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Survival after second primary lung cancer: a population-based study of 187 Hodgkin lymphoma patients.
Cancer 2011; 117(24):5538-47C

Abstract

BACKGROUND

Lung cancer accounts for the largest absolute risk of second malignancies among Hodgkin lymphoma (HL) survivors. However, no population-based studies have compared overall survival (OS) between HL survivors who developed nonsmall cell lung cancer (HL-NSCLC) versus patients with first primary NSCLC (NSCLC-1).

METHODS

The authors compared the OS of 178,431 patients who had NSCLC-1 and 187 patients who had HL-NSCLC (among 22,648 HL survivors), accounting for sex, race, sociodemographic status, calendar year, and age at NSCLC diagnosis, and NSCLC histology and stage. All patients were reported to the population-based Surveillance, Epidemiology, and End Results Program. Hazard ratios (HRs) were derived from a Cox proportional hazards model.

RESULTS

Although the NSCLC stage distribution was similar in both groups (20% localized, 30% regional, and 50% distant), HL survivors experienced significantly inferior stage-specific OS. For patients with localized, regional, and distant stage NSCLC, the HRs (95% confidence interval [CI]) for death among HL survivors were 1.60 (95% CI, 1.08-2.37; P < .0001), 1.67 (95% CI, 1.26-2.22; P = .0004), and 1.31 (95% CI, 1.06-1.61; P = .013), respectively. Among HL-NSCLC patients, significant associations were observed between more advanced NSCLC stage and the following variables: younger age at HL diagnosis (P = .003), younger age at NSCLC diagnosis (P = .048), and longer latency between HL and NSCLC diagnoses (P = .015).

CONCLUSIONS

Compared with patients who had de novo NSCLC, HL survivors experienced a significant 30% to 60% decrease in OS after an NSCLC diagnosis. Further research is needed to not only elucidate the clinical-biologic underpinnings of NSCLC after HL, including the influence of previous HL treatment, but also to define the role of lung cancer screening in selected patients.

Authors+Show Affiliations

Department of Radiation Oncology and Rubin Center for Cancer Survivorship, University of Rochester School of Medicine, Rochester, New York 14642, USA. michael_milano@urmc.rochester.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21692074

Citation

Milano, Michael T., et al. "Survival After Second Primary Lung Cancer: a Population-based Study of 187 Hodgkin Lymphoma Patients." Cancer, vol. 117, no. 24, 2011, pp. 5538-47.
Milano MT, Li H, Constine LS, et al. Survival after second primary lung cancer: a population-based study of 187 Hodgkin lymphoma patients. Cancer. 2011;117(24):5538-47.
Milano, M. T., Li, H., Constine, L. S., & Travis, L. B. (2011). Survival after second primary lung cancer: a population-based study of 187 Hodgkin lymphoma patients. Cancer, 117(24), pp. 5538-47. doi:10.1002/cncr.26257.
Milano MT, et al. Survival After Second Primary Lung Cancer: a Population-based Study of 187 Hodgkin Lymphoma Patients. Cancer. 2011 Dec 15;117(24):5538-47. PubMed PMID: 21692074.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Survival after second primary lung cancer: a population-based study of 187 Hodgkin lymphoma patients. AU - Milano,Michael T, AU - Li,Huilin, AU - Constine,Louis S, AU - Travis,Lois B, Y1 - 2011/06/20/ PY - 2011/02/20/received PY - 2011/04/12/revised PY - 2011/04/12/accepted PY - 2011/6/22/entrez PY - 2011/6/22/pubmed PY - 2012/4/12/medline SP - 5538 EP - 47 JF - Cancer JO - Cancer VL - 117 IS - 24 N2 - BACKGROUND: Lung cancer accounts for the largest absolute risk of second malignancies among Hodgkin lymphoma (HL) survivors. However, no population-based studies have compared overall survival (OS) between HL survivors who developed nonsmall cell lung cancer (HL-NSCLC) versus patients with first primary NSCLC (NSCLC-1). METHODS: The authors compared the OS of 178,431 patients who had NSCLC-1 and 187 patients who had HL-NSCLC (among 22,648 HL survivors), accounting for sex, race, sociodemographic status, calendar year, and age at NSCLC diagnosis, and NSCLC histology and stage. All patients were reported to the population-based Surveillance, Epidemiology, and End Results Program. Hazard ratios (HRs) were derived from a Cox proportional hazards model. RESULTS: Although the NSCLC stage distribution was similar in both groups (20% localized, 30% regional, and 50% distant), HL survivors experienced significantly inferior stage-specific OS. For patients with localized, regional, and distant stage NSCLC, the HRs (95% confidence interval [CI]) for death among HL survivors were 1.60 (95% CI, 1.08-2.37; P < .0001), 1.67 (95% CI, 1.26-2.22; P = .0004), and 1.31 (95% CI, 1.06-1.61; P = .013), respectively. Among HL-NSCLC patients, significant associations were observed between more advanced NSCLC stage and the following variables: younger age at HL diagnosis (P = .003), younger age at NSCLC diagnosis (P = .048), and longer latency between HL and NSCLC diagnoses (P = .015). CONCLUSIONS: Compared with patients who had de novo NSCLC, HL survivors experienced a significant 30% to 60% decrease in OS after an NSCLC diagnosis. Further research is needed to not only elucidate the clinical-biologic underpinnings of NSCLC after HL, including the influence of previous HL treatment, but also to define the role of lung cancer screening in selected patients. SN - 1097-0142 UR - https://www.unboundmedicine.com/medline/citation/21692074/Survival_after_second_primary_lung_cancer:_a_population_based_study_of_187_Hodgkin_lymphoma_patients_ L2 - https://doi.org/10.1002/cncr.26257 DB - PRIME DP - Unbound Medicine ER -