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Zhan X, Chen T, Xiong S, Li S, Deng X, Xu S, Fu B, Deng J. Causal relationship between prostate cancer and 12 types of cancers: multivariable and bidirectional Mendelian randomization analyses. Int Urol Nephrol 2024; 56:547-556. [PMID: 37740849 DOI: 10.1007/s11255-023-03793-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 09/03/2023] [Indexed: 09/25/2023]
Abstract
BACKGROUND Previous observational studies have shown an association between certain cancers and the subsequent risk of prostate cancer (PCa). However, the causal relationship between these cancers and PCa is still unclear. This study aimed to investigate the causal relationship between 12 common cancers and the risk of PCa. METHODS We employed genome-wide association studies (GWAS) to perform forward and reverse Mendelian randomization (MR) within two-sample frameworks. Furthermore, we conducted multivariable MR analyses to investigate the relationships between different types of cancer. In addition, multiple sensitivity analysis methods were employed to assess the robustness of our findings. RESULTS Our univariable MR analysis showed that genetically predicted hematological cancer was associated with a reduced risk of PCa (OR: 0.911, 95% CI 0.89-0.922, P = 0.03). Furthermore, MR analysis demonstrates that genetically predicted occurrence of thyroid gland and endocrine gland cancer also raised the risk of PCa (all P < 0.05). Multivariable analysis showed that thyroid gland cancer exhibited a higher incidence of PCa (OR: 1.12, 95% CI: 1.08-1.16, P = 0.008). In the reverse MR analysis, we found no significant inverse causal associations between PCa and 12 types of cancers. CONCLUSION In summary, this study provided insights into the causal relationships between various types of cancer and PCa. Hematological cancer was suggested to associate with a lower risk of PCa, while thyroid gland cancer and endocrine gland cancer might increase the risk. These findings contribute to the understanding of genetic factors related to PCa and its potential associations with other cancers.
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Affiliation(s)
- Xiangpeng Zhan
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Tao Chen
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Situ Xiong
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Sheng Li
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Xinxi Deng
- Department of Urology, Jiu Jiang First People's Hospital, Jiujiang, Jiangxi, China
| | - Songhui Xu
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Bin Fu
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Jun Deng
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
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van der Meer DJ, van der Graaf WTA, van de Wal D, Karim-Kos HE, Husson O. Long-term second primary cancer risk in adolescent and young adult (15-39 years) cancer survivors: a population-based study in the Netherlands between 1989 and 2018. ESMO Open 2024; 9:102203. [PMID: 38171190 PMCID: PMC10837779 DOI: 10.1016/j.esmoop.2023.102203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 11/16/2023] [Accepted: 11/17/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Few studies have comprehensively investigated the long-term second cancer risk among adolescent and young adult (AYA, aged 15-39 years) cancer survivors. This study investigated the long-term second cancer risk by including the full range of first and second cancer combinations with at least 10 observations in the Netherlands between 1989 and 2018. MATERIALS AND METHODS First and second primary cancer data of all 6-month AYA cancer survivors were obtained from the nationwide population-based Netherlands Cancer Registry. Excess cancer risk compared to the general population was assessed with standardized incidence ratio (SIR) and absolute excess risk (AER) statistics up to 25 years after diagnosis. Cumulative incidences were estimated, using death as a competing risk factor. Analyses were carried out with and without applying multiple cancer rules. RESULTS The cohort included 99 502 AYA cancer survivors. Male survivors had a 2-fold higher risk of developing any cancer compared to the general population, whereas this was around 1.3-fold in females. AERs were 17.5 and 10.1 per 10 000 person-years for males and females. The long-term excess risk of cancer was significantly higher for most first and second primary cancer combinations, but comparable and lower risk estimates were also observed. Application of the multiple cancer rules resulted in a noticeable risk underestimation in melanoma, testicular, and breast cancer survivors. Risk outcomes remained similar in most cases otherwise. The cumulative incidence of second cancer overall increased over time up to 8.9% in males and 10.3% in females at 25 years' follow-up. Highest long-term cumulative incidences were observed among lymphoma survivors (13.3% males and 18.9% females). CONCLUSIONS AYA cancer survivors have a higher cancer risk compared to the general population for most cancers up to 25 years after their initial cancer diagnosis. Additional studies that investigate risk factors for the specific cancer type combinations are needed to develop personalized follow-up strategies.
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Affiliation(s)
- D J van der Meer
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam; Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam; Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam.
| | - W T A van der Graaf
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam; Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam
| | - D van de Wal
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam
| | - H E Karim-Kos
- Princess Máxima Center for Pediatric Oncology, Utrecht; Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht
| | - O Husson
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam; Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam; Department of Surgical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
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Jung W, Shin DW, Jung KW, Kim D, Park J, Nari F, Suh M. The Impact of Neighborhood Deprivation on the Survival Rates of Patients with Cancer in Korea. Healthcare (Basel) 2023; 11:3171. [PMID: 38132061 PMCID: PMC10742845 DOI: 10.3390/healthcare11243171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/11/2023] [Accepted: 12/13/2023] [Indexed: 12/23/2023] Open
Abstract
The objective of this study is to investigate the correlation between the neighborhood deprivation index and survival rates of cancer patients in Korea. In this study, 5-year age-standardized survival rates of patients with cancer were determined using the National Cancer Cohort from 2014 to 2018 in Korea. The primary cancer sites were the stomach, colorectum, liver, lung, breast, cervix, prostate, and thyroid. Disparities were measured, and their impact on the overall survival rates was assessed using the Korean version of the Neighborhood Deprivation Index. Pearson's correlation coefficient was calculated to determine the strength of the correlation. The study cohort comprised 726,665 patients with cancer, of whom 50.7% were male. The predominant primary cancer sites were the stomach (n = 138,462), colorectum (n = 125,156), and thyroid gland (n = 120,886). Urban residents showed better survival outcomes than those situated in rural areas. The most deprived quartile had the lowest survival rate, while the least deprived quartile had the highest (p < 0.001). Most cancer types revealed significant correlations between neighborhood deprivation and 5-year age-standardized overall survival, with lung cancer showing the most substantial negative correlation (r = -0.510), followed by prostate cancer (r = -0.438). However, thyroid cancer showed only a marginal correlation (p = 0.069). The results of this study suggested that neighborhood deprivation is closely linked to disparities in overall survival across various types of cancer. A substantial negative correlation between the neighborhood deprivation index and all-cause mortality for lung and prostate cancer, as compared to breast and cervical cancers covered by the National Cancer Screening Program, may reinforce the need to address healthcare access and improve the early detection of cancer in socioeconomically deprived neighborhoods.
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Affiliation(s)
- Wonyoung Jung
- Department of Family Medicine/Obesity and Metabolic Health Center, Kangdong Sacred Heart Hospital, Hallym University, Seoul 05355, Republic of Korea;
| | - Dong Wook Shin
- Department of Family Medicine and Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea
- Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, Seoul 06355, Republic of Korea
| | - Kyu-Won Jung
- Korea Central Cancer Registry, National Cancer Center, Goyang 10408, Republic of Korea;
- National Cancer Control Institute, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang 10408, Republic of Korea; (J.P.)
| | - Dongjin Kim
- Center for Health Policy Research, Korea Institute for Health and Social Affairs, Sejong 30147, Republic of Korea;
| | - Juwon Park
- National Cancer Control Institute, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang 10408, Republic of Korea; (J.P.)
| | - Fatima Nari
- National Cancer Control Institute, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang 10408, Republic of Korea; (J.P.)
| | - Mina Suh
- National Cancer Control Institute, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang 10408, Republic of Korea; (J.P.)
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Ho J, Han M, Jung I, Jo YS, Lee J. Impact of thyroid hormone replacement on the risk of second cancer after thyroidectomy: a Korean National Cohort Study. Sci Rep 2023; 13:16280. [PMID: 37770542 PMCID: PMC10539343 DOI: 10.1038/s41598-023-43461-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 09/24/2023] [Indexed: 09/30/2023] Open
Abstract
We aimed to investigate the effect of thyroid hormone administration on the risk of second primary cancer in patients who underwent thyroidectomy for differentiated thyroid cancer. Data were extracted from the medical billing data of the Health Insurance Review and Assessment Service in South Korea. Patients between 19 and 80 years old who underwent thyroid surgery at least once between January 2009 and June 2020 were included. Data of patients with second primary cancer and control patients with matched age, sex, operation date, and follow-up duration were extracted at a ratio of 1:4. A nested case-control analysis was performed to exclude length bias to confirm the correlation between the duration of thyroid hormone administration, dose, and incidence of second primary cancer. Of the 261,598 patients who underwent surgery for thyroid cancer included in the study, 11,790 with second primary cancer and 47,160 without second primary cancer were matched. The average dose of thyroid hormone increased the adjusted odds ratio (OR) for both low (≤ 50 μg, OR 1.29, confidence interval (CI) 1.12-1.48) and high (< 100 μg, OR 1.24, CI 1.12-1.37) doses. Analyzing over time, the adjusted OR of second primary cancer increased, especially in short (≤ 1 year) (OR 1.19; CI 1.06-1.34) and long (> 5 years) duration (OR 1.25; CI 1.10-1.41). In conclusion, insufficient and excessive thyroid hormone replacement might be linked to increased second primary cancer in patients who underwent thyroidectomy for differentiated thyroid cancer.
