial to improve the prognosis of patients in both groups.

Conclusion

Patients with advanced esophageal cancer are more likely to develop SPC.SPC/MPC grouping is an independent prognostic factor for double primary cancer patients with esophageal cancer as the first primary cancer, and surgical treatment for the first and second primary cancer is associated with overall survival.

Key words: Esophageal cancer, Double primary cancer, Prognosis

Xinyu Su, Yan Yan, Qian Jiang, Jianhong Xia. Overall survival analysis of double primary cancer patients with esophageal cancer as the first primary cancer[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2021, 11(03): 121-125.

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Figures/Tables 5

References 23

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临床特征		同时性双原发癌组(n＝256)	异时性双原发癌组(n＝284)	P值
年龄^a				0.797
	<60岁	58(22.7)	67(23.6)
	≥60岁	198(77.3)	217(76.4)
种族				0.032
	白人	199(77.7)	244(85.9)
	黑人	35(13.7)	21(7.4)
	其他	22(8.6)	19(6.7)
性别				0.782
	男	193(75.4)	217(76.4)
	女	63(24.6)	67(23.6)
第二原发癌部位				0.005
	消化系统	107(41.8)	94(33.1)
	呼吸系统	46(18.0)	47(16.5)
	血液系统	13(5.1)	21(7.4)
	头颈部	33(12.9)	19(6.7)
	泌尿生殖系统	50(19.5)	92(32.4)
	上皮组织	3(1.2)	4(1.4)
	其他	4(1.6)	7(2.5)
T分期^a				<0.001
	T1	59(23.0)	124(43.7)
	T2	42(16.4)	29(10.2)
	T3	72(28.1)	91(32.0)
	T4	19(7.4)	18(6.3)
	Tx	64(25.0)	22(7.7)
N分期^a				<0.001
	N0	128(50.0)	168(59.2)
	N1	88(34.4)	105(37.0)
	Nx	40(15.6)	11(3.9)
M分期^a				<0.001
	M0	170(66.4)	247(87.0)
	M1	63(24.6)	27(9.5)
	Mx	23(9.0)	10(3.5)
SEER分期^a				<0.001
	局部	65(25.4)	124(43.7)
	区域	84(32.8)	113(39.8)
	远处	71(27.7)	33(11.6)
	未知	36(14.1)	14(4.9)
是否手术^a				<0.001
	否	191(74.6)	149(52.5)
	是	65(25.4)	135(47.5)
是否手术^b				0.128
	否	151(59.0)	149(52.5)
	是	105(41.0)	135(47.5)
是否手术^a/b				<0.001
	否/否	137(53.5)	86(30.3)
	否/是	14(5.5)	63(22.2)
	是/否	54(21.1)	63(22.2)
	是/是	51(19.9)	72(25.4)

临床特征		同时性双原发癌组(n＝256)	异时性双原发癌组(n＝284)	P值
年龄^a				0.797
	<60岁	58(22.7)	67(23.6)
	≥60岁	198(77.3)	217(76.4)
种族				0.032
	白人	199(77.7)	244(85.9)
	黑人	35(13.7)	21(7.4)
	其他	22(8.6)	19(6.7)
性别				0.782
	男	193(75.4)	217(76.4)
	女	63(24.6)	67(23.6)
第二原发癌部位				0.005
	消化系统	107(41.8)	94(33.1)
	呼吸系统	46(18.0)	47(16.5)
	血液系统	13(5.1)	21(7.4)
	头颈部	33(12.9)	19(6.7)
	泌尿生殖系统	50(19.5)	92(32.4)
	上皮组织	3(1.2)	4(1.4)
	其他	4(1.6)	7(2.5)
T分期^a				<0.001
	T1	59(23.0)	124(43.7)
	T2	42(16.4)	29(10.2)
	T3	72(28.1)	91(32.0)
	T4	19(7.4)	18(6.3)
	Tx	64(25.0)	22(7.7)
N分期^a				<0.001
	N0	128(50.0)	168(59.2)
	N1	88(34.4)	105(37.0)
	Nx	40(15.6)	11(3.9)
M分期^a				<0.001
	M0	170(66.4)	247(87.0)
	M1	63(24.6)	27(9.5)
	Mx	23(9.0)	10(3.5)
SEER分期^a				<0.001
	局部	65(25.4)	124(43.7)
	区域	84(32.8)	113(39.8)
	远处	71(27.7)	33(11.6)
	未知	36(14.1)	14(4.9)
是否手术^a				<0.001
	否	191(74.6)	149(52.5)
	是	65(25.4)	135(47.5)
是否手术^b				0.128
	否	151(59.0)	149(52.5)
	是	105(41.0)	135(47.5)
是否手术^a/b				<0.001
	否/否	137(53.5)	86(30.3)
	否/是	14(5.5)	63(22.2)
	是/否	54(21.1)	63(22.2)
	是/是	51(19.9)	72(25.4)

