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. 2021 Feb 17;21(1):26.
doi: 10.1186/s12894-021-00792-w.

Effect of prior cancer on survival outcomes for patients with advanced prostate cancer

Yechen Wu #  1 , Xi Chen #  2 , Duocheng Qian #  3 , Wei Wang  2 , Yiping Zhang  1 , Jinxin Hu  1 , Jun Zhu  1 , Qiang Wu  4 , Tinghu Cao  5
Affiliations

Effect of prior cancer on survival outcomes for patients with advanced prostate cancer

Yechen Wu et al. BMC Urol. .

Abstract

Background: A history of prior cancer commonly results in exclusion from cancer clinical trials. However, whether a prior cancer history has an adversely impact on clinical outcomes for patients with advanced prostate cancer (APC) remains largely unknown. We therefore aimed to investigate the impact of prior cancer history on these patients.

Methods: We identified patients with advanced prostate cancer diagnosed from 2004 to 2010 in the Surveillance, Epidemiology, and End Results (SEER) database. Propensity score matching (PSM) was used to balance baseline characteristics. Kaplan-Meier method and the Cox proportional hazard model were utilized for survival analysis.

Results: A total of 19,772 eligible APC patients were included, of whom 887 (4.5 %) had a history of prior cancer. Urinary bladder (19 %), colon and cecum (16 %), melanoma of the skin (9 %) malignancies, and non-hodgkin lymphoma (9 %) were the most common types of prior cancer. Patients with a history of prior cancer had slightly inferior overall survival (OS) (AHR = 1.13; 95 % CI [1.02-1.26]; P = 0.017) as compared with that of patients without a prior cancer diagnosis. Subgroup analysis further indicated that a history of prior cancer didn't adversely impact patients' clinical outcomes, except in patients with a prior cancer diagnosed within 2 years, at advanced stage, or originating from specific sites, including bladder, colon and cecum, or lung and bronchus, or prior chronic lymphocytic leukemia.

Conclusions: A large proportion of APC patients with a prior cancer history had non-inferior survival to that of patients without a prior cancer diagnosis. These patients may be candidates for relevant cancer trials.

Keywords: Advanced prostate cancer; Prior cancer; SEER; Survival; Trial eligibility.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Distributions of prior cancer types in patients with advanced prostate cancer
Fig. 2
Fig. 2
Kaplan–Meier survival curves of prior cancer impact on the overall survival (OS) in advanced prostate cancer patients with or without prior cancer. a The OS analysis before Propensity score matching (PSM); b The OS analysis after PSM
Fig. 3
Fig. 3
Kaplan–Meier survival curves of prior cancer impact on the overall survival (OS) stratified by timing of prior cancer in patients with advanced prostate cancer. a The OS analysis with time interval less than 1 year; b The OS analysis with time interval between 1–2 year; c The OS analysis with time interval between 2–3 year; d The OS analysis with time interval between 3–5 year; e The OS analysis with time interval between 5–10 year; f The OS analysis with time interval longer than 10 years
Fig. 4
Fig. 4
Kaplan–Meier survival curves of prior cancer impact on the overall survival (OS) stratified by stage of prior cancer in patients with advanced prostate cancer. a The OS analysis with prior cancer at in situ stage; b The OS analysis with prior cancer at localized stage; c The OS analysis with prior cancer at regional stage; (D) The OS analysis with prior cancer diagnosed at advanced stage
Fig. 5
Fig. 5
Kaplan–Meier survival curves of prior cancer impact on the overall survival (OS) stratified by different types of prior cancer in patients with advanced prostate cancer. a The impact of prior bladder cancer on OS; b The impact of prior colon and cecum cancer on OS; c The impact of prior melanoma skin cancer on OS; d The impact of prior non-hodgkin lymphoma on OS; e The impact of prior rectum cancer on OS; f The impact of prior lung and bronchus cancer on OS
See this image and copyright information in PMC

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