Better Prognosis and Survival in Esophageal Cancer Survivors After Comorbid Second Primary Malignancies: A SEER Database-Based Study

Abstract

BackgroundWith the development of surgical techniques and advances in systemic treatments, the survival time of esophageal cancer survivors has increased; however, the chance of developing a second primary malignancy (SPM) has also increased. These patients’ prognosis and treatment plans remain inconclusive.ObjectivesWe aimed to evaluate and predict the survival of patients with esophageal cancer with second primary tumors, to provide insights and the latest data on whether to pursue more aggressive treatment.Materials and MethodsWe selected esophageal cancer cases from the latest available data from the SEER database on April 15, 2021. We performed life table analysis, Kaplan–Meier analysis, and univariate and multivariate Cox proportional hazards analysis to assess the patient data. We conducted multiple Cox regression equation analyses under multiple covariate adjustment models, and performed a stratified analysis of multiple Cox regression equation analysis based on different covariates. To describe our study population more simply and clearly, we defined the group of patients with esophageal cancer combined with a second primary malignant tumor (the first of two or more primaries) as the EC-SPM group.ResultsOur analysis of 73,456 patients with esophageal cancer found the median survival time of the EC-SPM group was 47.00 months (95% confidence interval (CI), 43.87–50.13), and the mean survival time was 74.67 months (95% CI, 72.12–77.22). Kaplan–Meier curves of different esophageal cancer survivors showed that the survival of the EC-SPM group was significantly better than that of the other groups (p < 0.01). Univariate Cox regression analysis showed that compared with only one malignancy only group, the hazard ratio (HR) of the EC-SPM group was 0.95 (95% CI, 0.92–0.99; p < 0.05). In the multivariate Cox regression analysis under different adjustment models, the EC-SPM group had a reduced risk of death compared with the one primary malignancy only group (HR < 1, p < 0.05).ConclusionSurvivors of esophageal cancer with a second primary malignant cancer have a better prognosis, but require more aggressive treatment. This study provided new evidence and new ideas for future research on the pathophysiological mechanism and treatment concepts of esophageal cancer combined with SPM.

Incidence of multiple primary malignancies, human leukocyte antigen-restricted human endogenous retrovirus gene-derived peptides, and survival

“…The incidence of second cancers in gastric cancer has been reported by the IARC definition as being 1.3% 31) , 8.1% 32) , 0.5% 33) , and 12.9% by the SEER definition 34) . Ye et al reported that patients with esophageal MPM (+) had a better prognosis than those with MPM (-) 35) , similar to our results. However, the authors did not explain the mechanism.…”

Determinants of survival outcomes among esophageal cancer patients at a national referral hospital in Kenya

“…In addition, the overall 3‐year survival rate (2.4%) was lower in the Ethiopian study compared to our setting (56%) 35 . Despite this, the mean survival time was longer in western countries than the African esophageal cancer patients 36–39 . These disparities suggested that cancer care was not adequate in African countries.…”

“…35 Despite this, the mean survival time was longer in western countries than the African esophageal cancer patients. [36][37][38][39] These disparities suggested that cancer care was not adequate in African countries. Therefore, for better outcomes in cancer care, an improvement in treatment and diagnostic facilities should be the utmost priority of the health care delivery system, especially in the sub-Saharan African setting.…”

Composites of Gold Nanostars and Nitrogen- and Sulfur-Codoped Graphene Quantum Dots as Plasmon-Enhanced Immunosensors for Cancer Prognosis

“…This trend is attributed to the high fatality rate if cancer relapses in cured patients . An enhanced prognosis can guarantee a better survival rate among esophageal cancer patients up to 74.67 months of median survival time . Furthermore, studies have shown that there is a long-term prognosis risk, with complete recovery in cancer patients ranging from 5 years and above .…”

“…1 An enhanced prognosis can guarantee a better survival rate among esophageal cancer patients up to 74.67 months of median survival time. 2 Furthermore, studies have shown that there is a long-term prognosis risk, with complete recovery in cancer patients ranging from 5 years and above. 3 Unfortunately, the current prognosis of cancer depends heavily on limited clinical resources, which could hamper prognosis efficiency.…”