Abstract 1166
Background
With the increasement of cancer survivors of prior cancers, more and more pancreatic ductal adenocarcinomas (PDACs) are developed as second primary cancers. Whether a history of prior cancer has an inferior impact on survival outcomes for patients with PDAC remains unknown. The aim of this study was to evaluate the prognostic factors and assess the survival impact of a history of prior cancer in patients with second primary PDAC.
Methods
Patients with PDAC were retrospectively selected from Surveillance, Epidemiology, and End Results (SEER) database. Overall survival (OS) and cancer-specific mortalities were compared between patients with or without prior cancer.
Results
From 2004 to 2015, 9235 patients with PDAC from SEER database were included, including 438 (4.74%) patients with a history of prior caner and 8797 (95.26%) patients without a history of prior cancer. A total of 438 cases with prior cancers and 4380 cases without prior cancers were matched successfully after propensity score matching (PSM). The median OS were both 7 months for PDAC patients with or without a history of prior cancer. These two groups of patients had similar survival rates and cancer-specific mortalities before or after PSM analyses. Multivariate analysis also showed that a history of prior cancer was not associated with OS in patients with PDAC.Table:
702P Overall survival rates of patients
| Cancer type | No | Overall survival rates (%) | HR (95% CI) | pa | ||
|---|---|---|---|---|---|---|
| 1-year (95% CI) | 2-year (95% CI) | 3-year (95% CI) | ||||
| Whole cohort | 9235 | 36.7(36.6-36.7) | 18.7(18.6-18.7) | 11.7(11.6-11.7) | ||
| Without prior cancer | 8797 | 36.8(36.7-36.9) | 18.7(18.6-18.8) | 11.7(11.6-11.8) | ||
| Prostate cancer | 126 | 35.6(35.3-35.8) | 21.4(21.1-21.5) | 13.3(13.1-13.5) | 1.137(0.928-1.393) | 0.171 |
| Breast cancer | 110 | 36.5(36.4- 36.6) | 16.6(16.5-16.7) | 14.7 (14.6-14.8) | 0.966(0.780-1.197) | 0.749 |
| Renal and bladder cancer | 51 | 35.6(35.5-35.7) | 21.4(21.3-21.5) | 13.3(13.2-13.4) | 1.004(0.732-1.376) | 0.980 |
| Colon and rectum cancer | 43 | 30.2(30.1-30.3) | 15.3(15.2-15.4) | 12.3(12.2-12.4) | 1.149(0.813-1.624) | 0.382 |
| Uterine cancer | 24 | 41.8(41.6-42.0) | 36.6(36.4-36.8) | 36.6(36.4-36.8) | 0.700(0.451-1.086) | 0.165 |
| Lung cancer | 16 | 49.2(49.0-49.4) | 16.4(16.2-16.6) | 8.2(8.1-8.4) | 0.865(0.531-1.408) | 0.572 |
| Small intestinal cancer | 15 | 44.0(43.7-44.3) | 11.7(11.5-11.9) | 11.7(11.5-11.9) | 0.948(0.533-1.687) | 0.855 |
| Oral cancer | 13 | 51.9(51.6-52.2) | 17.3(17.1-17.5) | 0.0 | 0.976(0.544-1.752) | 0.935 |
| Stomach cancer | 12 | 36.5(36.2-36.8) | 0.0 | 0.0 | 1.150(0.571-2.318) | 0.663 |
| Hepatocellular cancer | 8 | 37.5(37.2-37.8) | 12.5(12.3-12.7) | 12.5(12.3-12.7) | 1.014(0.481-2.138) | 0.971 |
| Matched cohort | 4818 | 35.1(35.0-35.2) | 18.2(18.1-18.2) | 11.7(11.7-11.7) | ||
| Without prior cancer | 4380 | 33.0(32.9-33.1) | 18.2(18.1-18.3) | 11.7(11.6-11.7) | ||
| Prostate cancer | 126 | 35.6(35.3-35.5) | 21.4(21.1-21.5) | 13.3(13.1-13.5) | 0.967(0.708-1.318) | 0.826 |
| Breast cancer | 110 | 36.5(36.4- 36.6) | 16.6(16.5-16.7) | 14. (14.6-14.8) | 0.927(0.751-1.145) | 0.481 |
| Renal and bladder cancer | 51 | 35.6(35.5-35.7) | 21.4(21.3-21.5) | 13.3(13.2-13.4) | 0.967(0.709-1.318) | 0.826 |
| Colon and rectum cancer | 43 | 30.2(30.1-30.3) | 15.3(15.2-15.4) | 12.3(12.2-12.4) | 1.107(0.788-1.557) | 0.521 |
| Uterine cancer | 24 | 41.8(41.6-42.0) | 36.6(36.4-36.8) | 36.6(36.4-36.8) | 0.676(0.439-1.041) | 0.125 |
| Lung cancer | 16 | 49.2(49.0-49.4) | 16.4(16.2-16.6) | 8.2(8.048-8.352) | 0.842(0.520-1.364) | 0.504 |
| Small intestinal cancer | 15 | 44.0(43.7-44.3) | 11.7(11.5-11.9) | 11.7(11.5-11.9) | 0.908(0.517-1.596) | 0.739 |
| Oral cancer | 13 | 51.9(51.6-52.2) | 17.3(17.1-17.5) | 0.0 | 0.943(0.531-1.676) | 0.840 |
| Stomach cancer | 12 | 36.5(36.2-36.8) | 0.00 | 0.0 | 1.093(0.552-2.167) | 0.781 |
| Hepatocellular cancer | 8 | 37.5(37.2-37.8) | 12.5(12.3-12.7) | 12.5(12.3-12.7) | 0.982(0.471-2.010) | 0.961 |
Conclusions
PDAC patients with a history of prior cancer had similar OS and cancer-specific mortalities with those without a cancer history. The inclusion of patients with prior cancer into clinical trials of PDAC may be considerable.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The author.
Funding
Grants: The National Natural Science Foundation of China (81171890; 81672390), and the Major National Scientific Research Projects of China (No. 2013CB910304).
Disclosure
The authors has declared no conflicts of interest.
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