TY - JOUR
T1 - Second primary malignancy risk among patients with gastric cancer
T2 - a nationwide population-based study in Taiwan
AU - Chen, San Chi
AU - Liu, Chia Jen
AU - Hu, Yu Wen
AU - Yeh, Chiu Mei
AU - Hu, Li Yu
AU - Wang, Yen Po
AU - Hung, Yi Ping
AU - Tzeng, Cheng Hwai
AU - Chiou, Tzeon Jye
AU - Chen, Tzeng Ji
AU - Teng, Chung Jen
N1 - Funding Information:
This study was supported by a grant from Taipei Veterans General Hospital (V103B-022 and V103E10-001), and is based in part on data from the National Health Insurance Research Database, provided by the Bureau of National Health Insurance, Department of Health and managed by National Health Research Institutes. The interpretation and conclusions contained herein do not represent those of the Bureau of National Health Insurance, Department of Health or National Health Research Institutes.
Publisher Copyright:
© 2015, The International Gastric Cancer Association and The Japanese Gastric Cancer Association.
PY - 2016/4
Y1 - 2016/4
N2 - Background: Several studies have reported an increase in second primary malignancies (SPMs) among gastric cancer patients. Methods: Patients who were newly diagnosed with gastric cancer between 1997 and 2011 were recruited from the Taiwan National Health Insurance database. Those who had antecedent malignancies or gastrointestinal stromal tumor were excluded. Standardized incidence ratios (SIRs) of SPMs were calculated. Risk factors for cancer development were analyzed by Cox proportional hazards models. Effects of treatments for gastric cancer were treated as time-dependent variables. Results: During the 15-year study period, 47,729 gastric cancer patients were recruited. Overall, 2,110 SPMs developed during a total follow-up of 137,798 person-years. The SIR for all cancers was 1.46. The SIRs for specific follow-up periods were 1.43, 1.41, and 1.21 at >10 years, 5–10 years, and 1–5 years, respectively. After excluding SPMs that developed within 1 year, significantly higher SIRs were seen for cancers of the head and neck (1.34), esophagus (2.16), colon and rectum (1.37), bones and soft tissues (1.95), ovaries (2.89), bladder (1.47), or kidneys (1.44), as well as non-Hodgkin’s lymphoma (5.56). Multivariate analysis showed that age ≥70 years [hazard ratio (HR) 1.19], being male (HR 1.37), diabetes mellitus (HR 1.30), chronic obstructive pulmonary disease (HR 1.17), and liver cirrhosis (HR 1.94) were independent risk factors. Radiotherapy (HR 1.24) and chemotherapy (HR 1.87) were independent risk factors, but surgery (HR 0.67) was not. Conclusions: Patients with gastric cancer are at increased risk of developing SPM. Close surveillance of patients with risk factors over a longer period should be considered.
AB - Background: Several studies have reported an increase in second primary malignancies (SPMs) among gastric cancer patients. Methods: Patients who were newly diagnosed with gastric cancer between 1997 and 2011 were recruited from the Taiwan National Health Insurance database. Those who had antecedent malignancies or gastrointestinal stromal tumor were excluded. Standardized incidence ratios (SIRs) of SPMs were calculated. Risk factors for cancer development were analyzed by Cox proportional hazards models. Effects of treatments for gastric cancer were treated as time-dependent variables. Results: During the 15-year study period, 47,729 gastric cancer patients were recruited. Overall, 2,110 SPMs developed during a total follow-up of 137,798 person-years. The SIR for all cancers was 1.46. The SIRs for specific follow-up periods were 1.43, 1.41, and 1.21 at >10 years, 5–10 years, and 1–5 years, respectively. After excluding SPMs that developed within 1 year, significantly higher SIRs were seen for cancers of the head and neck (1.34), esophagus (2.16), colon and rectum (1.37), bones and soft tissues (1.95), ovaries (2.89), bladder (1.47), or kidneys (1.44), as well as non-Hodgkin’s lymphoma (5.56). Multivariate analysis showed that age ≥70 years [hazard ratio (HR) 1.19], being male (HR 1.37), diabetes mellitus (HR 1.30), chronic obstructive pulmonary disease (HR 1.17), and liver cirrhosis (HR 1.94) were independent risk factors. Radiotherapy (HR 1.24) and chemotherapy (HR 1.87) were independent risk factors, but surgery (HR 0.67) was not. Conclusions: Patients with gastric cancer are at increased risk of developing SPM. Close surveillance of patients with risk factors over a longer period should be considered.
KW - Gastric cancer
KW - Population-based study
KW - Second primary malignancy
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U2 - 10.1007/s10120-015-0482-3
DO - 10.1007/s10120-015-0482-3
M3 - Article
C2 - 25772342
AN - SCOPUS:84924561374
SN - 1436-3291
VL - 19
SP - 490
EP - 497
JO - Gastric Cancer
JF - Gastric Cancer
IS - 2
ER -