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Affiliation(s)
- Joon Ho
- Department of Surgery, Open NBI Convergence Technology Research Laboratory, Yonsei University College of Medicine, Seoul, South Korea
| | - Minkyung Han
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea
| | - Inkyung Jung
- Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea.
| | - Young Suk Jo
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.
| | - Jandee Lee
- Department of Surgery, Open NBI Convergence Technology Research Laboratory, Yonsei University College of Medicine, Seoul, South Korea.
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Kim MS, Lee SJ, Lee MH, Choi JH, Han HW, Song YS. Risk of Subsequent Primary Cancer in Thyroid Cancer Survivors: A Nationwide Population-Based Study. Diagnostics (Basel) 2023; 13:2903. [PMID: 37761273 PMCID: PMC10527961 DOI: 10.3390/diagnostics13182903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 08/31/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
Background: Despite obtaining a good prognosis and long life expectancy, survivors of thyroid cancer can nevertheless develop subsequent primary cancer (SPC). We investigated the risk and types of SPC in patients with thyroid cancer and compared them with subjects without thyroid cancer history (controls). Methods: We conducted a nationwide, population-based, retrospective cohort study based on the Korean National Health Insurance Database. A total of 432,654 patients diagnosed with thyroid cancer between 2004 and 2019 were 1:1 matched with controls for age, sex, income, and region of residence. The hazard ratios (HR) and 95% confidence intervals (CI) of SPC were estimated using Cox proportional hazard models. Results: In total, 78,584 (18.2%) patients with thyroid cancer and 49,979 (11.6%) controls were diagnosed with SPCs over a mean follow-up of 6.9 years. Patients with thyroid cancer had a higher risk of SPC at any site (adjusted HR, 1.62; 95% CI, 1.60-1.64) than the controls. The risk of SPCs was particularly high for patients diagnosed with thyroid cancer at a younger age (<40 years) and within 5 years. Conclusions: Medical caregivers should consider the long-term follow-up of patients with thyroid cancer and discuss the risk of SPC, especially if they complain of cancer-related symptoms.
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Affiliation(s)
- Min-Su Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, CHA Bundang Medical Center, CHA University School of Medicine, CHA University, Seongnam 13496, Republic of Korea
| | - Sang Jun Lee
- Department of Biomedical Informatics, CHA University School of Medicine, CHA University, Seongnam 13496, Republic of Korea
| | - Myeong Hoon Lee
- Department of Biomedical Informatics, CHA University School of Medicine, CHA University, Seongnam 13496, Republic of Korea
| | - Jay Hyug Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, CHA Bundang Medical Center, CHA University School of Medicine, CHA University, Seongnam 13496, Republic of Korea
| | - Hyun Wook Han
- Department of Biomedical Informatics, CHA University School of Medicine, CHA University, Seongnam 13496, Republic of Korea
| | - Young Shin Song
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Republic of Korea
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Dadey DYA, Medress ZA, Sharma M, Ugiliweneza B, Wang D, Rodrigues A, Parker J, Burton E, Williams B, Han SS, Boakye M, Skirboll S. Risk of developing glioblastoma following non-CNS primary cancer: a SEER analysis between 2000 and 2018. J Neurooncol 2023; 164:655-662. [PMID: 37792220 DOI: 10.1007/s11060-023-04460-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 09/22/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND Patients with a prior malignancy are at elevated risk of developing subsequent primary malignancies (SPMs). However, the risk of developing subsequent primary glioblastoma (SPGBM) in patients with a prior cancer history is poorly understood. METHODS We used the Surveillance, Epidemiology, and End Results (SEER) database and identified patients diagnosed with non-CNS malignancy between 2000 and 2018. We calculated a modified standardized incidence ratio (M-SIR), defined as the ratio of the incidence of SPGBM among patients with initial non-CNS malignancy to the incidence of GBM in the general population, stratified by sex latency, and initial tumor location. RESULTS Of the 5,326,172 patients diagnosed with a primary non-CNS malignancy, 3559 patients developed SPGBM (0.07%). Among patients with SPGBM, 2312 (65.0%) were men, compared to 2,706,933 (50.8%) men in the total primary non-CNS malignancy cohort. The median age at diagnosis of SPGBM was 65 years. The mean latency between a prior non-CNS malignancy and developing a SPGBM was 67.3 months (interquartile range [IQR] 27-100). Overall, patients with a primary non-CNS malignancy had a significantly elevated M-SIR (1.13, 95% CI 1.09-1.16), with a 13% increased incidence of SPGBM when compared to the incidence of developing GBM in the age-matched general population. When stratified by non-CNS tumor location, patients diagnosed with primary melanoma, lymphoma, prostate, breast, renal, or endocrine malignancies had a higher M-SIR (M-SIR ranges: 1.09-2.15). Patients with lung cancers (M-SIR 0.82, 95% CI 0.68-0.99), or stomach cancers (M-SIR 0.47, 95% CI 0.24-0.82) demonstrated a lower M-SIR. CONCLUSION Patients with a history of prior non-CNS malignancy are at an overall increased risk of developing SPGBM relative to the incidence of developing GBM in the general population. However, the incidence of SPGBM after prior non-CNS malignancy varies by primary tumor location, with some non-CNS malignancies demonstrating either increased or decreased predisposition for SPGBM depending on tumor origin. These findings merit future investigation into whether these relationships represent treatment effects or a previously unknown shared predisposition for glioblastoma and non-CNS malignancy.
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Affiliation(s)
- David Y A Dadey
- Department of Neurosurgery, Stanford University, Stanford, CA, 94301, USA.
| | - Zachary A Medress
- Department of Neurosurgery, Stanford University, Stanford, CA, 94301, USA
| | - Mayur Sharma
- Department of Neurosurgery, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Beatrice Ugiliweneza
- Department of Neurosurgery, University of Louisville, Louisville, KY, 40202, USA
| | - Dengzhi Wang
- Department of Neurosurgery, University of Louisville, Louisville, KY, 40202, USA
| | - Adrian Rodrigues
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Jonathon Parker
- Department of Neurosurgery, Mayo Clinic, Scottsdale, AZ, 85259, USA
| | - Eric Burton
- Neuro-Oncology Branch, National Cancer Institute, NIH, Bethesda, MD, 20892, USA
| | - Brian Williams
- Department of Neurosurgery, University of Louisville, Louisville, KY, 40202, USA
| | - Summer S Han
- Department of Neurosurgery, Stanford University, Stanford, CA, 94301, USA
| | - Maxwell Boakye
- Department of Neurosurgery, University of Louisville, Louisville, KY, 40202, USA
| | - Stephen Skirboll
- Department of Neurosurgery, Stanford University, Stanford, CA, 94301, USA
- Department of Surgery, Palo Alto Veterans Affairs, Palo Alto, CA, 94304, USA
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Wang H, Wang Y, Yang R, Liu D, Li W. Risk of second primary lung cancer in patients with thyroid cancer: a meta-analysis based on big population studies. Chin Med J (Engl) 2023:00029330-990000000-00536. [PMID: 37052139 DOI: 10.1097/cm9.0000000000002457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Previous studies have revealed that the number of cancer survivors developing a second primary malignancy is increasing, especially among thyroid cancer patients, and lung cancer is still the main cause of cancer death. Therefore, we aimed to investigate the risk of second primary lung cancer (SPLC) in patients with thyroid cancer. METHODS We searched the PubMed, Web of Science, Embase, and Scopus databases up to November 24, 2021, for relevant research and merged the standardized incidence ratios (SIRs) and 95% confidence intervals (95% CIs) to evaluate the risk of developing SPLC in patients with thyroid cancer. RESULTS Fourteen studies involving 1480,816 cases were included in our meta-analysis. The pooled result demonstrated that thyroid cancer patients may have a higher risk of SPLC than the general population (SIR = 1.21, 95% CI: 1.07-1.36, P < 0.01, I2 = 81%, P < 0.01). Subgroup analysis stratified by sex indicated that female patients may have a markedly higher risk of SPLC than male patients (SIR = 1.65, 95% CI: 1.40-1.94, P < 0.01, I2 = 75%, P < 0.01). CONCLUSIONS Thyroid cancer patients are more likely to develop SPLC than the general population, especially women. However, other risk factors must be investigated, and more prospective studies are needed to confirm our results.Registration: International Prospective Register of Systematic Reviews: No. CRD42021285399.
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Affiliation(s)
- Haoyu Wang
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
- Institute of Respiratory Health, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Yan Wang
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Ruiyuan Yang
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Dan Liu
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Weimin Li
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
- Institute of Respiratory Health, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
- Precision Medicine Center, Precision Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
- The Research Units of West China, Chinese Academy of Medical Sciences, West China Hospital, Chengdu, Sichuan 610041, China
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Ho J, Kim E, Lee M, Jung I, Jo YS, Lee J. Impact of thyroid cancer on the cancer risk in patients with non-alcoholic fatty liver disease or dyslipidemia. Sci Rep 2023; 13:1076. [PMID: 36658156 PMCID: PMC9852577 DOI: 10.1038/s41598-023-28112-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 01/12/2023] [Indexed: 01/20/2023] Open
Abstract
The raised prevalence of obesity has increased the incidence of obesity-related metabolic diseases such as dyslipidemia (DL) and non-alcoholic fatty liver disease (NAFLD), along with the development and progression of various types of cancer, including thyroid cancer. In this study, we investigated whether thyroid cancer in patients with DL and NAFLD could be a risk factor for other cancers. To achieve our goal, we generated two independent cohorts from our institution and from the National Health Insurance System in South Korea. Based on the ICD-10 code, we conducted exact matching (1:5 matching) and estimated the overall risk of thyroid cancer for other cancers in patients with DL or NAFLD. Univariate and multivariate analyses showed that the hazard ratio (HR) of thyroid cancer was 2.007 (95% Confidence Interval [CI], 1.597-2.522) and 2.092 (95% CI, 1.546-2.829), respectively in the institutional cohort and 1.329 (95% CI, 1.153-1.533) and 1.301 (95% CI, 1.115-1.517), respectively in the nationwide cohort. Risk analysis revealed a significant increase in the HR in lip, tongue, mouth, lung, bone, joint, soft tissue, skin, brain, male cancers and lymphoma after thyroid cancer occurred. Thyroid cancer in patients with DL or NAFLD might be a valuable factor for predicting the development of other cancers.
