Risk Factors Associated with a Second Primary Lung Cancer in Patients with an Initial Primary Lung Cancer
Research Mentor Name
Dr. Misako Nagasaka
Research Mentor Email Address
Institution / Department
Karmanos Cancer Institute Department of Oncology
Level of Research
Objectives: Increased patient survivorship following initial primary lung cancer (IPLC) due to advancing clinical practice has uncovered new clinical challenges. With growing patient longevity, individuals post-IPLC continue to be at higher subsequent risk of developing secondary primary lung cancer (SPLC). Proper SPLC surveillance guidelines aimed at monitoring IPLC survivors is crucial to enhancing life expectancy in this population. This study aims to categorize risk factors associated with SPLC emergence in IPLC survivors for clinical use following IPLC treatment.
Materials and Methods: Using the Karmanos Cancer Institute Tumor Registry, patients diagnosed with IPLC from 2000 to 2017 were identified. Patients diagnosed with SPLC were matched for histology, age and stage to individuals who did not develop SPLC. Logistic and Cox regression analyses were performed to identify potential risk factors for SPLC emergence and overall survival.
Results: 121 patients diagnosed with IPLC who later developed SPLC were identified and compared to 120 patients with IPLC who did not develop SPLC. Patients who did not undergo surgical resection had a significantly lower probability of developing SPLC (OR 0.235, 95% confidence interval [CI]: 0.118 to 0.450; p<0.001). Compared to surgical resection patients, individuals who did not have surgery as their primary treatment for IPLC had a significantly higher hazard of death (HR 3.088, 95% CI: 2.114 to 4.512; p<0.001).
Conclusion: This study uncovered notable associations and lack thereof between several competing risk factors and SPLC development as well as mortality. Further characterization of SPLC risk factors is essential for implementing effective surveillance recommendations.
Medicine and Health Sciences
Fisher, Amanda D.; Kim, Seongho PhD; Farhat, Dina; Belzer, Kimberly; Milczuk, MaryAnn; French, Courtney; Mamdani, Hirva MD; Sukari, Ammar MD; Baciewicz, Frank MD; Schwartz, Ann G. PhD, MPH; Wozniak, Antoinette MD; and Nagasaka, Misako MD, "Risk Factors Associated with a Second Primary Lung Cancer in Patients with an Initial Primary Lung Cancer" (2021). Medical Student Research Symposium. 78.