Muneer J Al-Husseini1, Anas M Saad1, Tarek Turk2, Mohamed A Tabash1, Omar Abdel-Rahman3,4. 1. Faculty of Medicine, Ain Shams University, Cairo, Egypt. 2. Faculty of Medicine, Damascus University, Damascus, Syria. 3. Clinical Oncology Department, Faculty of Medicine, Ain Shams University, Lofty Elsayed Street, Cairo, 11566, Egypt. omar.abdelrhman@med.asu.edu.eg. 4. Department of Oncology, University of Calgary and Tom Baker Cancer Center, Calgary, AB, Canada. omar.abdelrhman@med.asu.edu.eg.
Abstract
PURPOSE: Pancreatic cancer is one of the most fatal malignancies and the fourth leading cause of cancer-related mortality in the USA. Most clinical trials involving pancreatic adenocarcinoma (PAC) patients exclude subjects with a prior malignancy because of the possible effect of prior malignancies on survival. However, no data in the medical literature support this assumption. In this paper, we aim to study the impact of having a prior malignancy on the survival outcomes of stage IV PAC. METHODS: We used the surveillance, epidemiology, and end results database to review patients with stage IV PAC diagnosed between 1973 and 2014. We calculated overall and pancreatic cancer-specific survival of these patients using unadjusted Kaplan-Meier test and multivariable covariate-adjusted Cox models. RESULTS: We reviewed 66,874 stage IV PAC patients, of which 4942 had a prior malignancy. Kaplan-Meier and Cox models showed that a history of prior malignancy did not cause significant difference in overall survival (HR = 0.938, 95%CI = 0.880-1.000, p = .052). However, a prior malignancy was associated with a better pancreatic cancer-specific survival (HR = 0.855, 95% CI = 0.796-0.918, p < .001). CONCLUSION: A prior malignancy before stage IV PAC was not associated with worse survival outcomes. Researchers should take these results into consideration when including/excluding patients to improve the generalizability and accuracy of their results.
PURPOSE:Pancreatic cancer is one of the most fatal malignancies and the fourth leading cause of cancer-related mortality in the USA. Most clinical trials involving pancreatic adenocarcinoma (PAC) patients exclude subjects with a prior malignancy because of the possible effect of prior malignancies on survival. However, no data in the medical literature support this assumption. In this paper, we aim to study the impact of having a prior malignancy on the survival outcomes of stage IV PAC. METHODS: We used the surveillance, epidemiology, and end results database to review patients with stage IV PAC diagnosed between 1973 and 2014. We calculated overall and pancreatic cancer-specific survival of these patients using unadjusted Kaplan-Meier test and multivariable covariate-adjusted Cox models. RESULTS: We reviewed 66,874 stage IV PAC patients, of which 4942 had a prior malignancy. Kaplan-Meier and Cox models showed that a history of prior malignancy did not cause significant difference in overall survival (HR = 0.938, 95%CI = 0.880-1.000, p = .052). However, a prior malignancy was associated with a better pancreatic cancer-specific survival (HR = 0.855, 95% CI = 0.796-0.918, p < .001). CONCLUSION: A prior malignancy before stage IV PAC was not associated with worse survival outcomes. Researchers should take these results into consideration when including/excluding patients to improve the generalizability and accuracy of their results.
Authors: P N Lara; R Higdon; N Lim; K Kwan; M Tanaka; D H Lau; T Wun; J Welborn; F J Meyers; S Christensen; R O'Donnell; C Richman; S A Scudder; J Tuscano; D R Gandara; K S Lam Journal: J Clin Oncol Date: 2001-03-15 Impact factor: 44.544
Authors: Anne-Michelle Noone; Jennifer L Lund; Angela Mariotto; Kathleen Cronin; Timothy McNeel; Dennis Deapen; Joan L Warren Journal: Med Care Date: 2016-09 Impact factor: 3.178