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Affiliation(s)
- Joon Ho
- Open NBI Convergence Technology Research Laboratory, Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea
| | - Eunhwa Kim
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea
| | - Myeongjee Lee
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea
| | - Inkyung Jung
- Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea.
| | - Young Suk Jo
- Open NBI Convergence Technology Research Laboratory, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.
| | - Jandee Lee
- Open NBI Convergence Technology Research Laboratory, Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea.
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[Treatment and prognosis of multiple primary malignant neoplasms complicated with renal cell carcinoma]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2022. [PMID: 35950392 PMCID: PMC9385529 DOI: 10.19723/j.issn.1671-167x.2022.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE To investigate the treatment and prognosis of multiple primary malignant neoplasms (MPMN) complicated with renal cell carcinoma (RCC), and to make risk stratification. METHODS A retrospective study of 27 cases of MPMN with RCC in two centers, including the different tumors of MPMN, specific treatment methods, and the interval between primary cancers. At the same time, the survival conditions, including recurrence, metastasis and survival, were followed up for statistical analysis. The interval between the two kinds of primary cancer within 6 months was simultaneous MPMNs, and more than 6 months was metachronous MPMNs. For simple risk stratification of cases, as long as one of the MPMNs had a stage Ⅲ or higher malignancy, which was defined as high risk. RESULTS Among the 27 patients, 20 were male and 7 were female, with age at the time of diagnosis was 42-82 years, with an average age of (61.3±11.7) years. The age at the diagnosis of renal cancer was 43-87 years, with an average age of (66.0±11.3) years. There were 21 cases with duplex primary malignant neoplasms, 4 cases with triple primary malignant neoplasms, and 2 cases with quadruple primary malignant neoplasms. The interval between first cancer and second cancer was 0-360 months, with a median of 18 months. There were 17 cases of metachronous multiple primary malignant neoplasms and 10 cases of simultaneous multiple primary malignant neoplasms. The most common system of MPMN with comorbid RCC involved urologic system, digestive system and respiratory system. The most common locations of MPMN with comorbid RCC were bladder cancer, lung cancer and colon cancer. Follow-up time calcu- lated from the last cancer was 2-156 months, with a median of 32 months. And 14 cases survived and 13 cases died, with 11 cases being tumor related. Tumor stage was the risk factor of prognosis. Any kind of tumor stage in stage Ⅲ or above had a relatively poor prognosis. CONCLUSION MPMN complicated with RCC is relatively rare. Standard treatment should be used for each cancer type during the treatment process. The prognosis mainly depends on the highest stage of each tumor. Simple risk stratification shows that the prognosis of the high-risk group is worse. This simple stratification method may be helpful to predict the prognosis.
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Hussein M, Mueller L, Issa PP, Haidari M, Trinh L, Toraih E, Kandil E. Latency Trend Analysis as a Guide to Screening Malignancy Survivors for Second Primary Thyroid Cancer. Biomedicines 2022; 10:biomedicines10081984. [PMID: 36009531 PMCID: PMC9406053 DOI: 10.3390/biomedicines10081984] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/10/2022] [Accepted: 08/11/2022] [Indexed: 11/29/2022] Open
Abstract
Primary cancer survivors have a higher risk of developing second primary thyroid cancer (SPTC). Patients with SPTC who survived primary malignancies, diagnosed from 1975 to 2016, were identified from the Surveillance, Epidemiology, and End Results (SEER) database (SEER 18 Registry). A total of 33,551 cancer cases were enrolled in the final analysis. Individuals with a primary malignancy were at a significant 90% increased risk of developing SPTC (SIR = 1.90, 95%CI = 1.86−1.93, p < 0.05) compared to the general population. More than half (54.7%) of SPTC diagnoses were made in the first three years after primary cancer diagnosis, and the most aggressive presentations of SPTC occurred within the first year following malignancy. A latency trend analysis identified persistent high risk for development of SPTC after diagnosis of lymphoma, leukemia, soft tissue tumors, kidney, breast, and uterine cancer; elevated 10-year risk for most cancers such as salivary gland, melanoma, stomach, lung, colon, ovarian, pancreas, prostate, and bladder; and high 5-year risk after cancers such as larynx, oral, orbit, bone, small intestine, and liver. Our latency period model identifying risk according to each type of primary cancer may aid clinicians in identifying at-risk patients to be screened for thyroid cancer and guide them in developing a surveillance plan according to the latency period attributed to a patient’s primary cancer.
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Affiliation(s)
- Mohammad Hussein
- Department of Surgery, School of Medicine, Tulane University, New Orleans, LA 70112, USA
| | - Lauren Mueller
- School of Medicine, Tulane University, New Orleans, LA 70112, USA
| | - Peter P. Issa
- School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA
| | - Muhib Haidari
- School of Medicine, Tulane University, New Orleans, LA 70112, USA
| | - Lily Trinh
- School of Medicine, Tulane University, New Orleans, LA 70112, USA
- Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA 02114, USA
| | - Eman Toraih
- Department of Surgery, School of Medicine, Tulane University, New Orleans, LA 70112, USA
- Genetics Unit, Department of Histology and Cell Biology, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt
- Correspondence: ; Tel.: +1-504-988-2301; Fax: +1-504-988-4762
| | - Emad Kandil
- Department of Surgery, School of Medicine, Tulane University, New Orleans, LA 70112, USA
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11
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Borges Duarte D, Benido Silva V, Assunção G, Couto Carvalho A, Freitas C. Non-thyroidal second primary malignancy in papillary thyroid cancer patients. Eur Thyroid J 2022; 11:e220018. [PMID: 35900869 PMCID: PMC9346322 DOI: 10.1530/etj-22-0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 06/23/2022] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION The occurrence of non-thyroidal second primary malignancy (NTSPM) in patients with papillary thyroid cancer (PTC) is well documented, but epidemiological data are conflicting. OBJECTIVE The aim of this study was to evaluate the incidence of NTSPM in a large series of patients with PTC and to assess its potential risk factors. METHODS Single-center cohort study with retrospective data collection conducted on consecutive PTC patients diagnosed from 1988 to 2018 with a minimum follow-up time of 2 years. NTSPM was defined as any primary malignancy with histological confirmation occurring in an anatomical site other than the thyroid. According to the timing of occurrence, NTSPM were subdivided into anachronous, synchronous or metachronous (diagnosed >6 months before, within 6 months and >6 months after PTC diagnosis, respectively). RESULTS We included 773 individuals (83.3% females), median age at PTC diagnosis was 47.0 (IQR: 37.0-58.0) years and median follow-up time was 9.9 (6.2-16.3) years. Incidence of NTSPM was 15.5% (n = 120) and its standard incidence ratio (SIR) was higher when compared to the general population (SIR: 2.70). Family history of malignancy and younger age at diagnosis were associated respectively with 206 and 4% increased risk of developing metachronous neoplasia (HR: 2.06 (95% CI: 1.10-3.86) and 1.04 (95% CI: 1.02-1.05), respectively). CONCLUSION In our series, the occurrence of NTSPM was not uncommon and its incidence was higher compared to the general population. First-degree family history of malignancy was a strong risk factor for multiple primary malignancies.
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Affiliation(s)
- Diana Borges Duarte
- Division of Endocrinology, Centro Hospitalar e Universitário do Porto, Porto, Portugal
- Correspondence should be addressed to D Borges Duarte:
| | - Vânia Benido Silva
- Division of Endocrinology, Centro Hospitalar e Universitário do Porto, Porto, Portugal
| | - Guilherme Assunção
- Division of Endocrinology, Centro Hospitalar e Universitário do Porto, Porto, Portugal
| | - André Couto Carvalho
- Division of Endocrinology, Centro Hospitalar e Universitário do Porto, Porto, Portugal
| | - Cláudia Freitas
- Division of Endocrinology, Centro Hospitalar e Universitário do Porto, Porto, Portugal
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12
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Zhao X, Yang G, Zhang W, Dong Q, Yang Q. Age-related risk for second breast cancer and gynecological malignant neoplasms after differentiated thyroid cancer. Endocrine 2022; 76:385-394. [PMID: 35122212 DOI: 10.1007/s12020-022-02999-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 01/22/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE In this study, we aimed to investigate the age-related risk of second breast cancer (SBC) and second gynecological malignant neoplasms (SGMNs) in female differentiated thyroid cancer (DTC) survivors by utilizing the Surveillance, Epidemiology, and End Results (SEER) database. METHODS A total number of 55,622 female DTC patients were identified between 1975 and 2016, including 2168 patients who developed SBC and SGMNs. The Fine and Gray model was used to calculate the cumulative incidence and sub-distribution hazards ratios (SHR). Poisson regression analysis was employed to calculate the relative risk (RR) and standardized incidence ratio (SIR). Kaplan-Meier survival and log-rank test analyses were also performed. RESULTS The overall 40-year cumulative incidence of SBC and SGMNs was 18.9%. Their incidence in the adolescent and young adults (AYA) group increased slowly in the first 30 years, but then was rapidly elevated in the last decade. It increased gradually in the middle-aged adults group and in the first 25 years in the older adults group, but it scarcely increased thereafter. Both the middle-aged adults (adjusted SHR, 2.09; RR, 1.76) and the older adults (adjusted SHR, 1.32; RR, 1.58) groups had higher risks of developing combined SBC and SGMNs than the AYA group. The risks increased mainly in the early latency period. The three groups also had higher SIRs than the US general population. Besides, the best survival after SBC and SGMNs was observed in the AYA group. CONCLUSIONS Age was an independent risk factor for SBC and SGMNs incidences among female DTC survivors.
