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Abstract：
Reduced cancer deaths have led to an increase in the number of cancer survivors and the risk of the second primary tumor. This study explored the surgical outcomes of patients with non-small cell lung cancer as the second primary tumor and the impact of previous extra-pulmonary malignancies. Patients\' data were obtained from Surveillance, Epidemiology and End Results database. The patients were divided into lung surgery and non-surgery groups. Propensity-score matching was used to balance potential confounders. Kaplan-Meier curves were generated to test the overall survival and lung-cancer-specific survival. Cox regression analysis was performed to calculate death risk. In total 3054 lung surgery and 1094 non-surgery patients with stage I-II non-small cell lung cancer as the second primary tumor were included. The surgery group showed longer overall survival (68 vs. 22 months) and lung cancer-specific survival (not reached vs. 37 months) than those of non-surgery groups (both P < 0.001). Patients with previous hormone-dependent malignancies had similar survival rates (overall survival: 22 vs. 20 months, P = 0.666; lung cancer-specific survival: 38 vs. 37 months, P = 0.292) as those with non-hormone dependent malignancies in the non-surgery group. Significantly longer overall survival (90 vs. 60 months, P = 0.001) was observed in patients with hormone-dependent malignancies in the surgery group; however, there was no difference in lung cancer-specific survival (P = 0.225). Competing risk analysis showed that for patients undergoing lung surgery, there was higher previous malignancy-induced mortality in patients with non-hormone dependent malignancies than in patients with hormone-dependent malignancies. However, there was no difference in lung cancer-induced mortality between the two groups. Patients who underwent lobectomy showed longer survival than those who underwent pneumonectomy and other resection types (89, 27.5 and 65 months, P < 0.001). In summary, lung surgery is beneficial for patients with stage I-II non-small cell lung cancer as the second primary tumor after hormone-dependent malignancy resection.
摘要：
癌症死亡人数的减少导致癌症幸存者的数量和第二原发肿瘤的风险增加。这项研究探讨了非小细胞肺癌作为第二原发肿瘤的患者的手术效果以及先前肺外恶性肿瘤的影响。患者数据来自监测，流行病学和最终结果数据库。将患者分为肺部手术组和非手术组。倾向得分匹配用于平衡潜在的混杂因素。生成Kaplan-Meier曲线以测试总生存期和肺癌特异性生存期。Cox回归分析计算死亡风险。总共包括3054例肺手术和1094例以I-II期非小细胞肺癌为第二原发肿瘤的非手术患者。手术组显示出更长的总生存期（68vs.22个月）和肺癌特异性生存期（未达到vs.37个月）比非手术组（均P<0.001）。既往有激素依赖性恶性肿瘤的患者生存率相似(总生存率：22vs.20个月,P=0.666；肺癌特异性生存率：38vs.37个月,P=0.292）与非手术组的非激素依赖性恶性肿瘤患者一样。显著延长总生存期（90vs.60个月,P=0.001）在手术组中的激素依赖性恶性肿瘤患者中观察到；然而，肺癌特异性生存率无差异(P=0.225).竞争风险分析表明，对于接受肺部手术的患者，非激素依赖性恶性肿瘤患者的既往恶性肿瘤诱导死亡率高于激素依赖性恶性肿瘤患者.然而,两组肺癌诱导的死亡率无差异.接受肺叶切除术的患者比接受肺切除术和其他切除类型的患者生存期更长（89、27.5和65个月，P<0.001)。总之,肺手术对作为激素依赖性恶性肿瘤切除术后第二原发肿瘤的I-II期非小细胞肺癌患者是有益的.
