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Second primary malignancy in patients with cholangiocarcinoma: a population-based study

BACKGROUND: A population-based estimate of risk of second primary malignancy (SPM) in patients with cholangiocarcinoma (CCA) is still lacking. OBJECTIVES: To investigate the overall and site-specific risk of SPM in patients with CCA. To identify risk factors of SPM and further evaluate the impact of...

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Autores principales: Zhuang, Liping, Yan, Xia, Meng, Zhiqiang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6402443/
https://www.ncbi.nlm.nih.gov/pubmed/30881122
http://dx.doi.org/10.2147/CMAR.S187614
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author Zhuang, Liping
Yan, Xia
Meng, Zhiqiang
author_facet Zhuang, Liping
Yan, Xia
Meng, Zhiqiang
author_sort Zhuang, Liping
collection PubMed
description BACKGROUND: A population-based estimate of risk of second primary malignancy (SPM) in patients with cholangiocarcinoma (CCA) is still lacking. OBJECTIVES: To investigate the overall and site-specific risk of SPM in patients with CCA. To identify risk factors of SPM and further evaluate the impact of SPM on overall survival (OS) and disease specific survival (DSS) in patients with CCA. METHODS: Patients with histologically diagnosed CCA between 1973 and 2015 were identified from the Surveillance, Epidemiology and End Results database. Standardized incidence ratio (SIR) was calculated. Risk factors for SPM and CCA survival were evaluated by logistic, Cox, and nomogram methods. RESULTS: We found that the overall risk of SPM in patients with CCA was significantly higher than that in the general population (SIR =1.27, 95% CI =1.03–1.55, P<0.05). The risk of SPM was significantly increased at specific sites, including transverse colon, intrahepatic bile duct, other biliary, and thyroid. A significant increase in overall risk was characterized in the subgroups of patients aged ≤29, patients aged 30–59 years, females, whites, and patients with latency ≤11 months (63.41, 2.45, 1.4, 1.3, and 2.6-fold, respectively). In patients with CCA, not having undergone surgery for the first primary malignancy (vs having undergone surgery for the first primary malignancy; HR =0.269; 95% CI =0.211–0.342; P<0.001) was associated with significantly decreased risk of SPM. Patients with SPM had better OS and DSS than those without SPM (Log rank P<0.001). Absence of SPM was an independent risk factor for poorer OS and DSS. CONCLUSION: Although the risk of SPM in patients with CCA was significantly increased, the presence of SPM did not shorten OS and DSS of patients with CCA, possibly due to the relatively poorer survival of patients with CCA.
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spelling pubmed-64024432019-03-16 Second primary malignancy in patients with cholangiocarcinoma: a population-based study Zhuang, Liping Yan, Xia Meng, Zhiqiang Cancer Manag Res Original Research BACKGROUND: A population-based estimate of risk of second primary malignancy (SPM) in patients with cholangiocarcinoma (CCA) is still lacking. OBJECTIVES: To investigate the overall and site-specific risk of SPM in patients with CCA. To identify risk factors of SPM and further evaluate the impact of SPM on overall survival (OS) and disease specific survival (DSS) in patients with CCA. METHODS: Patients with histologically diagnosed CCA between 1973 and 2015 were identified from the Surveillance, Epidemiology and End Results database. Standardized incidence ratio (SIR) was calculated. Risk factors for SPM and CCA survival were evaluated by logistic, Cox, and nomogram methods. RESULTS: We found that the overall risk of SPM in patients with CCA was significantly higher than that in the general population (SIR =1.27, 95% CI =1.03–1.55, P<0.05). The risk of SPM was significantly increased at specific sites, including transverse colon, intrahepatic bile duct, other biliary, and thyroid. A significant increase in overall risk was characterized in the subgroups of patients aged ≤29, patients aged 30–59 years, females, whites, and patients with latency ≤11 months (63.41, 2.45, 1.4, 1.3, and 2.6-fold, respectively). In patients with CCA, not having undergone surgery for the first primary malignancy (vs having undergone surgery for the first primary malignancy; HR =0.269; 95% CI =0.211–0.342; P<0.001) was associated with significantly decreased risk of SPM. Patients with SPM had better OS and DSS than those without SPM (Log rank P<0.001). Absence of SPM was an independent risk factor for poorer OS and DSS. CONCLUSION: Although the risk of SPM in patients with CCA was significantly increased, the presence of SPM did not shorten OS and DSS of patients with CCA, possibly due to the relatively poorer survival of patients with CCA. Dove Medical Press 2019-03-01 /pmc/articles/PMC6402443/ /pubmed/30881122 http://dx.doi.org/10.2147/CMAR.S187614 Text en © 2019 Zhuang et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Original Research
Zhuang, Liping
Yan, Xia
Meng, Zhiqiang
Second primary malignancy in patients with cholangiocarcinoma: a population-based study
title Second primary malignancy in patients with cholangiocarcinoma: a population-based study
title_full Second primary malignancy in patients with cholangiocarcinoma: a population-based study
title_fullStr Second primary malignancy in patients with cholangiocarcinoma: a population-based study
title_full_unstemmed Second primary malignancy in patients with cholangiocarcinoma: a population-based study
title_short Second primary malignancy in patients with cholangiocarcinoma: a population-based study
title_sort second primary malignancy in patients with cholangiocarcinoma: a population-based study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6402443/
https://www.ncbi.nlm.nih.gov/pubmed/30881122
http://dx.doi.org/10.2147/CMAR.S187614
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