Risk Of Primary Malignancy Research Articles

Risk of second primary malignancy in patients with sinonasal tumors: a population-based cohort study.

The 5-year overall survival rate for patients with sinonasal cancers has remained around 50% for the last 3 decades. Prior studies on head and neck cancers have suggested that 1 reason for poor survival is the frequent development of second primary malignancies (SPMs). The purpose of this study is to assess overall and site-specific risks of SPM following treatment of sinonasal malignancy. A retrospective, population-based cohort study was performed on 2614 patients in the Surveillance, Epidemiology, and End Results (SEER) database who were diagnosed with primary sinonasal malignancy between 1973 and 2014. Standardized incidence ratios (SIRs) and absolute excess risks (AERs) were calculated to assess risk of SPM relative to incidence in the general population. A total of 422 (16.1%) patients with primary sinonasal malignancies developed a total of 480 SPMs. This cohort had a significantly higher frequency of SPMs than expected in the general population (SIR 1.32; 95% confidence interval [CI], 1.20 to 1.44; AER 53.41). Site-specific analyses of SIRs suggested highest risk of malignancy in the sinonasal tract (SIR 75.64; 95% CI, 53.53 to 103.83; AER 17.22), followed by bone, eye and orbit, oral cavity and pharynx, and lung and mediastinum. Patients with history of sinonasal cancer are at significantly increased risk of developing an SPM. Careful monitoring for development of additional tumors may be warranted.

Metachronous Lung Cancer Developing after 11 Years of Chemo-Radiotherapy in a Patient with Non-Small Cell Lung Carcinoma

The success rate of the chemo-radiotherapy is low for the patients with lung cancer. The risk of second primary malignancy (SPM) in lung cancer survivors is also not well reported in the literature. A 77-year-old male patient was given chemo-radiotherapy (KT_RT) 11 years ago because of the low respiratory function of the non-small cell lung cancer in the right lung. He applied to hospital for complaining cough. NSCLC was diagnosed and doctors performed left lower lobectomy to the patient. We presented the case in which the patient was cured after chemo-radiotherapy which is an extremely rare condition and the development of a second tumor 11 years later.

The risk of second primary malignancy in patients with stage Ia non-small cell lung cancer: a U.S. population-based study

Background: Lung cancer is one of the most common cancers worldwide. Patients with early stage lung cancer have improved long-term survival. With the introduction of low-dose CT scan, more patients are going to be diagnosed at an early stage. However, there is limited data on the risk of second primary malignancies (SPMs) in these subsets of patients in the United States.Methods: We utilized SEER-13 (Surveillance, Epidemiology and End Results) registry to obtain Multiple Primary- Standardized Incidence Ratio and an Absolute Excess Risk between January 2004 and December 2010 for patients with Stage Ia non-small cell lung cancer.Results: The database comprised of 12,246 patients. A total of 1431 (11.68%) patients developed 1563 SPMs with an observed to expected (O/E) ratio of 2.07 (95% CI = 1.92–2.23, p < .001) in patients with adenocarcinoma and 2.05 (95% CI = 1.92–2.19, p < .001) in squamous cell carcinoma group.Conclusions: This study showed an excess risk of SPMs in patients with early stage non-small cell lung cancer. We recommend a close follow-up, paying attention to concerning symptoms or examination findings and judicious use of age-appropriate cancer screening.

Post-transplant consolidation plus lenalidomide maintenance vs lenalidomide maintenance alone in multiple myeloma: A systematic review.

