Resection of Early-Stage Second Primary Non-small Cell Lung Cancer After Small Cell Lung Cancer: A Population-Based Study
Introduction: A certain number of small cell lung cancer (SCLC) patients become long-term survivors after treatment, and they are at high risk to develop a second primary malignancy, including non-small cell lung cancer. However, the optimal management of early-stage second primary non-small cell lu...
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Frontiers Media S.A.
2020-02-01
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Series: | Frontiers in Oncology |
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Online Access: | https://www.frontiersin.org/article/10.3389/fonc.2019.01552/full |
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Article |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Rusi Zhang Rusi Zhang Rusi Zhang Ling Cai Ling Cai Gongming Wang Gongming Wang Yingsheng Wen Yingsheng Wen Fang Wang Fang Wang Ningning Zhou Ningning Zhou Xuewen Zhang Xuewen Zhang Zirui Huang Zirui Huang Xiangyang Yu Kexing Xi Longjun Yang Longjun Yang Dechang Zhao Dechang Zhao Yongbin Lin Yongbin Lin Lanjun Zhang Lanjun Zhang |
spellingShingle |
Rusi Zhang Rusi Zhang Rusi Zhang Ling Cai Ling Cai Gongming Wang Gongming Wang Yingsheng Wen Yingsheng Wen Fang Wang Fang Wang Ningning Zhou Ningning Zhou Xuewen Zhang Xuewen Zhang Zirui Huang Zirui Huang Xiangyang Yu Kexing Xi Longjun Yang Longjun Yang Dechang Zhao Dechang Zhao Yongbin Lin Yongbin Lin Lanjun Zhang Lanjun Zhang Resection of Early-Stage Second Primary Non-small Cell Lung Cancer After Small Cell Lung Cancer: A Population-Based Study Frontiers in Oncology small cell lung cancer non-small cell lung cancer second primary lung cancer surgery survival SEER database |
author_facet |
Rusi Zhang Rusi Zhang Rusi Zhang Ling Cai Ling Cai Gongming Wang Gongming Wang Yingsheng Wen Yingsheng Wen Fang Wang Fang Wang Ningning Zhou Ningning Zhou Xuewen Zhang Xuewen Zhang Zirui Huang Zirui Huang Xiangyang Yu Kexing Xi Longjun Yang Longjun Yang Dechang Zhao Dechang Zhao Yongbin Lin Yongbin Lin Lanjun Zhang Lanjun Zhang |
author_sort |
Rusi Zhang |
title |
Resection of Early-Stage Second Primary Non-small Cell Lung Cancer After Small Cell Lung Cancer: A Population-Based Study |
title_short |
Resection of Early-Stage Second Primary Non-small Cell Lung Cancer After Small Cell Lung Cancer: A Population-Based Study |
title_full |
Resection of Early-Stage Second Primary Non-small Cell Lung Cancer After Small Cell Lung Cancer: A Population-Based Study |
title_fullStr |
Resection of Early-Stage Second Primary Non-small Cell Lung Cancer After Small Cell Lung Cancer: A Population-Based Study |
title_full_unstemmed |
Resection of Early-Stage Second Primary Non-small Cell Lung Cancer After Small Cell Lung Cancer: A Population-Based Study |
title_sort |
resection of early-stage second primary non-small cell lung cancer after small cell lung cancer: a population-based study |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Oncology |
issn |
2234-943X |
publishDate |
2020-02-01 |
description |
Introduction: A certain number of small cell lung cancer (SCLC) patients become long-term survivors after treatment, and they are at high risk to develop a second primary malignancy, including non-small cell lung cancer. However, the optimal management of early-stage second primary non-small cell lung cancer (SPLC) after SCLC remains unknown. This study aims to evaluate the survival benefits of surgery in these patients.Methods: Patients with early-stage SPLC after SCLC were identified from the Surveillance, Epidemiology, and End Results database. Patients were balanced with propensity score matching (PSM). Overall survival (OS) and lung cancer-specific survival (CSS) were compared between non-surgery group and surgery group with the Kaplan–Meier method and Cox multivariate regressions.Results: A total of 228 patients with early-stage SPLC after SCLC were identified. Surgery was associated with significantly improved OS and CSS in the multivariate Cox regression analysis (OS, 5-year survival: 41.2 vs. 11.6%, HR: 0.42, 95% CI: 0.31–0.59, P < 0.01; CSS, 5-year survival: 46.8 vs. 24.3%, HR: 0.53, 95% CI: 0.37–0.75, P < 0.01). However, no statistically significant survival difference was found between sublobar resection and lobectomy (OS, 5-year survival: 41.0 vs. 45.3%, P = 0.73; CSS, 5-year survival: 43.5 vs. 54.1%, P = 0.49). After 1:1 PSM, 162 patients were selected for further analysis, and surgery continued to demonstrate superior survival (OS, 5-year survival: 44.2 vs. 7.2%, HR: 0.48, 95% CI: 0.33–0.70, P < 0.01; CSS, 5-year survival: 48.0 vs. 20.6%, HR: 0.44, 95% CI: 0.42–0.97, P = 0.03).Conclusion: The resection of early-stage SPLC after SCLC led to significantly improved OS and CSS and therefore should be considered whenever possible. Nevertheless, further randomized controlled trials are warranted to investigate the safety and effect of surgery in these patients. |
