Abstract

LANA PEREZ, Alberto et al. Survival analysis in multiple cancer patients in Asturias, Spain, 1975-2004. Rev. Esp. Salud Publica [online]. 2008, vol.82, n.2, pp.167-177. ISSN 2173-9110.

Background. Almost one in ten survivors of cancer suffers a second primary. Some studies try to clarify the causes, but there are few that study the time variable. Our research aim was to describe this variable in multiple cancer (MC) patients and to detect others associated with time without MC and survival. Methods. We performed a descriptive study, and the Kaplan Meyer method and Cox Regression were used to study the patients with MC included in the tumour registry of the reference hospital of Asturias. Results. Time between the first symptom and diagnosis was significantly reduced in the second tumour when compared with the first one (113 to 88 days). Time between the first two tumours (median=2.93 years) and the risk of an earlier second primary was higher in older people (RR=1,03) with: primaries diagnosed in advanced stage (RR=1.55), treated with palliative surgery (RR=2.67) or chemotherapy (RR=1.51); second neoplasm located in the prostate (RR=1.67). 60.9% survived at least 5 years after the first diagnosis and 19.1% after the second. These probabilities decreased with age (RR=1.04) and advanced stages (RR=2.48). Nevertheless, locations with good prognosis (prostate, breast or skin) and almost any treatment with surgery or radiotherapy increase survival. Conclusion. Physicians should be alert to new cancer symptoms in patients with previous neoplasms during the follow-up period to improve early MC diagnosis. Survival in MC patients is acceptable, and it largely depends on the location and stage of the cancer involved, but also upon the strategy of treatment.

Keywords : Neoplasms; Second Primary; Survival Analysis; Proportional Hazards Models; Time factors; Prognosis; Prevention and control.

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