BACKGROUND: Prior cancer is a common exclusion criterion in nasopharyngeal carcinoma (NPC) trials. However, whether a prior cancer diagnosis affects trial outcomes is still unknown. We aimed to determine the impact of prior cancer on survival in NPC patients. METHODS: We identified patients diagnosed with NPC between 2004 and 2009 in the Surveillance, Epidemiology, and End Results (SEER) database. Variables were compared by chi-squared test and t-test as appropriate. Propensity score-adjusted Kaplan-Meier methods and Cox proportional hazard models were used to evaluate the impact of prior cancer on overall survival (OS). RESULTS: Among 3,131 eligible NPC patients, 349 (11.15%) patients had a history of prior cancer. The Kaplan-Meier curves did not show a statistically significantly different OS (P=0.19). Subgroup analyses stratified by timing of prior cancer and AJCC TNM stage of index cancer displayed the same tendency: prior cancer did not adversely affect OS compared to patients without prior cancer (P>0.05). Furthermore, in propensity score-adjusted COX models analysis, patients with prior cancer had the same/non-inferior OS [hazard ratio (HR) =1.12; 95% confidence interval, 0.88 to 1.42]. CONCLUSIONS: Among patients with NPC, prior cancer does not convey an adverse effect on clinical outcomes, regardless of the timing of prior cancer and AJCC TNM stage of index cancer. Broader inclusion trial criteria could be adopted in NPC patients with a history of prior cancer. However, further studies are still needed to confirm this conclusion.
BACKGROUND: Prior cancer is a common exclusion criterion in nasopharyngeal carcinoma (NPC) trials. However, whether a prior cancer diagnosis affects trial outcomes is still unknown. We aimed to determine the impact of prior cancer on survival in NPC patients. METHODS: We identified patients diagnosed with NPC between 2004 and 2009 in the Surveillance, Epidemiology, and End Results (SEER) database. Variables were compared by chi-squared test and t-test as appropriate. Propensity score-adjusted Kaplan-Meier methods and Cox proportional hazard models were used to evaluate the impact of prior cancer on overall survival (OS). RESULTS: Among 3,131 eligible NPC patients, 349 (11.15%) patients had a history of prior cancer. The Kaplan-Meier curves did not show a statistically significantly different OS (P=0.19). Subgroup analyses stratified by timing of prior cancer and AJCC TNM stage of index cancer displayed the same tendency: prior cancer did not adversely affect OS compared to patients without prior cancer (P>0.05). Furthermore, in propensity score-adjusted COX models analysis, patients with prior cancer had the same/non-inferior OS [hazard ratio (HR) =1.12; 95% confidence interval, 0.88 to 1.42]. CONCLUSIONS: Among patients with NPC, prior cancer does not convey an adverse effect on clinical outcomes, regardless of the timing of prior cancer and AJCC TNM stage of index cancer. Broader inclusion trial criteria could be adopted in NPC patients with a history of prior cancer. However, further studies are still needed to confirm this conclusion.
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Keywords:
Prior cancer; Surveillance, Epidemiology, and End Results (SEER); clinical trial; nasopharyngeal carcinoma (NPC); survival
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: Janet S de Moor; Angela B Mariotto; Carla Parry; Catherine M Alfano; Lynne Padgett; Erin E Kent; Laura Forsythe; Steve Scoppa; Mark Hachey; Julia H Rowland Journal: Cancer Epidemiol Biomarkers Prev Date: 2013-03-27 Impact factor: 4.254
Authors: Jacques Ferlay; Isabelle Soerjomataram; Rajesh Dikshit; Sultan Eser; Colin Mathers; Marise Rebelo; Donald Maxwell Parkin; David Forman; Freddie Bray Journal: Int J Cancer Date: 2014-10-09 Impact factor: 7.396