In newly diagnosed multiple myeloma (NDMM), autologous stem cell transplantation (ASCT) remains the standard approach for transplant-eligible patients. To control the inevitable relapse, post-transplant consolidation/maintenance strategies are commonly used. However, the benefit of post-transplant consolidation is still uncertain METHOD: We conducted a systematic review of phase II/III studies to compare the efficacy of post-ASCT consolidation plus lenalidomide maintenance (CON+LEN) vs lenalidomide maintenance alone (LEN alone) in NDMM. A meta-analysis using fixed and random effects models was performed. Fourteen studies were included with 2275 participants with NDMM treated with ASCT and lenalidomide maintenance. Two groups were identified: CON+LEN group (n=1102) and LEN alone group (n=1173). There was no statistically significant difference in the complete response rate between the two groups [RR=1.1; 95% CI: 0.83-1.44; P=.490]. Interestingly, we found that very good partial response or better rate is around 1.5-fold significantly higher in the CON+LEN group compared to LEN alone group [RR: 1.46; 95% CI: 1.25-1.70; P<.0001]. However, there was no significant difference between the two groups regarding PFS [RR: 1.0; 95% CI: 0.92-1.08, P=.929] and OS [RR: 0.9; 95% CI: 0.92-1.01; P=.148] at 3-4years follow-up. The risk of secondary primary malignancy (SPM) was also similar between the two groups (RR: 1.2; 95% CI: 0.84-1.92; P=.2). Data on adverse events were limited. Our data suggest that, in NDMM patients treated with upfront ASCT, post-transplant consolidation may improve depth of response, but does not add to OS or PFS, compared to lenalidomide maintenance alone. However, data in this context are still immature.

Second Primary Malignancy Risk in Thyroid Cancer Survivors Treated with Radioactive Iodine: An Updated Systematic Review and Meta-analysis

Second Primary Malignancy Risk in Thyroid Cancer Survivors Treated with Radioactive Iodine: An Updated Systematic Review and Meta-analysis

Risk of Second Primary Malignancy in Head and Neck Cancer Patients: A Population-Based Study

Risk of Second Primary Malignancy in Head and Neck Cancer Patients: A Population-Based Study

Risk of second primary malignancy in patient with stage IA non-small cell lung cancer in US.

e20027Background: The risk of second primary malignancy is early stage non-small cell lung cancer is not well known. We evaluated the risk of second primary malignancies (SPM) in adult patients wit...

Risk of Second Non-Breast Primary Cancer in Male and Female Breast Cancer Patients: A Population-Based Cohort Study.

Female breast cancer patients have an increased risk of developing subsequent malignant diseases, but this issue is rarely discussed in regards to male breast cancer patients. Thus, we conducted a national survey that included 100,915 female and 578 male breast cancer patients to investigate the risk of second primary malignancy (SPM). During a follow-up period that included 529,782 person-years, 3,153 cases of SPM developed. Compared with the general population, the standardized incidence ratio (SIR) of SPM in breast cancer patients was 1.51 [95% confidence interval (CI): 1.46–1.56]. The observed risk was significantly higher in male patients (SIR 2.17, 95% CI 1.70–2.73) and in patients whose age at breast cancer diagnosis was 40 years or younger (SIR 3.39, 95% CI 2.80–4.07), comparing to age-matched general population. Compared with the overall female population, the SIRs of female breast cancer patients with uterine (SIR: 2.66, 95% CI: 2.37–2.98), thyroid (SIR: 2.30, 95% CI: 2.02–2.62), and bone and soft tissue (SIR: 2.16, 95% CI: 1.56–2.91) cancers were significantly increased. Male breast cancer patients also displayed significantly higher SIRs for thyroid (SIR: 13.2, 95% CI: 1.60–47.69), skin (SIR: 8.24, 95% CI: 3.02–17.94) and head and neck (SIR: 4.41, 95% CI: 2.35–7.54) cancers. Among breast cancer patients, risk factors significantly associated with SPM included male gender, older age, chemotherapy treatment and comorbidity with liver cirrhosis. From our analysis, we concluded that the risk of SPM was significantly higher for both male and female breast cancer patients compared with the general population, suggesting that more intensive surveillance may be needed, especially in high-risk patients.

Risk of second primary malignancies in a population-based study of adult patients with essential thrombocythemia.

