Clinical and Translational Research
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 16, 2022; 10(5): 1485-1497
Published online Feb 16, 2022. doi: 10.12998/wjcc.v10.i5.1485
Effect of prior malignancy on the prognosis of gastric cancer and somatic mutation
Xin Yin, Xing-Kang He, Ling-Yun Wu, Sen-Xiang Yan
Xin Yin, Ling-Yun Wu, Sen-Xiang Yan, Department of Radiation Oncology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310000, Zhejiang Province, China
Xing-Kang He, Department of Gastroenterology, Sir Run Run Shaw Hospital, Hangzhou 310000, Zhejiang Province, China
Author contributions: Yin X, Yan SX, and He XK conceived and designed the study, conducted data extraction statistical analyses, interpreted the study results, and wrote the first draft of the manuscript; Wu LY extracted and analyzed the data, and interpreted the study results; All authors edited and critically revised the final version of the manuscript.
Institutional review board statement: The data that support the findings of this study are publicly available. The current study does not require approval from an ethics committee.
Conflict-of-interest statement: The authors declare that they have no competing interests.
Data sharing statement: The data that support the findings of this study are publicly available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sen-Xiang Yan, MD, Chief Doctor, Department of Radiation Oncology, the First Affiliated Hospital, College of Medicine, Zhejiang University, the First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, Zhejiang 310003, PR China, Hangzhou 310000, Zhejiang Province, China. yansenxiang@zju.edu.cn
Received: July 10, 2021
Peer-review started: July 10, 2021
First decision: November 8, 2021
Revised: November 8, 2021
Accepted: January 6, 2022
Article in press: January 6, 2022
Published online: February 16, 2022
ARTICLE HIGHLIGHTS
Research background

Cancer survivors had a higher risk of developing secondary cancer, and previous studies have indicated the heterogeneous effects of prior cancer on cancer survivors.

Research motivation

To evaluate prior malignancy on patients with gastric cancer (GC).

Research objectives

To describe the features and clinical significance of a prior malignancy on patients with GC.

Research methods

We identified eligible cases from the Surveillance, Epidemiology, and End Results (SEER) database and compared clinical features of GC patients with/without prior cancer. We adopted Kaplan-Meier curves and Cox analyses to assess the prognostic impact of a prior cancer on the overall survival (OS) and GC-specific survival outcomes. We also validated these results in The Cancer Genome Atlas (TCGA) cohort and compared mutation patterns.

Research results

In the SEER dataset, 35,492 patients newly diagnosed with GC during 2004-2011, 4,001 (11.3%) cases had at least one prior cancer, including 576 (1.62%) cases with multiple prior cancers. Patients with a history of prior cancer tended to be elderly, with a more localized stage and less positive lymph nodes. Prostate (32%) was the most common initial cancer site. The median interval from the initial diagnosis of malignancy to secondary gastric cancer was 68 mo. A history of prior cancer was not significantly associated with overall (hazard ratio:1.01, 95% confidence interval: 0.97-1.05) survival in multivariable Cox analyses.

Research conclusions

The prognosis for GC patients with a diagnosis of prior cancer was not inferior to primary GC patients.

Research perspectives

The prognosis for GC patients with a diagnosis of prior cancer was not inferior to primary GC patients. Our results suggest that a wide range of conclusions should be considered in the clinical trials of GC patients with a previous cancer to obtain the best inclusion rate and generalizable results.