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Affiliation(s)
- Xianlan Zhao
- People's Hospital of Honghuagang District, Zunyi, China
| | - Guangrong Yang
- Department of Oncology, Qijiang Hospital of the First Affiliated Hospital of Chongqing Medical University, Qijiang, China
| | - Weina Zhang
- Department of Critical Care Medicine, The 941st Hospital of the PLA Joint Logistic Support Force, Xining, China
| | - Qiang Dong
- Department of General Medicine, Qijiang Hospital of the First Affiliated Hospital of Chongqing Medical University, Qijiang, China
| | - Qiao Yang
- Department of Ultrasound, The 941st Hospital of the PLA Joint Logistic Support Force, Xining, China.
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13
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Kim M, Kim H, Park S, Joo J, Kim IJ, Kim BH. Risk factors for second primary malignancies following thyroid cancer: a nationwide cohort study. Eur J Endocrinol 2022; 186:561-571. [PMID: 35286279 DOI: 10.1530/eje-21-1208] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 03/14/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Thyroid cancer survivors have a high risk of second primary malignancies (SPMs). We aimed to evaluate the site-specific incidence, prognosis, and risk factors for metachronous SPMs following thyroid cancer. DESIGN A nationwide cohort study. METHODS This study included data from the Korea National Health Insurance Service (between 2002 and 2018). Exposure to diagnostic radiation was defined by the number of computed tomography (CT) and positron emission tomography-CT scans after the index date. A cumulative radioactive iodine (RAI) dose >100 mCi was considered high-dose RAI. RESULTS During the median 6 years of follow-up, among 291 640 patients, 13 083 (4.5%) developed SPMs. Thyroid cancer survivors had a 26% increased risk of SPMs compared with the general population (standardized incidence ratio: 1.26; 95% CI: 1.22-1.29). Furthermore, those with SPMs had a significantly poorer survival rate than those without SPMs (hazard ratio: 11.85; 95% CI: 11.21-12.54; P < 0.001). Significantly elevated risks were observed in myeloid leukemia and 13 solid cancer sites: lip, salivary gland, small intestine, larynx, lung, mediastinum and pleura, mesothelium, breast, corpus uteri, ovary, prostate, kidney, and bladder. Frequent diagnostic medical radiation exposure and high-dose RAI therapy were independent risk factors for several SPMs, including the cancer of salivary gland, lung, mediastinum and pleura, breast, kidney, and bladder, as well as myeloid leukemia. CONCLUSIONS Frequent diagnostic radiation exposure and high-dose RAI therapy are independent risk factors for SPM following thyroid cancer. Clinicians need to consider minimizing unnecessary diagnostic radiation exposure and administering a high dose RAI only when justified in patients with thyroid cancer.
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Affiliation(s)
- Mijin Kim
- Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Hyereen Kim
- Hyereen Kim's Internal Medicine Clinic, Yangsan, Korea
| | - Sojeong Park
- Data Science Team, Hanmi Pharmaceuticals Co., Ltd., Seoul, Korea
| | - Jaeeun Joo
- Data Science Team, Hanmi Pharmaceuticals Co., Ltd., Seoul, Korea
| | - In Ju Kim
- Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Bo Hyun Kim
- Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
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14
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Iodine-131 S values for use in organ dose estimation of Korean patients in radioiodine therapy. NUCLEAR ENGINEERING AND TECHNOLOGY 2022. [DOI: 10.1016/j.net.2021.08.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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15
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Eilsberger F, Reinecke M, Luster M. Genetic damage associated to 131I therapy and secondary cancer risk. Nucl Med Mol Imaging 2022. [DOI: 10.1016/b978-0-12-822960-6.00122-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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16
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Capezzone M, Sagnella A, Cantara S, Fralassi N, Maino F, Forleo R, Brilli L, Pilli T, Cartocci A, Castagna MG. Risk of Second Malignant Neoplasm in Familial Non-Medullary Thyroid Cancer Patients. Front Endocrinol (Lausanne) 2022; 13:845954. [PMID: 35311228 PMCID: PMC8931333 DOI: 10.3389/fendo.2022.845954] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 02/08/2022] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Survival rates in patients with non-medullary thyroid carcinoma (NMTC) are high, increasing the possibility to develop a second malignant neoplasm (SMN). Many studies investigated the relationship between increased risk of SMN in NMTC patients treated with radioiodine, but few data are available about the impact of family history (FH) of thyroid cancer on SMN risk. PURPOSE To assess the risk of SMN in a large cohort of sporadic and familial NMTC using the standardized incidence ratio (SIR). PATIENTS AND METHODS We studied 918 NMTC patients (73.9% female patients) followed for a median follow-up of 9 years. In 798/918 (86.9%) patients, NMTC was sporadic, while the remaining 120 (13.1%) were familial NMTC (FNMTC). RESULTS We identified 119/918 (13%) patients with SMN in association with NMTC. NMTCs had an increased risk of SMN when compared to the general population (SIR 2.1, 95% CI 1.7-2.5). The rate of SMN for all sites was significantly higher in familial compared to sporadic NMTC (20% versus 11.9%, p = 0.01), primarily driven by families with more than two affected members. The risk of SMN was remarkably higher for breast cancer, especially in familial cases (SIR 22.03, 95% CI 14.4-41.2) compared to sporadic cases (SIR:17, 95% CI 11.9-24.6). CONCLUSIONS NMTC patients have a higher risk of SMN compared to the general population and this risk is much higher in patients with FNMTC. This observation raises the hypothesis that genetic risk factors for a first cancer may predispose to SMN, especially among individuals with familial clustering of the same or other tumors.
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Affiliation(s)
- Marco Capezzone
- Unit of Endocrinology, Misericordia Hospital, Grosseto, Italy
| | - Alfonso Sagnella
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Silvia Cantara
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Noemi Fralassi
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Fabio Maino
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Raffaella Forleo
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Lucia Brilli
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Tania Pilli
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | | | - Maria Grazia Castagna
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
- *Correspondence: Maria Grazia Castagna,
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17
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Liu CY, Huang CS, Huang CC, Ku WC, Shih HY, Huang CJ. Co-Occurrence of Differentiated Thyroid Cancer and Second Primary Malignancy: Correlation with Expression Profiles of Mismatch Repair Protein and Cell Cycle Regulators. Cancers (Basel) 2021; 13:cancers13215486. [PMID: 34771648 PMCID: PMC8582561 DOI: 10.3390/cancers13215486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/26/2021] [Accepted: 10/29/2021] [Indexed: 12/21/2022] Open
Abstract
Simple Summary Although the incidence of thyroid cancer is increasing, improvements in treatment have resulted in more patients being confirmed to have a second primary cancer. However, studies on potential biomarkers for predicting the risk of second primary malignancy are extremely limited. Therefore, our objective was to establish molecular biomarkers for the risk prediction of second primary malignancy using routinely collected formalin-fixed paraffin-embedded tissue specimens. Our results suggest that the deficient mismatch repair phenotype, the expression of pRb, and the lack of CDK4 or CDK6 are significantly associated with co-occurrence of nonthyroid malignancy. The predictive value of these immunohistochemical profiles for the co-occurrence of nonthyroid malignancy was also assessed. The combined evaluation of a four-biomarker signature model may provide the most important predictive innovation. Our study proposes the first tissue-based screening tool for risk stratification and further active surveillance in patients with thyroid cancer. Abstract Some patients with thyroid cancer develop a second primary cancer. Defining the characteristics of patients with double primary cancers (DPCs) is crucial and needs to be followed. In this study, we examine molecular profiles in DPC. We enrolled 71 patients who received thyroid cancer surgery, 26 with single thyroid cancer (STC), and 45 with DPC. A retrograde cohort was used to develop immunohistochemical expressions of mismatch repair (MMR) proteins and cell-cycle-related markers from tissue microarrays to produce an equation for predicting the occurrence of DPC. The multivariate logistic model of 67 randomly selected patients (24 with STC and 43 with DPC) identified that the expression of deficient MMR (dMMR) (odds ratio (OR), 10.34; 95% confidence interval (CI), 2.17–49.21) and pRb (OR, 62.71; 95% CI, 4.83–814.22) were significantly associated with a higher risk of DPC. In contrast, the expression of CDK4 (OR, 0.19; 95% CI, 0.04–0.99) and CDK6 (OR, 0.03; 95% CI, 0.002–0.44) was significantly associated with a lower risk of DPC. Collectively, dMMR, pRb, CDK4, and CDK6 have a sensitivity of 88.9% (95% CI, 75.1–95.8) and a specificity of 69.2% (95% CI, 48.1–84.9) for occurrence of DPC in all 71 patients. This is the first report to demonstrate the molecular differentiation of STC and DPC. Overall, the integral molecular profile performed excellent discrimination and denoted an exponential function to predict the probability of DPC.
