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Abstract：
BACKGROUND: Although the incidence of double primary cancers (DPCs) involving lung cancer is rising, they have not been studied sufficiently. This study retrospectively analyzed the clinicopathological and prognostic characteristics of DPC patients with lung cancer and developed a survival nomogram to predict the individual OS rates.
METHODS: We included 103 DPC patients with lung cancer from Shengjing Hospital between 2016 and 2021. Based on the 6-month cancer occurrence interval, the cases were categorized as synchronous DPCs (sDPCs) or metachronous DPCs (mDPCs). Furthermore, the mDPCs were subdivided based on whether the lung cancer occurred first (LCF cohort) or the other cancer occurred first (OCF cohort).
RESULTS: Among the patients, 35 (33.98%) and 68 (66.02%) had sDPCs and mDPCs, respectively. In the mDPCs cohort, 18 (26.47%) belonged to the LCF cohort and 50 (73.53%) to the OCF cohort. The most frequent primary cancer sites were the breast (27.18%), colorectum (22.33%), and urinary system (18.45%). Independent risk factors for progression-free survival were Stage IV lung cancer (p = 0.008) and failure to undergo radical lung cancer surgery (p = 0.028). The risk factors for OS included squamous carcinoma (p = 0.048), Stage IV lung cancer (p = 0.001), single cancer resection plus drug therapy (p < 0.001), drug therapy alone (p = 0.002), failure to undergo radical lung cancer surgery (p = 0.014), and chemotherapy (p = 0.042). The median OS was 37 months, with 3- and 5-year rates of 50.9% and 35.9%, respectively.
CONCLUSIONS: DPCs involving lung cancer account for 1.11% of cases. The breast, colorectum, and urinary system were the most common extra-pulmonary sites, and mDPCs were more frequent than sDPCs. Radical lung cancer surgery significantly affects prognosis, and drug therapy alone may be preferable when only one tumor is operable. The developed nomogram can accurately predict individual 3-year and 5-year OS rates.
METHODS: We included 103 DPC patients with lung cancer from Shengjing Hospital between 2016 and 2021. Based on the 6-month cancer occurrence interval, the cases were categorized as synchronous DPCs (sDPCs) or metachronous DPCs (mDPCs). Furthermore, the mDPCs were subdivided based on whether the lung cancer occurred first (LCF cohort) or the other cancer occurred first (OCF cohort).
RESULTS: Among the patients, 35 (33.98%) and 68 (66.02%) had sDPCs and mDPCs, respectively. In the mDPCs cohort, 18 (26.47%) belonged to the LCF cohort and 50 (73.53%) to the OCF cohort. The most frequent primary cancer sites were the breast (27.18%), colorectum (22.33%), and urinary system (18.45%). Independent risk factors for progression-free survival were Stage IV lung cancer (p = 0.008) and failure to undergo radical lung cancer surgery (p = 0.028). The risk factors for OS included squamous carcinoma (p = 0.048), Stage IV lung cancer (p = 0.001), single cancer resection plus drug therapy (p < 0.001), drug therapy alone (p = 0.002), failure to undergo radical lung cancer surgery (p = 0.014), and chemotherapy (p = 0.042). The median OS was 37 months, with 3- and 5-year rates of 50.9% and 35.9%, respectively.
CONCLUSIONS: DPCs involving lung cancer account for 1.11% of cases. The breast, colorectum, and urinary system were the most common extra-pulmonary sites, and mDPCs were more frequent than sDPCs. Radical lung cancer surgery significantly affects prognosis, and drug therapy alone may be preferable when only one tumor is operable. The developed nomogram can accurately predict individual 3-year and 5-year OS rates.
摘要：
背景：尽管涉及肺癌的双原发癌（DPC）的发病率正在上升，他们没有得到充分的研究。这项研究回顾性分析了DPC肺癌患者的临床病理特征和预后特征，并建立了生存列线图来预测个体OS率。
方法：纳入2016-2021年盛京医院103例肺癌DPC患者。根据6个月的癌症发生间隔，这些病例分为同步DPC（sDPC）或异时DPC（mDPC）。此外，mDPC根据肺癌首先发生(LCF队列)还是其他癌症首先发生(OCF队列)进行细分.
结果：在患者中，35(33.98%)和68(66.02%)有sDPC和mDPC，分别。在mDPC队列中，18（26.47％）属于LCF队列，50（73.53％）属于OCF队列。最常见的原发癌部位是乳腺（27.18%），结肠直肠（22.33%），和泌尿系统(18.45%)。无进展生存期的独立危险因素是IV期肺癌（p=0.008）和未接受根治性肺癌手术（p=0.028）。OS的危险因素包括鳞癌（p=0.048），IV期肺癌（p=0.001），单个癌症切除加药物治疗（p<0.001），单独药物治疗（p=0.002），未能接受根治性肺癌手术（p=0.014），和化疗（p=0.042）。中位OS为37个月，3年期和5年期利率分别为50.9%和35.9%，分别。
结论：涉及肺癌的DPC占病例的1.11%。乳房，结肠直肠,泌尿系统是最常见的肺外部位，mDPC比sDPC更频繁。肺癌根治术显著影响预后,当只有一个肿瘤可手术时，单独的药物治疗可能是优选的。开发的列线图可以准确预测个人3年和5年OS率。
方法：纳入2016-2021年盛京医院103例肺癌DPC患者。根据6个月的癌症发生间隔，这些病例分为同步DPC（sDPC）或异时DPC（mDPC）。此外，mDPC根据肺癌首先发生(LCF队列)还是其他癌症首先发生(OCF队列)进行细分.
结果：在患者中，35(33.98%)和68(66.02%)有sDPC和mDPC，分别。在mDPC队列中，18（26.47％）属于LCF队列，50（73.53％）属于OCF队列。最常见的原发癌部位是乳腺（27.18%），结肠直肠（22.33%），和泌尿系统(18.45%)。无进展生存期的独立危险因素是IV期肺癌（p=0.008）和未接受根治性肺癌手术（p=0.028）。OS的危险因素包括鳞癌（p=0.048），IV期肺癌（p=0.001），单个癌症切除加药物治疗（p<0.001），单独药物治疗（p=0.002），未能接受根治性肺癌手术（p=0.014），和化疗（p=0.042）。中位OS为37个月，3年期和5年期利率分别为50.9%和35.9%，分别。
结论：涉及肺癌的DPC占病例的1.11%。乳房，结肠直肠,泌尿系统是最常见的肺外部位，mDPC比sDPC更频繁。肺癌根治术显著影响预后,当只有一个肿瘤可手术时，单独的药物治疗可能是优选的。开发的列线图可以准确预测个人3年和5年OS率。
