Clinical and Translational Research
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 16, 2022; 10(5): 1485-1497
Published online Feb 16, 2022. doi: 10.12998/wjcc.v10.i5.1485
Effect of prior malignancy on the prognosis of gastric cancer and somatic mutation
Xin Yin, Xing-Kang He, Ling-Yun Wu, Sen-Xiang Yan
Xin Yin, Ling-Yun Wu, Sen-Xiang Yan, Department of Radiation Oncology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310000, Zhejiang Province, China
Xing-Kang He, Department of Gastroenterology, Sir Run Run Shaw Hospital, Hangzhou 310000, Zhejiang Province, China
Author contributions: Yin X, Yan SX, and He XK conceived and designed the study, conducted data extraction statistical analyses, interpreted the study results, and wrote the first draft of the manuscript; Wu LY extracted and analyzed the data, and interpreted the study results; All authors edited and critically revised the final version of the manuscript.
Institutional review board statement: The data that support the findings of this study are publicly available. The current study does not require approval from an ethics committee.
Conflict-of-interest statement: The authors declare that they have no competing interests.
Data sharing statement: The data that support the findings of this study are publicly available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sen-Xiang Yan, MD, Chief Doctor, Department of Radiation Oncology, the First Affiliated Hospital, College of Medicine, Zhejiang University, the First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, Zhejiang 310003, PR China, Hangzhou 310000, Zhejiang Province, China. yansenxiang@zju.edu.cn
Received: July 10, 2021
Peer-review started: July 10, 2021
First decision: November 8, 2021
Revised: November 8, 2021
Accepted: January 6, 2022
Article in press: January 6, 2022
Published online: February 16, 2022
Processing time: 215 Days and 13.3 Hours
Abstract
BACKGROUND

Cancer survivors have a higher risk of developing secondary cancer, with previous studies showing heterogeneous effects of prior cancer on cancer survivors.

AIM

To describe the features and clinical significance of a prior malignancy in patients with gastric cancer (GC).

METHODS

We identified eligible patients from the Surveillance, Epidemiology, and End Results (SEER) database, and compared the clinical features of GC patients with/without prior cancer. Kaplan-Meier curves and Cox analyses were used to assess the prognostic impact of prior cancer on overall survival (OS) and cancer-specific survival (CSS) outcomes. We also validated our results in The Cancer Genome Atlas (TCGA) cohort and compared mutation patterns.

RESULTS

In the SEER dataset, of the 35492 patients newly diagnosed with GC between 2004 and 2011, 4,001 (11.3%) had at least one prior cancer, including 576 (1.62%) patients with multiple cancers. Patients with a prior cancer history tended to be elderly, with a more localized stage and less positive lymph nodes. The prostate (32%) was the most common initial cancer site. The median interval from initial cancer diagnosis to secondary GC was 68 mo. By using multivariable Cox analyses, we found that a prior cancer history was not significantly associated with OS (hazard ratio [HR]: 1.01, 95% confidence interval [CI]: 0.97–1.05). However, a prior cancer history was significantly associated with better GC-specific survival (HR: 0.82, 95% CI: 0.78–0.85). In TCGA cohort, no significant difference in OS was observed for GC patients with or without prior cancer. Also, no significant differences in somatic mutations were observed between groups.

CONCLUSION

The prognosis of GC patients with previous diagnosis of cancer was not inferior to that of primary GC patients.

Keywords: Gastric cancer; Secondary cancer; Survivorship; Prognosis; Lymph nodes

Core Tip: We identified eligible cases during 2004-2011 from the Surveillance, Epidemiology, and End Results database and compared the clinical features of gastric cancer (GC) patients with/without prior cancer. We found that patients with a history of prior cancer tended to be elderly, with a more localized stage and less positive lymph nodes. The prognosis of GC patients with diagnosis of prior cancer was not inferior to primary GC.