Second primary cancers and survival among neuroendocrine tumor patients

医学 内科学 危险系数 神经内分泌肿瘤 比例危险模型 胃肠病学 队列 流行病学 胰腺癌 人口 队列研究 肿瘤科 癌症 置信区间 环境卫生
作者
Sarah B. Bateni,Natalie G. Coburn,Calvin Law,Simron Singh,Sten Myrehaug,Angela Assal,Julie Hallet
出处
期刊:Endocrine-related Cancer [Bioscientifica]
卷期号:30 (8) 被引量:1
标识
DOI:10.1530/erc-22-0337
摘要

There is an increased risk of second primary cancers (SPCs) after neuroendocrine tumor (NET) diagnosis. The clinical significance of SPCs in this population is unknown. The purpose of this study was to evaluate the association between SPCs after NET diagnosis and survival. We performed a population-based, retrospective cohort study of NET patients (gastrointestinal, pancreatic, or lung primary) from 2000 to 2016 using the Surveillance, Epidemiology, and End Results database. Cox regression models assessed the association between SPCs and NET-specific (NET-SS), cancer-specific (CSS), and overall survival (OS). Of 58,553 NET patients, 7.9% experienced an SPC. SPCs were associated with worse OS (hazard ratio (HR) 2.14, 95% CI 1.94–2.36) and CSS (HR 2.31, 95% CI 2.06–2.59) with no difference in NET-SS (HR 1.04, 95% CI 0.87–1.23). Stratified analyses by histologic grade showed similar results for well and moderately differentiated NETs, but no difference in OS or CSS for poorly differentiated NETs ( P > 0.05). In stratified analyses by NET site, SPCs were associated with worse OS (HR 3.41, 95% CI 3.01–3.87) and CSS (HR 4.96, 95% CI 4.28–5.74) in gastrointestinal NETs and worse OS (HR 1.25, 95% CI 1.03–1.52) with no difference in CSS (HR 1.08, 95% CI 0.85–1.36) in lung NETs. SPCs were not associated with a difference in OS or CSS in pancreatic NETs ( P > 0.05). In conclusion, SPCs after NETs were associated with inferior OS and CSS compared to no SPC but were not associated with NET-SS. These data highlight the need for long-term follow-up in NETs to include the detection of SPCs to ensure early diagnosis and timely management.
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