临床特征		P值	HR	95% CI
年龄^a
	<60岁		1(reference)
	≥60岁	0.539	0.925	0.720～1.187
种族		0.012
	白人		1(reference)
	黑人	0.003	1.624	1.177～2.242
	其他	0.469	1.157	0.779～1.720
性别
	男		1(reference)
	女	0.645	0.942	0.732～1.213
第二原发癌部位		<0.001
	消化系统		1(reference)
	呼吸系统	0.439	0.892	0.668～1.191
	血液系统	0.786	0.942	0.661～1.452
	头颈部	0.587	0.904	0.630～1.299
	泌尿生殖系统	0.000	0.343	0.250～0.471
	上皮组织	0.231	0.544	0.201～1.473
	其他	0.288	1.395	0.755～2.578
T分期^a		<0.001
	T1		1(reference)
	T2	0.058	1.413	0.989～2.020
	T3	0.042	1.338	1.010～1.771
	T4	<0.001	2.667	1.784～3.989
	Tx	<0.001	3.303	2.416～4.515
N分期^a		<0.001
	N0		1(reference)
	N1	0.662	1.053	0.835～1.327
	Nx	<0.001	2.779	1.984～3.891
M分期^a		<0.001
	M0		1(reference)
	M1	<0.001	2.702	2.071～3.525
	Mx	<0.001	2.527	1.695～3.767
SEER分期^a		<0.001
	局部		1(reference)
	区域	0.066	1.285	0.984～1.679
	远处	<0.001	3.160	2.356～4.239
	未知	<0.001	3.019	2.074～4.394
是否手术^a
	否		1(reference)
	是	<0.001	0.358	0.280～0.457
是否手术^b
	否		1(reference)
	是	<0.001	0.611	0.490～0.761
是否手术^a/b		<0.001
	否/否		1(reference)
	否/是	<0.001	0.326	0.228～0.465
	是/否	0.003	0.668	0.510～0.874
	是/是	<0.001	0.301	0.220～0.412
同时性/异时性分组
	同时性组		1(reference)
	异时性组	<0.001	0.168	0.132～0.213

临床特征		P值	HR	95% CI
年龄^a
	<60岁		1(reference)
	≥60岁	0.539	0.925	0.720～1.187
种族		0.012
	白人		1(reference)
	黑人	0.003	1.624	1.177～2.242
	其他	0.469	1.157	0.779～1.720
性别
	男		1(reference)
	女	0.645	0.942	0.732～1.213
第二原发癌部位		<0.001
	消化系统		1(reference)
	呼吸系统	0.439	0.892	0.668～1.191
	血液系统	0.786	0.942	0.661～1.452
	头颈部	0.587	0.904	0.630～1.299
	泌尿生殖系统	0.000	0.343	0.250～0.471
	上皮组织	0.231	0.544	0.201～1.473
	其他	0.288	1.395	0.755～2.578
T分期^a		<0.001
	T1		1(reference)
	T2	0.058	1.413	0.989～2.020
	T3	0.042	1.338	1.010～1.771
	T4	<0.001	2.667	1.784～3.989
	Tx	<0.001	3.303	2.416～4.515
N分期^a		<0.001
	N0		1(reference)
	N1	0.662	1.053	0.835～1.327
	Nx	<0.001	2.779	1.984～3.891
M分期^a		<0.001
	M0		1(reference)
	M1	<0.001	2.702	2.071～3.525
	Mx	<0.001	2.527	1.695～3.767
SEER分期^a		<0.001
	局部		1(reference)
	区域	0.066	1.285	0.984～1.679
	远处	<0.001	3.160	2.356～4.239
	未知	<0.001	3.019	2.074～4.394
是否手术^a
	否		1(reference)
	是	<0.001	0.358	0.280～0.457
是否手术^b
	否		1(reference)
	是	<0.001	0.611	0.490～0.761
是否手术^a/b		<0.001
	否/否		1(reference)
	否/是	<0.001	0.326	0.228～0.465
	是/否	0.003	0.668	0.510～0.874
	是/是	<0.001	0.301	0.220～0.412
同时性/异时性分组
	同时性组		1(reference)
	异时性组	<0.001	0.168	0.132～0.213

临床特征		P值	HR	95% CI
第二原发癌部位		<0.001
	消化系统		1(reference)
	呼吸系统	0.314	0.858	0.636～1.156
	血液系统	0.325	1.253	0.800～1.961
	头颈部	0.156	0.765	0.528～1.108
	泌尿生殖系统	<0.001	0.417	0.300～0.580
	上皮组织	0.394	0.637	0.226～1.795
	其他	0.002	2.854	1.459～5.581
T分期^a		0.082
	T1		1(reference)
	T2	0.949	1.013	0.686～1.495
	T3	0.265	1.293	0.823～2.032
	T4	0.024	1.819	1.083～3.056
	Tx	0.030	1.828	1.062～3.146
N分期^a		0.001
	N0		1(reference)
	N1	0.001	0.591	0.433～0.805
	Nx	0.553	1.128	0.758～1.679
SEER分期^a		0.016
	局部		1(reference)
	区域	0.182	1.403	0.854～2.307
	远处	0.013	1.833	1.137～2.955
	未知	0.995	0.998	0.523～1.905
是否手术^a/b		<0.001
	否/否		1(reference)
	否/是	0.005	0.579	0.394～0.851
	是/否	0.085	0.770	0.573～1.036
	是/是	<0.001	0.279	0.198～0.393
同时性/异时性分组
	同时性组		1(reference)
	异时性组	<0.001	0.144	0.109～0.189

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