topic |
small cell lung cancer non-small cell lung cancer second primary lung cancer surgery survival SEER database |
url |
https://www.frontiersin.org/article/10.3389/fonc.2019.01552/full |
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doaj-1cd3e2ff0e824f288eddd27307319d152020-11-25T03:48:44ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2020-02-01910.3389/fonc.2019.01552505583Resection of Early-Stage Second Primary Non-small Cell Lung Cancer After Small Cell Lung Cancer: A Population-Based StudyRusi Zhang0Rusi Zhang1Rusi Zhang2Ling Cai3Ling Cai4Gongming Wang5Gongming Wang6Yingsheng Wen7Yingsheng Wen8Fang Wang9Fang Wang10Ningning Zhou11Ningning Zhou12Xuewen Zhang13Xuewen Zhang14Zirui Huang15Zirui Huang16Xiangyang Yu17Kexing Xi18Longjun Yang19Longjun Yang20Dechang Zhao21Dechang Zhao22Yongbin Lin23Yongbin Lin24Lanjun Zhang25Lanjun Zhang26State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, ChinaDepartment of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, ChinaZhongshan School of Medicine, Sun Yat-sen University, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, ChinaDepartment of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, ChinaDepartment of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, ChinaDepartment of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, ChinaDepartment of Molecular Pathology, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, ChinaDepartment of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, ChinaDepartment of Anesthesiology, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, ChinaDepartment of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Thoracic Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, ChinaDepartment of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, ChinaDepartment of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, ChinaDepartment of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, ChinaDepartment of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, ChinaIntroduction: A certain number of small cell lung cancer (SCLC) patients become long-term survivors after treatment, and they are at high risk to develop a second primary malignancy, including non-small cell lung cancer. However, the optimal management of early-stage second primary non-small cell lung cancer (SPLC) after SCLC remains unknown. This study aims to evaluate the survival benefits of surgery in these patients.Methods: Patients with early-stage SPLC after SCLC were identified from the Surveillance, Epidemiology, and End Results database. Patients were balanced with propensity score matching (PSM). Overall survival (OS) and lung cancer-specific survival (CSS) were compared between non-surgery group and surgery group with the Kaplan–Meier method and Cox multivariate regressions.Results: A total of 228 patients with early-stage SPLC after SCLC were identified. Surgery was associated with significantly improved OS and CSS in the multivariate Cox regression analysis (OS, 5-year survival: 41.2 vs. 11.6%, HR: 0.42, 95% CI: 0.31–0.59, P < 0.01; CSS, 5-year survival: 46.8 vs. 24.3%, HR: 0.53, 95% CI: 0.37–0.75, P < 0.01). However, no statistically significant survival difference was found between sublobar resection and lobectomy (OS, 5-year survival: 41.0 vs. 45.3%, P = 0.73; CSS, 5-year survival: 43.5 vs. 54.1%, P = 0.49). After 1:1 PSM, 162 patients were selected for further analysis, and surgery continued to demonstrate superior survival (OS, 5-year survival: 44.2 vs. 7.2%, HR: 0.48, 95% CI: 0.33–0.70, P < 0.01; CSS, 5-year survival: 48.0 vs. 20.6%, HR: 0.44, 95% CI: 0.42–0.97, P = 0.03).Conclusion: The resection of early-stage SPLC after SCLC led to significantly improved OS and CSS and therefore should be considered whenever possible. Nevertheless, further randomized controlled trials are warranted to investigate the safety and effect of surgery in these patients.https://www.frontiersin.org/article/10.3389/fonc.2019.01552/fullsmall cell lung cancernon-small cell lung cancersecond primary lung cancersurgerysurvivalSEER database |