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Affiliation(s)
- Chih-Yi Liu
- Division of Pathology, Sijhih Cathay General Hospital, New Taipei City 221, Taiwan;
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 242, Taiwan;
| | - Ching-Shui Huang
- Division of General Surgery, Department of Surgery, Cathay General Hospital, Taipei 106, Taiwan; (C.-S.H.); (H.-Y.S.)
- School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
| | - Chi-Cheng Huang
- Comprehensive Breast Health Center, Department of Surgery, Taipei Veterans General Hospital, Taipei 1121, Taiwan;
- School of Public Health, College of Public Health, National Taiwan University, Taipei 100, Taiwan
| | - Wei-Chi Ku
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 242, Taiwan;
| | - Hsing-Yu Shih
- Division of General Surgery, Department of Surgery, Cathay General Hospital, Taipei 106, Taiwan; (C.-S.H.); (H.-Y.S.)
| | - Chi-Jung Huang
- Department of Medical Research, Cathay General Hospital, Taipei 106, Taiwan
- Department of Biochemistry, National Defense Medical Center, Taipei 114, Taiwan
- Correspondence:
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18
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Crocetti E, Mattioli V, Buzzoni C, Franceschi S, Serraino D, Vaccarella S, Ferretti S, Busco S, Fedeli U, Varvarà M, Falcini F, Zorzi M, Carrozzi G, Mazzucco W, Gasparotti C, Iacovacci S, Toffolutti F, Cavallo R, Stracci F, Russo AG, Caldarella A, Rosso S, Musolino A, Mangone L, Casella C, Fusco M, Tagliabue G, Piras D, Tumino R, Guarda L, Dinaro YM, Piffer S, Pinna P, Mazzoleni G, Fanetti AC, Dal Maso L. Risk of thyroid as a first or second primary cancer. A population-based study in Italy, 1998-2012. Cancer Med 2021; 10:6855-6867. [PMID: 34533289 PMCID: PMC8495271 DOI: 10.1002/cam4.4193] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/14/2021] [Accepted: 07/14/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The number of patients living after a cancer diagnosis is increasing, especially after thyroid cancer (TC). This study aims at evaluating both the risk of a second primary cancer (SPC) in TC patients and the risk of TC as a SPC. METHODS We analyzed two population-based cohorts of individuals with TC or other neoplasms diagnosed between 1998 and 2012, in 28 Italian areas covered by population-based cancer registries. Standardized incidence ratios (SIRs) of SPC were stratified by sex, age, and time since first cancer. RESULTS A total of 38,535 TC patients and 1,329,624 patients with other primary cancers were included. The overall SIR was 1.16 (95% CI: 1.12-1.21) for SPC in TC patients, though no increase was shown for people with follicular (1.06) and medullary (0.95) TC. SPC with significantly increased SIRs was bone/soft tissue (2.0), breast (1.2), prostate (1.4), kidney (2.2), and hemolymphopoietic (1.4) cancers. The overall SIR for TC as a SPC was 1.49 (95% CI: 1.42-1.55), similar for all TC subtypes, and it was significantly increased for people diagnosed with head and neck (2.1), colon-rectum (1.4), lung (1.8), melanoma (2.0), bone/soft tissue (2.8), breast (1.3), corpus uteri (1.4), prostate (1.5), kidney (3.2), central nervous system (2.3), and hemolymphopoietic (1.8) cancers. CONCLUSIONS The increased risk of TC after many other neoplasms and of few SPC after TC questions the best way to follow-up cancer patients, avoiding overdiagnosis and overtreatment for TC and, possibly, for other malignancies.
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Affiliation(s)
- Emanuele Crocetti
- Cancer Epidemiology UnitCentro di Riferimento Oncologico di Aviano (CRO) IRCCSAvianoItaly
| | - Veronica Mattioli
- Cancer Epidemiology UnitCentro di Riferimento Oncologico di Aviano (CRO) IRCCSAvianoItaly
| | - Carlotta Buzzoni
- Global Patient Outcomes and Real World Evidence (GPORWE) International Eli Lilly Italy S.p.ASesto FiorentinoFlorenceItaly
- AIRTUM Database (in charge until January 2019)FlorenceItaly
| | - Silvia Franceschi
- Cancer Epidemiology UnitCentro di Riferimento Oncologico di Aviano (CRO) IRCCSAvianoItaly
| | - Diego Serraino
- Cancer Epidemiology UnitCentro di Riferimento Oncologico di Aviano (CRO) IRCCSAvianoItaly
| | - Salvatore Vaccarella
- Section of Cancer SurveillanceInternational Agency for Research on CancerLyonFrance
| | - Stefano Ferretti
- Romagna Cancer RegistrySection of FerraraLocal Health UnitUniversity of FerraraFerraraItaly
| | - Susanna Busco
- Cancer Registry of Latina ProvinceASL LatinaLatinaItaly
| | - Ugo Fedeli
- Epidemiological DepartmentAzienda ZeroPaduaItaly
| | - Massimo Varvarà
- Registro Tumori Integrato Catania‐Messina‐Siracusa‐EnnaUniversità degli Studi di CataniaCataniaItaly
| | - Fabio Falcini
- Romagna Cancer RegistryIstituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST)IRCCSMeldolaItaly
| | | | - Giuliano Carrozzi
- Modena Cancer RegistryPublic Health DepartmentAUSL ModenaModenaItaly
| | - Walter Mazzucco
- Palermo and Province Cancer RegistryClinical Epidemiology Unit with Cancer RegistryAzienda Ospedaliera Universitaria Policlinico “Paolo Giaccone”University of PalermoPalermoItaly
| | - Cinzia Gasparotti
- Brescia Cancer RegistryEpidemiology UnitBrescia Health Protection AgencyBresciaItaly
| | | | - Federica Toffolutti
- Cancer Epidemiology UnitCentro di Riferimento Oncologico di Aviano (CRO) IRCCSAvianoItaly
| | | | - Fabrizio Stracci
- Public Health SectionDepartment of Medicine and SurgeryUniversity of PerugiaPerugiaItaly
| | - Antonio G. Russo
- Cancer Registry of MilanEpidemiology UnitAgency for Health ProtectionMilanItaly
| | - Adele Caldarella
- Tuscany Cancer RegistryClinical Epidemiology UnitInstitute for Cancer Research, Prevention and Clinical Network (ISPRO)FlorenceItaly
| | - Stefano Rosso
- Piedmont Cancer RegistryAzienda Ospedaliera‐Universitaria Città della Salute e della Scienza di TorinoItaly
| | - Antonino Musolino
- Parma Cancer RegistryOncology UnitAzienda Ospedaliera Universitaria di ParmaParmaItaly
| | - Lucia Mangone
- Reggio Emilia Cancer RegistryEpidemiology UnitAUSL ASMN‐IRCCSAzienda USL di Reggio EmiliaReggio EmiliaItaly
| | - Claudia Casella
- Liguria Cancer RegistryClinical EpidemiologyIRCCS Ospedale Policlinico San MartinoGenovaItaly
| | - Mario Fusco
- Cancer Registry of ASL Napoli 3 SudNapoliItaly
| | - Giovanna Tagliabue
- Lombardy Cancer RegistryCancer Registry UnitDepartment of ResearchFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
| | - Daniela Piras
- North Sardinia Cancer RegistryAzienda Regionale per la Tutela della SaluteSassariItaly
| | - Rosario Tumino
- Cancer Registry and Histopathology DepartmentProvincial Health Authority (ASP 7)RagusaItaly
| | - Linda Guarda
- Mantova Cancer RegistryEpidemilogy UnitAgenzia di Tutela della Salute (ATS) della Val PadanaMantovaItaly
| | | | - Silvano Piffer
- Trento Province Cancer RegistryUnit of Clinical EpidemiologyTrentoItaly
| | - Pasquala Pinna
- Nuoro Cancer RegistryRT NuoroASSL Nuoro/ATS SardegnaNuoroItaly
| | | | | | - Luigino Dal Maso
- Cancer Epidemiology UnitCentro di Riferimento Oncologico di Aviano (CRO) IRCCSAvianoItaly
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Zhao H, Guo H, Zhao L, Cao J, Sun Y, Wang C, Zhang Z. Subclassification of the Bethesda Category III (AUS/FLUS): A study of thyroid FNA cytology based on ThinPrep slides from the National Cancer Center in China. Cancer Cytopathol 2021; 129:642-648. [PMID: 34139103 DOI: 10.1002/cncy.22417] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 01/20/2021] [Accepted: 02/01/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND The atypia of an undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) category in the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) is a heterogeneous category, which includes various cell patterns. The subclassification of AUS/FLUS was suggested in the 2017 TBSRTC. However, the risk of malignancy (ROM) associated with different subgroups remains unresolved. Herein, AUS/FLUS aspirates were subclassified, from which the ROM of each subgroup was determined. METHODS All cases undergoing fine-needle aspiration (FNA) from July 2013 to December 2018 were reviewed. Of 12,913 thyroid FNAs, 1053 (8.2%) were AUS/FLUS. The slides of 222 patients with AUS/FLUS with surgical follow-up were reviewed and subclassified according to the recommendations of the 2017 TBSRTC. There were 195 aspirates consistently diagnosed as AUS/FLUS and subclassified as cytologic atypia 1 (AUS-C1); cytologic atypia 2 (AUS-C2); architectural atypia (AUS-A); cytologic and architectural atypia (AUS-C&A); Hürthle cell aspirates (AUS-H); atypia, not otherwise specified (AUS-NOS); and atypical lymphoid cells, rule out lymphoma (AUS-L). RESULTS Malignancy was identified in 83.3% (185 of 222) of the AUS/FLUS nodules. The AUS-C1 group was the most common (62.1%), followed by the AUS-C&A (12.8%), AUS-C2 (10.8%), AUS-H (6.7%), AUS-NOS (5.6%), AUS-L (1.5%), and AUS-A (0.5%) groups. AUS-C1 had the highest ROM (92.6%) among the groups and varied significantly from that of the AUS-C&A (P = .171), AUS-C2 (P = .001), AUS-H (P = .001), and AUS-NOS (P < .001) groups. CONCLUSIONS As a heterogeneous category of TBSRTC, the ROM for AUS/FLUS varies greatly among medical centers. Subclassification of AUS/FLUS might be helpful in identifying nodules with a high ROM in this category and improving the management of such nodules.