To determine the risk of second primary malignancy (SPM) and survival of patients with essential thrombocythemia (ET). We identified all patients with ET diagnosed during 2001 to 2011 from the Surveillance, Epidemiology and End Results (SEER) 18 database. Actuarial and relative survival methods were used to calculate the survival statistics. We utilized the SEER 13 database to calculate SPM. We used multiple primary standardized incidence ratio (SIR) session of the SEER*Stat software (version 8.1.5) to calculate SIR and excess risk of SPM for ET patients. Age standardized five-year cause-specific survival was greater for patients < 50 years vs those ≥ 50 years (99.4% vs 93.5%, P < 0.01). Five-year cause-specific survival was lower for men vs women (70.2% vs 79.7%). A total of 201 patients (2.46%) developed SPM at a median age of 75 years. SPMs occurred at an observed/expected (O/E) ratio of 1.26 (95%CI: 1.09-1.45, P = 0.002) with an absolute excess risk (AER) of 37.44 per 10000 population. A significantly higher risk was noted for leukemia (O/E 3.78; 95%CI: 2.20-6.05, P < 0.001; AER 11.28/10000). ET patients have an excellent cause-specific five-year survival but are at an increased risk of SPM, particularly leukemia, which may contribute to excess deaths.

Risk of Breast Cancer in Patients with Thyroid Cancer Receiving or Not Receiving 131I Treatment: A Nationwide Population-Based Cohort Study.

An increased risk of second primary malignancy after (131)I therapy has been reported. The objective of this study was to determine the risk of breast cancer in patients with thyroid cancer receiving or not receiving radioiodine treatment in Taiwan. This nationwide population-based cohort study was conducted using data obtained from the Taiwan National Health Insurance Database from 2000 to 2011. A total of 10,361 female patients with thyroid cancer (3,292 did not receive (131)I treatment and 7,069 received (131)I treatment) were enrolled, and 41,444 female controls were frequency-matched to the thyroid cancer patients in a 1:4 ratio by age (5-y age group). A Cox proportional hazards model was applied to estimate the risk of breast cancer in thyroid cancer patients receiving or not receiving (131)I treatment in terms of hazard ratios and 95% and 98% confidence intervals. The incidence rates of breast cancer in patients with thyroid cancer receiving (131)I therapy, those not receiving (131)I therapy, and controls were 18.9, 17.7, and 13.1 per 10,000 person-years, respectively. Compared with patients with thyroid cancer treated with a cumulative (131)I dose of 4.44 GBq or less, the risk of breast cancer was not significantly increased in those treated with a cumulative (131)I dose of more than 4.44 GBq (adjusted hazard ratio, 0.78; 95% confidence interval, 0.50-1.21, P = 0.26; 98% confidence interval, 0.45-1.33, P > 0.02). The greatest increased risk of breast cancer in patients with thyroid cancer is associated with the fact that the patient has thyroid cancer regardless of (131)I administration. However, (131)I further increased that risk but not as much as just having thyroid cancer.

Myeloma XI Trial for Newly Diagnosed Multiple Myeloma (NDMM); A Report of Second Primary Malignancy (SPM) Rates and the Importance of Review of Reported Cases

Myeloma XI Trial for Newly Diagnosed Multiple Myeloma (NDMM); A Report of Second Primary Malignancy (SPM) Rates and the Importance of Review of Reported Cases

Secondary Primary Malignancy Risk in Patients With Cervical Cancer in Taiwan: A Nationwide Population-Based Study.

