Published online Feb 16, 2022. doi: 10.12998/wjcc.v10.i5.1485
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
Cancer survivors had a higher risk of developing secondary cancer, and previous studies have indicated the heterogeneous effects of prior cancer on cancer survivors.
To evaluate prior malignancy on patients with gastric cancer (GC).
To describe the features and clinical significance of a prior malignancy on patients with GC.
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.
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.
The prognosis for GC patients with a diagnosis of prior cancer was not inferior to primary GC patients.
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.