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Affiliation(s)
- Huan Zhao
- Department of Pathology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - HuiQin Guo
- Department of Pathology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - LinLin Zhao
- Department of Pathology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jian Cao
- Department of Pathology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yue Sun
- Department of Pathology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Cong Wang
- Department of Pathology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - ZhiHui Zhang
- Department of Pathology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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20
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Comparison of Four Ultrasonography-Based Risk Stratification Systems in Thyroid Nodules with Nondiagnostic/Unsatisfactory Cytology: A Real-World Study. Cancers (Basel) 2021; 13:cancers13081948. [PMID: 33919595 PMCID: PMC8073392 DOI: 10.3390/cancers13081948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 04/10/2021] [Accepted: 04/13/2021] [Indexed: 12/02/2022] Open
Abstract
Simple Summary Although ultrasound-based risk stratification systems (RSSs) including Thyroid Imaging, Reporting and Data Systems (TIRADSs) may play an important role in triaging nodules with nondiagnostic/unsatisfactory cytology, no previous studies have compared ultrasound-based RSSs for these nodules. In this retrospective, longitudinal, real-world study in Korea including 1143 thyroid aspirations with nondiagnostic/unsatisfactory results from 1125 patients, further diagnostic evaluations, including repeat fine-needle aspiration, were conducted more commonly as the categories of ultrasound-based RSSs increased. The American Thyroid Association (ATA) guidelines, Korean (K)-TIRADS, and American College of Radiology (ACR) TIRADS were more competent in predicting malignancy from nondiagnostic/unsatisfactory nodules. The EU-TIRADS, although it was also helpful, demonstrated less effective diagnostic performance in predicting malignancy for nondiagnostic/unsatisfactory nodules in Korea, where iodine intake is more than adequate. These findings have implications for developing and verifying universal guidelines for the ultrasound-based stratification of thyroid nodules and applying these guidelines to nondiagnostic/unsatisfactory nodules. Abstract We compared American Thyroid Association (ATA) guidelines, Korean (K)-Thyroid Imaging, Reporting and Data Systems (TIRADS), EU-TIRADS, and American College of Radiology (ACR) TIRADS in diagnosing malignancy for thyroid nodules with nondiagnostic/unsatisfactory cytology. Among 1143 nondiagnostic/unsatisfactory aspirations from April 2011 to March 2016, malignancy was detected in 39 of 89 excised nodules. The minimum malignancy rate was 7.82% in EU-TIRADS 5 and 1.87–3.00% in EU-TIRADS 3–4. In the other systems, the minimum malignancy rate was 14.29–16.19% in category 5 and ≤3% in the remaining categories. Although the EU-TIRADS category ≥ 5 exhibited the highest positive likelihood ratio (LR) of only 2.214, category ≥ 5 in the other systems yielded the highest positive LR of >5. Receiver operating characteristic (ROC) curves of all systems to predict malignancy were located statistically above the diagonal nondiscrimination line (P for ROC curve: EU-TIRADS, 0.0022; all others, 0.0001). The areas under the ROC curve (AUCs) were not significantly different among the four systems. The ATA guidelines, K-TIRADS, and ACR TIRADS may be useful to guide management for nondiagnostic/unsatisfactory nodules. The EU-TIRADS, although also useful, exhibited inferior performance in predicting malignancy for nondiagnostic/unsatisfactory nodules in Korea, an iodine-sufficient area.
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Ho J, Kim E, Han M, Jung I, Lee J, Jo YS. ASO Author Reflection: The Effect of Dyslipidemia on the Occurrence of Secondary Cancer in Patients With thyroid Cancer. Ann Surg Oncol 2021; 28:4385-4386. [PMID: 33751299 DOI: 10.1245/s10434-021-09636-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 01/13/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Joon Ho
- Department of Surgery, Open NBI Convergence Technology Research Laboratory, Yonsei University College of Medicine, Seoul, South Korea
| | - Eunhwa Kim
- Department of Biomedical Systems Informatics, Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, South Korea
| | - Minkyung Han
- Department of Biomedical Systems Informatics, Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, South Korea
| | - Inkyung Jung
- Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea.
| | - Jandee Lee
- Department of Surgery, Open NBI Convergence Technology Research Laboratory, Yonsei University College of Medicine, Seoul, South Korea.
| | - Young Suk Jo
- Department of Internal Medicine, Open NBI Convergence Technology Research Laboratory, Yonsei University College of Medicine, Seoul, South Korea.
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22
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Semrad TJ, Li Q, Goldfarb M, Semrad A, Campbell M, Farwell DG, Keegan THM. Influence of Socioeconomic Status on Incident Medical Conditions in Two-Year Survivors of Adolescent or Young Adult Differentiated Thyroid Cancer. J Adolesc Young Adult Oncol 2021; 10:521-533. [PMID: 33512275 DOI: 10.1089/jayao.2020.0142] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Purpose: We sought to enumerate secondary medical conditions from hospitalization records in adolescent and young adult (AYA) differentiated thyroid cancer (DTC) survivors and identify characteristics of patients with increased likelihood of subsequent medical diagnoses. Methods: Using data from the California Cancer Registry and statewide hospitalization data, we examined incident oncologic, endocrine, pulmonary, hematologic, and cardiovascular diagnoses in 12,312 AYA (aged 15-39) patients diagnosed with DTC in 1996-2012 and surviving >2 years after diagnosis with follow-up through 2014. We calculated the cumulative incidence of each condition accounting for the competing risk of death and used multivariable Cox proportional hazards regression to evaluate sociodemographic and clinical characteristics associated with each incident condition. Results: The 10-year cumulative incidences of multiple medical conditions were particularly high in blacks and Hispanics. Asian/Pacific Islander survivors were most likely to develop subsequent cancers. Men had higher rates of cardiovascular and diabetes diagnoses than women, but lower rates of asthma and cytopenias. Low socioeconomic status and/or public or no insurance were associated with a higher risk of several diagnoses. More extensive disease stage and thyroid surgery increased the risk of calcium and phosphorus metabolism disorders. Neck reoperation associated with the risk of cytopenias, as well as subsequent endocrine, cardiovascular, and respiratory diagnoses. Conclusions: The incidence of medical conditions after thyroid cancer diagnosis and treatment differ among racial/ethnic groups and sexes. Those residing in lower socioeconomic neighborhoods, those with public or no insurance, and those who require further neck surgery have substantially higher burdens of subsequent medical diagnoses.
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Affiliation(s)
- Thomas J Semrad
- Gene Upshaw Memorial Tahoe Forest Cancer Center, Truckee, California, USA.,Center for Oncology Hematology Outcomes Research and Training (COHORT), University of California Davis Comprehensive Cancer Center, Sacramento, California, USA
| | - Qian Li
- Center for Oncology Hematology Outcomes Research and Training (COHORT), University of California Davis Comprehensive Cancer Center, Sacramento, California, USA
| | - Melanie Goldfarb
- Center for Endocrine Tumors and Disorders, John Wayne Cancer Institute at Providence Saint John's Health Center, Santa Monica, California, USA
| | - Alison Semrad
- Division of Endocrinology, University of California Davis Medical Center, Sacramento, California, USA.,Division of Endocrinology, Tahoe Forest Hospital District, Truckee, California, USA
| | - Michael Campbell
- Section of Endocrine Surgery, University of California Davis Comprehensive Cancer Center, Sacramento, California, USA
| | - D Gregory Farwell
- Department of Otolaryngology, University of California Davis Medical Center, Sacramento, California, USA
| | - Theresa H M Keegan
- Center for Oncology Hematology Outcomes Research and Training (COHORT), University of California Davis Comprehensive Cancer Center, Sacramento, California, USA
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23
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Ho J, Kim E, Han M, Jung I, Lee J, Jo YS. Impact of Dyslipidemia on the Risk of Second Cancer in Thyroid Cancer Patients: A Korean National Cohort Study. Ann Surg Oncol 2021; 28:4373-4384. [PMID: 33483844 DOI: 10.1245/s10434-020-09570-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 12/26/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Studies have shown that radioactive iodine therapy (RAIT) affects the development of second cancer in thyroid cancer patients. The impact of other factors, such as dyslipidemia are not clear. METHODS A retrospective analysis of thyroid cancer patients with a 1,251,913 person-year follow-up was conducted using data from the Health Insurance Review and Assessment database in South Korea from January 2008 to December 2018. We investigated factors related to second cancer development using a nested case-control analysis to avoid length bias. RESULTS The overall risk of developing second cancer was higher in thyroid cancer patients than in the general population [standardized incidence ratio, 3.34; 95% confidence interval (CI) 3.30-3.39]. Second cancer incidence was higher in patients who received RAIT than in those who did not [odds ratio (OR) 1.130; 95% CI 1.094-1.169]. Moreover, the risk of second cancer was higher in patients with dyslipidemia than in those without dyslipidemia (OR 1.265; 95% CI 1.223-1.309). After adjustment for RAIT, the incidence of a second cancer was higher in patients with dyslipidemia than in those without dyslipidemia (OR 1.262; 95% CI 1.221-1.306). CONCLUSIONS The risk of second cancer development in patients with thyroid cancer appears to be high. Dyslipidemia may be associated with an increased risk of several types of second cancers.