To evaluate the risk of secondary primary malignancy (SPM) in patients with cervical cancer using a nationwide population-based dataset.Patients newly diagnosed with cervical cancer between 1997 and 2011 were identified using Taiwan's National Health Insurance database. Patients with antecedent malignancies were excluded. Standardized incidence ratios (SIRs) for SPM were calculated by comparing with the cancer incidence in the general population. Risk factors for cancer development were analyzed using Cox proportional hazard models.During the 14-year study period (follow-up of 223,062 person-years), 2004 cancers developed in 35,175 patients with cervical cancer. The SIR for all cancers was 1.56 (95% confidence interval, 1.50–1.63, P < 0.001). SIRs for follow-up periods of >10, 5 to 10, 1 to 5, and <1 year were 1.37, 1.51, 1.34, and 2.59, respectively. After the exclusion of SPM occurring within 1 year of cervical cancer diagnosis, SIRs were significantly higher for cancers of the esophagus (2.05), stomach (1.38), colon, rectum, and anus (1.36); lung and mediastinum (2.28), bone and soft tissue (2.23), uterus (3.76), bladder (2.26), and kidneys (1.41). Multivariate analysis showed that age ≥60 was a significant SPM risk factor (hazard ratio [HR] 1.59). Different treatments for cervical cancer, including radiotherapy (HR 1.41) and chemotherapy (HR 1.27), had different impacts on SPM risk. Carboplatin and fluorouracil independently increased SPM risk in cervical cancer patients.Patients with cervical cancer are at increased risk of SPM development. Age ≥60 years, chemotherapy, and radiotherapy are independent risk factors. Carboplatin and fluorouracil also increased SPM risk independently. Close surveillance of patients at high risk should be considered for the early detection of SPMs.

1031 Secondary primary malignancy risk among in patients with ovarian cancer in Taiwan: A nationwide population-based study

1031 Secondary primary malignancy risk among in patients with ovarian cancer in Taiwan: A nationwide population-based study

Risk of second primary malignancy after nasopharyngeal carcinoma in the United States: A population-based study.

The purpose of this study was to evaluate the incidence of second primary malignancies in patients diagnosed with an index nasopharyngeal carcinoma (NPC) in the United States. The cohort was assembled from the Surveillance, Epidemiology, and End Results (SEER) database with a primary NPC between 1973 and 2005. There was a 47% increased risk of second primary malignancy. The sites with increased risk include the oral cavity and pharynx (standardized incidence ratio [SIR] = 7.11; 95% confidence interval [CI] = 5.21-9.49), esophagus (SIR = 3.50; 95% CI = 1.68-6.44), nose, nasal cavity, and middle ear (SIR = 15.54; 95% CI = 5.70-33.83), and lung and bronchus (SIR = 2.39; 95% CI = 1.91-2.96). Patients with NPC are likely at a significant risk for second primary malignancies, most notably in the oral cavity and pharynx, which is most likely related to genetic susceptibility, increased surveillance, and treatment effects. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1130-E1136, 2016.

Editorial: Old Problems and New Solutions in Pediatric Pulmonology

The series on pediatric pulmonology continues in this issue of the Journal, with four manuscripts that illustrate the new problems of our burgeoning speciality [1–4]. These are how the management of old problems (in this case TB) is being transformed by cutting edge science [1]; how the application of new technologies are creating challenging problems (congenital lung disease) [2]; and how new technologies are transforming the lives of children (neuromuscular disease and NIV) and taking mechanical ventilation, what used to be the prerogative of intensive care into the home, transforming the prognosis of children [3, 4]. However, as we shall see, the more the speciality advances, the more the basic truths we learned as students remain the bedrock of our practice. Old disease, new technology: TB, the captain of the men of death, used to be simple – the tuberculin skin test, sputum (or other biological sample) microscopy and culture, and evidence based treatment with quadruple therapy for 2 mo, and rifampicin and isoniazid for a further 4 mo. Problem solved, even though diagnostics and determining sensitivities might take weeks – treatment could confidently be started while waiting. In children, admittedly diagnosis often had to be on clinical suspicion, because it was difficult to obtain samples. Enter the Dragon! Or rather, multidrug-resistant TB, extremely drug-resistant TB and totally drug resistant TB [5]. Perspectives have had to change rapidly; now we need rapid diagnosis and rapid sensitivity testing, for fear of starting drugs to which the organism is resistant, effectively but inadvertently proposing a single agent regime which will lead to worse problems of drug resistance. The problem has been made worse with the advent of HIVand the consequent worsening of the manifestations of TB. The modern approach is firstly to use novel tests to obtain specimens, such as sputum induction which can be taken in very young babies, and the string test. The second approach is newer microscopy and culture techniques, and specific molecular diagnostics, which are reviewed [1]. Molecular tests not merely detect MTB rapidly in sputum or gastric aspirates, but also allow drug sensitivities to be determined, a major management advance. The future will undoubtedly include molecular handprints on blood samples, as sophisticated techniques become cheaper and more accessible. New technology, new problems: Increased monitoring of pregnant women with ultrasound scanning, and increasingly MRI, has identified abnormalities which previously passed us by. Congenital lung malformations come into just this category. In this issue, a simple clinical classification of congenital thoracic malformations (CTM), which is applicable preand post-natally, is described. However, description is one thing, evidence based management is another. How should you counsel a woman with a fetus with a large CTM at 20 wk of the pregnancy? If the baby is born well, what further imaging should be done and when? What is the risk of complications, and should well babies be submitted to surgery to reduce the risk? And when should surgery be performed? Finally, the biggest elephant in the room, what is the risk of primary lung malignancy in a baby with a CTM? High risk groups can be delineated, but most babies with CTMs are low risk. * Andrew Bush A.Bush@rbht.nhs.uk

