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. 2024 Feb;7(2):e1984.
doi: 10.1002/cnr2.1984.

Impact of prior cancer history on survival in brain malignancy: A propensity score-adjusted, population-based study

Mohammad Ebad Ur Rehman  1 , Fatima Faraz  1 , Huzaifa Ahmad Cheema  2 , Omer S Ashruf  3 , Hamna Raheel  4 , Syeda Zainab Ali Naqvi  1 , Nimrah Jabeen  1 , Areesha Abid  1 , Haris Mumtaz Malik  1 , Ahmad Iftikhar  5 , Ahmed Ibrahim  6 , Sarya Swed  7
Affiliations

Impact of prior cancer history on survival in brain malignancy: A propensity score-adjusted, population-based study

Mohammad Ebad Ur Rehman et al. Cancer Rep (Hoboken). 2024 Feb.

Abstract

Background: Individuals with a Prior Cancer History (PCH) are often excluded from clinical trials. However, a growing body of evidence suggests that prior cancer history does not present adverse outcomes on cancer patients. The evidence on the survival of brain cancer patients in this regard remains widely unknown.

Methods: We conducted a retrospective cohort study to estimate the prevalence and impact of prior cancer on survival of patients diagnosed with brain cancer. Data of patients who were diagnosed with brain cancer as their first or second primary malignancy between 2000 and 2019 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Propensity Score Matching (PSM) was used to ensure comparable baseline characteristics among the patients. Survival analysis was conducted using the Kaplan-Meier method, as well as multivariate Cox proportional hazard and multivariate competing risk models.

Results: Out of 42 726 patients, 1189 (2.78%) had PCH. Genitourinary (40.4%), Breast (13.6%), Hematologic and Lymphatic (11.4%), and Gastrointestinal malignancies (11.3%) were the most common types of prior cancer. PCH served as a significant risk factor for Overall Survival (OS) (Adjusted Hazard Ratio [AHR] 1.26; 95% CI [1.15-1.39]; p < .001) but did not have a statistically significant impact on Brain Cancer-Specific Survival (BCSS) (AHR 0.97; 95% CI [0.88-1.07]; p = .54). Glioblastoma exhibited the most substantial and statistically significant impact on survival as compared to other histological types. Of all the organs systems, only prior Gastrointestinal and Hematologic and Lymphatic malignancies had a statistically significant impact on OS of patients.

Conclusion: Our findings indicate that PCH does not exert a substantial impact on the survival of brain cancer patients, except in cases involving gastrointestinal or hematologic and lymphatic PCH, or when the brain cancer is glioblastoma.

Keywords: brain cancer; cancer-specific survival; overall survival; prior cancer.

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Conflict of interest statement

The authors have stated explicitly that there are no conflicts of interest in connection with this article.

Figures

FIGURE 1
FIGURE 1
Flowchart demonstrating case selection process from SEER.
FIGURE 2
FIGURE 2
Propensity score matching.
FIGURE 3
FIGURE 3
Cumulative incidence and Kaplan–Meier survival curves illustrating the effect of prior cancer history on the overall survival (OS) of brain cancer patients before and after PSM (A: Cumulative incidence of death in patients with and without PCH before PSM. B: Cumulative incidence of death in patients with and without PCH after PSM. C: KM curve of patients with and without PCH before PSM. D: KM curve of patients with and without PCH after PSM).
FIGURE 4
FIGURE 4
Pie chart demonstrating distribution of prior cancer types in various organ systems.
FIGURE 5
FIGURE 5
Site specific survival of patients with previous cancer history.
See this image and copyright information in PMC

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