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Affiliation(s)
- Joon Ho
- Department of Surgery, Open NBI Convergence Technology Research Laboratory, Yonsei University College of Medicine, Seoul, South Korea
| | - Eunhwa Kim
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea
| | - Minkyung Han
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea
| | - Inkyung Jung
- Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea.
| | - Jandee Lee
- Department of Surgery, Open NBI Convergence Technology Research Laboratory, Yonsei University College of Medicine, Seoul, South Korea.
| | - Young Suk Jo
- Department of Internal Medicine, Open NBI Convergence Technology Research Laboratory, Yonsei University College of Medicine, Seoul, South Korea.
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24
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Zhao X, Chen M, Qi X, Zhu H, Yang G, Guo Y, Dong Q, Yang Q. Association of Radioiodine for Differentiated Thyroid Cancer and Second Breast Cancer in Female Adolescent and Young Adult. Front Endocrinol (Lausanne) 2021; 12:805194. [PMID: 35154006 PMCID: PMC8832493 DOI: 10.3389/fendo.2021.805194] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 12/13/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Exposure to radiation is related to breast cancer occurrence. While whether the radioiodine (RAI) increases the risk of second breast cancer (SBC) in female differentiated thyroid cancer (DTC) patients is not well addressed. METHODS All patients were identified from Surveillance, Epidemiology, and End Results database. At least a 5-year latency was guaranteed since exposure to RAI. Fine and Gray model was used to calculate the cumulative incidence and hazards ratios (HR) and 95% confidence interval (CI). Standardized incidence ratio (SIR) was calculated by Poisson regression analysis. Propensity score matching was used for match analysis. Survival analyses were performed by the Kaplan-Meier method and the log-rank test. RESULTS A total of 406 out of 16,850 patients in the RAI group and 733 out of 22,135 patients in the no RAI group developed SBC. The cumulative incidences of SBC were higher in patients with RAI compared with patients without RAI in the adolescent and young adult (AYA) group and the middle-aged adult group. In the AYA group, patients with RAI had increased HR (1.65; 95% CI, 1.33-2.05, p < 0.001) compared with those without RAI, and the HR increased slightly with latency. In addition, the SIR (1.21; 95% CI, 1.02-1.44, p < 0.05) increased compared with the general population. Whereas, in the middle-aged adult group, only a slightly higher HR (1.18) was found. The survival after SBC was inferior to those with matched only primary breast cancer. CONCLUSIONS RAI treatment increased the risk of SBC in female AYA DTC patients. A long-term follow-up should be performed in this population.
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Affiliation(s)
- Xianlan Zhao
- People's Hospital of Honghuagang District, Zunyi, China
| | - Mingjing Chen
- Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaojing Qi
- Department of Ultrasound, The 941st Hospital of the People’s Liberation Army (PLA) Joint Logistic Support Force, Xining, China
| | - Haizhen Zhu
- Department of Oncology, Guizhou Provincial People’s Hospital, Guizhou Cancer Center, Guiyang, China
| | - Guangrong Yang
- Department of Oncology, Qijiang Hospital of the First Affiliated Hospital of Chongqing Medical University, Qijiang, China
| | - Yi Guo
- Department of Basic Knowledge, Guiyang Nursing Vocational College, Guiyang, China
| | - Qiang Dong
- Department of General Medicine, Qijiang Hospital of the First Affiliated Hospital of Chongqing Medical University, Qijiang, China
- *Correspondence: Qiao Yang, ; Qiang Dong,
| | - Qiao Yang
- Department of Ultrasound, The 941st Hospital of the People’s Liberation Army (PLA) Joint Logistic Support Force, Xining, China
- *Correspondence: Qiao Yang, ; Qiang Dong,
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25
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Wu ST, Chi SY, Wang PW, Chen YN, Yang YT, Chen WC, Chen JF, Chou CK. Analysis of overall survival in differentiated thyroid cancer patients with double primary malignancy. Kaohsiung J Med Sci 2020; 37:63-71. [PMID: 32841516 DOI: 10.1002/kjm2.12286] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 07/16/2020] [Indexed: 01/14/2023] Open
Abstract
Differentiated thyroid cancer (DTC) survivors are at increased risk of developing double primary malignancy (DPM). The aim of this study was to investigate clinicopathological characteristics and survival in DTC patients diagnosed with DPM. A total of 975 patients with DTC diagnosed between 2013 and 2017, treated, and followed at a medical center in Taiwan were retrospectively reviewed. Data from enrolled patients were analyzed for differences in prognosis dependent on the presence of DPM, and which clinicopathological variables affected their prognosis. Among 975 thyroid cancer patients, 94 (9.6%) were diagnosed with DPMs and 16 (1.6%) patients died of any cause. DPM patients had a greater proportion of males, had a higher mean age, more commonly presented with a thyroid mass incidentally by imaging and cervical lymph node metastases, showed a more advanced thyroid cancer stage, and had a higher proportion of lymph node metastases. Overall survival (OS) was significantly lower in patients diagnosed with DPM. Male gender (hazard ratio [HR] = 4.597), two or more DPMs (HR = 8.071), and shorter time interval between two cancers occurrences (HR = 7.101) were significantly risk factors for DPM-related death. In conclusion, the risk of developing DPM in DTC patients was elevated in older, male patients with an advanced tumor-node-metastasis stage. DPM adversely affected the OS of thyroid cancer patients. Male gender, two or more DPMs, and shorter time interval between occurrences were significant risk factors for OS in DPM patients.
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Affiliation(s)
- Shu-Ting Wu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Shun-Yu Chi
- Division of General Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Pei-Wen Wang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yung-Nien Chen
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yi-Ting Yang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Wen-Chieh Chen
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Jung-Fu Chen
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chen-Kai Chou
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
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26
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Singer MC, Marchal F, Angelos P, Bernet V, Boucai L, Buchholzer S, Burkey B, Eisele D, Erkul E, Faure F, Freitag SK, Gillespie MB, Harrell RM, Hartl D, Haymart M, Leffert J, Mandel S, Miller BS, Morris J, Pearce EN, Rahmati R, Ryan WR, Schaitkin B, Schlumberger M, Stack BC, Van Nostrand D, Wong KK, Randolph G. Salivary and lacrimal dysfunction after radioactive iodine for differentiated thyroid cancer: American Head and Neck Society Endocrine Surgery Section and Salivary Gland Section joint multidisciplinary clinical consensus statement of otolaryngology, ophthalmology, nuclear medicine and endocrinology. Head Neck 2020; 42:3446-3459. [PMID: 32812307 DOI: 10.1002/hed.26417] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 08/03/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Postoperative radioactive iodine (RAI) administration is widely utilized in patients with differentiated thyroid cancer. While beneficial in select patients, it is critical to recognize the potential negative sequelae of this treatment. The prevention, diagnosis, and management of the salivary and lacrimal complications of RAI exposure are addressed in this consensus statement. METHODS A multidisciplinary panel of experts was convened under the auspices of the American Head and Neck Society Endocrine Surgery and Salivary Gland Sections. Following a comprehensive literature review to assess the current best evidence, this group developed six relevant consensus recommendations. RESULTS Consensus recommendations on RAI were made in the areas of patient assessment, optimal utilization, complication prevention, and complication management. CONCLUSION Salivary and lacrimal complications secondary to RAI exposure are common and need to be weighed when considering its use. The recommendations included in this statement provide direction for approaches to minimize and manage these complications.
