Abstract
PurposeThe eye and its adnexal structures can give rise to first or consecutive primary malignancies or to encounter metastasis. Our aim was to define the characteristics of the second primary neoplasms affecting the eye and its adnexa and find the risk modifying factors for them after malignancies elsewhere in the body.MethodsWe have queried the Surveillance, Epidemiology and End-Results “SEER”-9 program of the National Cancer Institute for the malignancies of the eye and its adnexa that occurred between 1973 and 2015. The malignancies were ordered chronologically according to their incidence: first or second primary malignancies. The tumors were classified according to ICD-O-3 classification. Standardized incidence ratios (SIR) and survival probabilities were calculated for subgroups.ResultsAmong 3,578,950 cancer patients, 1203 experienced a second malignancies of the eye and its adnexa. The first malignancy was diagnosed between 50 and 69 years of age in 58.94% of them. The eyelid showed 280 events, while 50 in lacrimal gland, 181 in the orbit, 21 in the overlapping lesions, 15 in optic nerve, 148 in the conjunctiva, 9 in the cornea, 6 in the Retina, 379 in the choroid, and 93 in the ciliary body. The SIR of a second malignancy after a prior non-Hodgkin lymphoma was 2.42, and in case of previous skin carcinomas it was 3.02, melanoma of skin, and 2.13 and 1.58 in oral cavity/pharynx malignancies. The second ocular and adnexal neoplasms increased steadily over the 5-year periods on contrary to first primary neoplasms. The survival of patients affected with first ocular and adnexal neoplasms was significantly higher than those with second ocular and adnexal neoplasms. On the other side, second primary ocular and adnexal tumors showed a better survival than second primary malignancies elsewhere.ConclusionsThe epidemiological differences between first and second ocular and adnexal primaries suggest different underlying mechanisms. Careful ocular examination should be integrated in the long-term follow-up plan of cancer patients. Special attention should be given to patients with non-Hodgkin’s lymphoma and melanoma as first primary.
Highlights
The eye and its ocular adnexa (EOA) are affected by a broad spectrum of malignant tumors
We aimed to explore the major themes of Second primary malignant tumors (SPMTs) in the ocular and its adnexal regionusing data from the Surveillance, Epidemiology and End Results (SEER) Program of the US National Cancer Institute (NCI)
We reviewed a total of 3,578,950 cancer patients’ records, of which 1222 primary malignancies of the EA in 1203 patients after a previous malignancy elsewhere
Summary
The eye and its ocular adnexa (EOA) are affected by a broad spectrum of malignant tumors. Second primary malignant tumors (SPMTs) are defined as new primary malignant tumors that are encountered after another primary one. Different factors are involved, yet, without an established pattern. Environmental factors, and various treatment options are correlated with the second primary malignancies. Symptoms can be overlooked in the context of fatigability attributed to the primary tumor and/or its therapy. Planning another therapeutic course, like radiotherapy, after a prior one can have various drawbacks, including induction of another malignancy [2,3,4,5]
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