Risk of subsequent primary neoplasms developing in lung cancer patients with prior malignancies

J Thorac Cardiovasc Surg. 2004 Apr;127(4):1119-25. doi: 10.1016/j.jtcvs.2003.10.039.


Background: This study was performed to test the hypothesis that a history of other primary neoplasms before a lung cancer diagnosis increases the risk of subsequent malignancy.

Methods: Of 8363 lung cancer patients seen from 1978 to 2002, 881 (11%) had at least 1 previous nonlung primary malignancy. Charts were analyzed for the occurrence of subsequent malignancies.

Results: Lung cancer diagnosis in 881 patients consisted of 75% non-small cell, 12% small cell, and 13% other histologies. The median age was 66 years, with 56% male, 76% white, and 86% smokers. Of the 881 patients, 92% had no subsequent cancer (group 1), and 8% went on to experience the development of a new primary neoplasm (including lung) after their lung cancer (group 2). After adequate follow-up, the cumulative probability of developing a subsequent cancer did not differ markedly between those with and without a prior non-lung cancer diagnosis at 2 years (12% vs 10%) or 5 years (16% vs 15%). Group 1 patients had a significantly lower 1- and 5-year survival than group 2 patients (59% vs 48% and 29% vs 17%, respectively; P =.008). Although multivariate analysis suggested that stage, history of tobacco-associated neoplasm, and history of definitive surgical resection were important determinants in predicting long-term survival, a prior malignancy was not an independent risk factor in the development of subsequent malignancy.

Conclusions: The risk of developing a subsequent malignancy is very high in lung cancer patients with prior primary malignancies, but it is not markedly different from the risks experienced by patients with no prior malignancies.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Baltimore / epidemiology
  • Carcinoma, Non-Small-Cell Lung / epidemiology*
  • Carcinoma, Non-Small-Cell Lung / etiology
  • Carcinoma, Non-Small-Cell Lung / pathology
  • Carcinoma, Small Cell / epidemiology
  • Carcinoma, Small Cell / etiology
  • Carcinoma, Small Cell / pathology
  • Female
  • Follow-Up Studies
  • Humans
  • Lung Neoplasms / epidemiology*
  • Lung Neoplasms / etiology
  • Lung Neoplasms / pathology
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Staging
  • Neoplasms, Multiple Primary / epidemiology*
  • Neoplasms, Multiple Primary / etiology
  • Neoplasms, Multiple Primary / pathology
  • Predictive Value of Tests
  • Risk Factors
  • Smoking / adverse effects
  • Survival Analysis
  • Time Factors