Secondary primary malignancy risk among patients with esophageal cancer in Taiwan: A nationwide population-based study

San Chi Chen, Chung Jen Teng, Yu Wen Hu, Chiu Mei Yeh, Man Hsin Hung, Li Yu Hu, Fan Chen Ku, Cheng Hwai Tzeng, Tzeon Jye Chiou, Tzeng Ji Chen, Chia Jen Liu

研究成果: Article同行評審

30 引文 斯高帕斯(Scopus)

摘要

Background: To evaluate the risk and sites of metachronous secondary primary malignancies (SPMs) among patients with esophageal cancer. Methods: Newly diagnosed esophageal cancer patients between 1997 and 2011 were recruited. To avoid surveillance bias, SPMs that developed within one year were excluded. Standardized incidence ratios (SIRs) of metachronous SPMs in these patients were calculated by comparing to the cancer incidence in the general population. Risk factors for SPM development, included age, sex, comorbidities and cancer-related treatments, were estimated by Cox proportional hazards models. Results: During the 15-year study period, 870 SPMs developed among 18,026 esophageal cancer patients, with a follow-up of 27,056 person-years. The SIR for all cancers was 3.53. The SIR of follow-up period ≥ 10 years was 3.56; 5-10 years, 3.14; and 1-5 years, 3.06. The cancer SIRs of head and neck (15.83), stomach (3.30), lung and mediastinum (2.10), kidney (2.24) and leukemia (2.72), were significantly increased. Multivariate analysis showed that age ≥ 60 years (hazard ratio [HR] 0.74), being male (HR 1.46) and liver cirrhosis (HR 1.46) were independent factors. According to the treatments, major surgery (HR 1.24) increased the risk, but chemotherapy was nearly significant. Conclusions: Patients with esophageal cancer were at increased risk of developing metachronous SPMs. The SIR remained high in follow-up > 10 years, so that close monitoring may be needed for early detection of SPM among these esophageal cancer patients.

原文English
文章編號e0116384
期刊PLoS ONE
10
發行號1
DOIs
出版狀態Published - 30 1月 2015

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