Risk of second primary malignancy (SPM) and survival of adult patients with polycythemia vera (PV): A U.S. population-based study.

e18081 Risk of Second Primary Malignancy (SPM) and Survival of Adult Patients with Polycythemia Vera (PV): A US population-based study Background: Although the median survival in PV is as high as 1...

Outcomes of primary plasmacytoma (PP) in United States (US).

8597 Background: Studies on multiple myeloma demonstrate an improvement in overall survival (OS) and increased risk of second primary malignancy (SPM); Population level data on OS and the risk of S...

Survival and risk of second primary malignancy (SPM) in essential thrombocythemia (ET): An analysis of the Surveillance, Epidemiology and End Results (SEER) database.

e18083 Background: ET patients have better overall survival (OS) than other myeloproliferative disorders; however, patients may have worse OS than general population as a result of thrombohemorrhag...

Secondary primary malignancy risk among patients with gastric cancer: A nationwide population-based study in Taiwan.

e15104 Background: Several studies have reported an increase in secondary primary malignancies (SPMs) among gastric cancer patients. Methods: Newly diagnosed gastric cancer patients between 1997 an...

(131)I treatment for thyroid cancer and the risk of developing salivary and lacrimal gland dysfunction and a second primary malignancy: a nationwide population-based cohort study.

The aim of this study was to determine the prevalence of salivary and lacrimal gland dysfunction and a second primary malignancy in patients from Taiwan with thyroid cancer after radioiodine therapy. This nationwide population-based cohort study was based on data obtained from the Taiwan National Health Insurance Database from 2000 to 2011. A total of 1,834 thyroid cancer patients treated with (131)I therapy and 1,834 controls (thyroid cancer without (131)I therapy) selected by 1:1 matching on a propensity score were enrolled. The cumulative (131)I dose in each patient was calculated. A Cox proportional hazards model was applied to estimate the effect of radiation from the (131)I therapy on the risk of salivary and lacrimal gland impairment as well as second primary malignancies in terms of hazard ratios (HRs) and 95% confidence intervals (CIs). In patients treated with (131)I therapy and in controls, the incidence rates of salivary gland dysfunction were 6.76 and 1.01 per 10,000 person-years, respectively (HR 6.81, 95% CI 0.74 - 55.3), the incidence rates of keratoconjunctivitis sicca (KCS) were 13.6 and 16.3 per 10,000 person-years, respectively (HR 0.84, 95% CI 0.41 - 1.73), and the incidence rates of second primary malignancy were 76.7 and 62.4 per 10,000 person-years, respectively (HR 1.23, 95% CI 0.88 - 1.72). The risk of salivary secretion impairment significantly increased with increasing administered doses (HR 14.3, 95% CI 1.73 - 119.0). However, there was no increase in the incidence of KCS or secondary cancer in patients treated with higher doses. (131)I therapy insignificantly increased the risk of salivary gland dysfunction and second primary malignancy. In patients with higher cumulative doses, an increase in the incidence of salivary gland dysfunction was observed. By contrast, we did not find an association between (131)I treatment and KCS development.