Effect Of Prior Cancer History on The Survival of Gallbladder Cancer Patients: A Propensity Score Matching Study Based on The SEER Database
Background: The effect of previous malignancy history on the survival of individuals with a second primary gallbladder cancer remains unclear. Therefore, this study was conducted to analyze the impact of previous malignancy history on the survival of individuals with gallbladder cancer and to compare the prognostic differences between gallbladder cancer patients with and without previous cancer.Methods: Extract the United States Surveillance, Epidemiology, and End Results (SEER) database from
... ER) database from 2004 to 2015 for cases diagnosed with gallbladder cancer. The Kaplan-Meier curves and log-rank test were used to compare the survival difference between gallbladder cancer individuals with and without previous malignancy. Cox proportional hazards regression model was used to explore the risk factors of gallbladder cancer.Results: A total of 5861 patients with gallbladder cancer were enrolled, including 5622 (95.9%) patients without prior primary cancer and 239 (4.1%) patients with prior primary cancer. Patients with gallbladder cancer with prior primary malignancy were older, and the tumors were at localized and regional stages more frequently and more early stages. The Kaplan-Meier curves showed that gallbladder cancer patients with prior cancer had better overall survival (OS) (P=0.027) and gallbladder cancer-specific survival (GCSS) (P<0.001) before propensity score matching (PSM), and gallbladder cancer patients with prior cancer had better GCSS (P<0.001), and there was no difference in OS (P=0.113) between gallbladder cancer patients with and without prior cancer after PSM. Multivariable cox regression analysis revealed that prior malignancy history was not a risk factor for OS (HR=0.875, 95%CI: 0.752-1.018, P=0.084), but it was beneficial to GCSS (HR=0.404, 95%CI: 0.318-0.513, P<0.001).Conclusions: Gallbladder cancer individuals with previous primary malignancy have different clinical characteristics from those without previous primary malignancy. Gallbladder cancer patients with previous primary malignancy have better progress than those without previous malignancy.