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Affiliation(s)
- Michael C Singer
- Department of Otolaryngology - Head and Neck Surgery, Henry Ford Health System, Detroit, Michigan, USA
| | - Francis Marchal
- Department of Otolaryngology - Head and Neck Surgery, Geneva University Hospital, Geneva, Switzerland
| | - Peter Angelos
- Department of Surgery, University of Chicago Medical Center, Chicago, Illinois, USA
| | - Vic Bernet
- Department of Endocrinology, Mayo Clinic Jacksonville, Jacksonville, Florida, USA
| | - Laura Boucai
- Department of Endocrinology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Samanta Buchholzer
- Maxillofacial Surgery and Oral Medicine and Pathology, Geneva University Hospital, Geneva, Switzerland
| | - Brian Burkey
- Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - David Eisele
- Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Evren Erkul
- Department of Otorhinolaryngology, Gulhane Medical School, University of Health Sciences, Istanbul, Turkey
| | - Frederic Faure
- Department of Otolaryngology - Head and Neck Surgery, Geneva University Hospital, Geneva, Switzerland
| | - Suzanne K Freitag
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
| | - Marion Boyd Gillespie
- Department of Otolaryngology, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Richard Mack Harrell
- Memorial Center for Integrative Endocrine Surgery, Memorial Healthcare System, Hollywood, Florida, USA
| | - Dana Hartl
- Department of Head and Neck Oncology, Institut de Cancerologie Gustave Roussy, Villejuif, France
| | - Megan Haymart
- Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Susan Mandel
- Department of Endocrinology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Barbra S Miller
- Division of Endocrine Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - John Morris
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, Minnesota, USA
| | - Elizabeth N Pearce
- Department of Medicine, Section of Endocrinology, Diabetes, Nutrition & Weight Management, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Rahmatullah Rahmati
- Division of Otolaryngology, Yale School of Medicine, New Haven, Connecticut, USA
| | - William R Ryan
- Department of Otolaryngology - Head and Neck Surgery, University of California, San Francisco, California, USA
| | - Barry Schaitkin
- Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Martin Schlumberger
- Department of Nuclear Medicine and Endocrine Oncology, Gustave Roussy and University Paris-Saclay, Villejuif, France
| | - Brendan C Stack
- Department of Otolaryngology-Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, Illinois, USA
| | - Doug Van Nostrand
- Division of Nuclear Medicine, MedStar Washington Hospital Center, Washington, District of Columbia, USA
| | - Ka Kit Wong
- Department of Radiology, Division of Nuclear Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Gregory Randolph
- Department of Otolaryngology - Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts, USA
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27
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Oh CM, Lee D, Kong HJ, Lee S, Won YJ, Jung KW, Cho H. Causes of death among cancer patients in the era of cancer survivorship in Korea: Attention to the suicide and cardiovascular mortality. Cancer Med 2020; 9:1741-1752. [PMID: 31960609 PMCID: PMC7050076 DOI: 10.1002/cam4.2813] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 12/15/2019] [Accepted: 12/16/2019] [Indexed: 12/15/2022] Open
Abstract
Background Improved cancer survival is expected to increase noncancer deaths; however, detailed causes of death have rarely been discussed. Changing landscapes in mortality patterns and noncancer mortality risks in patients with cancer require evaluation. Methods We identified cancer and noncancer‐related causes of death using data from the 2000‐2016 national cancer registry in Korea (n = 2 707 520), and we characterized the leading causes of death and proportionate mortalities over time. Risks of noncancer deaths relative to the general population were estimated using standardized mortality ratios (SMRs). Results Of 1 105 607 identified deaths, 87% were due to the primary cancer. Proportionate mortalities of primary cancer among overall deaths remained high in patients with liver (86%) and lung (70%) cancers and in female patients with breast cancer (77%), even 5 to 10 years following diagnosis, whereas proportionate mortalities reduced to ≤50% in patients with stomach (men, 39%; women, 48%), prostate (47%), and female thyroid (27%) cancers. Despite the predominance of index cancer deaths, the proportion of noncancer deaths among all deaths increased over time. There was a 20‐fold increase in cardiovascular disease deaths among patients with cancer from 2000 to 2016, and the risk of suicide among patients with cancer was higher than that among the general population (SMR: 1.68 [95% confidence interval (CI): 1.63‐1.74] in men, SMR: 1.42 [95% CI: 1.33‐1.55] in women). Conclusions Deaths from primary cancer remain a major concern; however, follow‐up is required for both cancer and noncancer‐related health issues in cancer survivors, especially concerning suicide and cardiovascular deaths.
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Affiliation(s)
- Chang-Mo Oh
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Dahhay Lee
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea.,Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| | - Hyun-Joo Kong
- Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| | - Seokmin Lee
- Vital Statistics Division, Statistics Korea, Daejeon, Republic of Korea
| | - Young-Joo Won
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea.,Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| | - Kyu-Won Jung
- Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| | - Hyunsoon Cho
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea.,Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
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Reiners C, Schneider R, Platonova T, Fridman M, Malzahn U, Mäder U, Vrachimis A, Bogdanova T, Krajewska J, Elisei R, Vaisman F, Mihailovic J, Costa G, Drozd V. Breast Cancer After Treatment of Differentiated Thyroid Cancer With Radioiodine in Young Females: What We Know and How to Investigate Open Questions. Review of the Literature and Results of a Multi-Registry Survey. Front Endocrinol (Lausanne) 2020; 11:381. [PMID: 32754115 PMCID: PMC7381297 DOI: 10.3389/fendo.2020.00381] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 05/14/2020] [Indexed: 01/18/2023] Open
Abstract
Published studies on the risk of radiation-induced second primary malignancy (SPM) after radioiodine treatment (RAI) of differentiated thyroid cancer (DTC) refer mainly to patients treated as middle-aged or older adults and are not easily generalizable to those treated at a younger age. Here we review available literature on the risk of breast cancer as an SPM after RAI of DTC with a focus on females undergoing such treatment in childhood, adolescence, or young adulthood. Additionally, we report the results of a preliminary international survey of patient registries from academic tertiary referral centers specializing in pediatric DTC. The survey sought to evaluate the availability of sufficient patient data for a potential international multicenter observational case-control study of females with DTC given RAI at an early age. Our literature review identified a bi-directional association of DTC and breast cancer. The general breast cancer risk in adult DTC survivors is low, ~2%, slightly higher in females than in males, but presumably lower, not higher, in those diagnosed as children or adolescents than in those diagnosed at older ages. RAI presumably does not substantially influence breast cancer risk after DTC. However, data from patients given RAI at young ages are sparse and insufficient to make definitive conclusions regarding age dependence of the risk of breast cancer as a SPM after RAI of DTC. The preliminary analysis of data from 10 thyroid cancer registries worldwide, including altogether 6,449 patients given RAI for DTC and 1,116 controls, i.e., patients not given RAI, did not show a significant increase of breast cancer incidence after RAI. However, the numbers of cases and controls were insufficient to draw statistically reliable conclusions, and the proportion of those receiving RAI at the earliest ages was too low.In conclusion, a potential international multicenter study of female patients undergoing RAI of DTC as children, adolescents, or young adults, with a sufficient sample size, is feasible. However, breast cancer screening of a larger cohort of DTC patients is not unproblematic for ethical reasons, due to the likely, at most slightly, increased risk of breast cancer post-RAI and the expected ~10% false-positivity rate which potentially produced substantial "misdiagnosis."
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Affiliation(s)
- Christoph Reiners
- University Hospital, Würzburg, Germany
- *Correspondence: Christoph Reiners
| | | | - Tamara Platonova
- The International Fund “Help for Patients With Radiation-Induced Thyroid Cancer ‘ARNICA”’, Minsk, Belarus
| | - Mikhail Fridman
- The International Fund “Help for Patients With Radiation-Induced Thyroid Cancer ‘ARNICA”’, Minsk, Belarus
| | | | - Uwe Mäder
- University Hospital, Würzburg, Germany
| | | | | | - Jolanta Krajewska
- M. Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | | | | | | | | | - Valentina Drozd
- The International Fund “Help for Patients With Radiation-Induced Thyroid Cancer ‘ARNICA”’, Minsk, Belarus
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29
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Schonfeld SJ, Morton LM, Berrington de González A, Curtis RE, Kitahara CM. Risk of second primary papillary thyroid cancer among adult cancer survivors in the United States, 2000-2015. Cancer Epidemiol 2019; 64:101664. [PMID: 31884334 DOI: 10.1016/j.canep.2019.101664] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 12/16/2019] [Accepted: 12/17/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND While radiotherapy is a major risk factor for thyroid cancer after childhood cancer, factors contributing to increased thyroid cancer risk after adulthood cancer remain unclear. METHODS We evaluated second primary papillary thyroid cancer (PTC) risk among 3,175,216 ≥ 1-year adult survivors of non-thyroid malignancies from US population-based cancer registries (2000-2015), using standardized incidence ratios (SIRs). Because heightened surveillance may increase detection of indolent thyroid tumors and earlier detection of advanced tumors, we examined SIRs by PTC stage and time since first cancer (latency). RESULTS SIRs for second primary PTC (N = 4333) were statistically-significantly 1.2-3.5-fold elevated overall and after 23/27 first cancer types evaluated, with generally similar risks for localized and regional/distant PTC. SIRs for regional/distant PTC (N = 1501) were highest after pancreatic (SIR = 3.7; 95% confidence interval [CI] = 1.9-6.5) and soft tissue (SIR = 4.2; 95%CI = 2.8-6.2) cancers, followed by melanoma, chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), diffuse large B-cell lymphoma, and larynx, kidney, and brain/central nervous system (SIRs = 2.0-2.9) cancers. SIRs typically decreased with increasing latency but remained statistically-significantly elevated for regional/distant-PTC ≥5 years after diagnosis of cancers of the rectum, pancreas, lung/bronchus, soft tissue, female breast, uterine corpus, prostate, and kidney, and after melanoma, Hodgkin lymphoma, CLL/SLL, and follicular lymphoma. Neither total nor regional/distant PTC were clearly associated with initial course of radiotherapy or chemotherapy. CONCLUSIONS PTC risk was elevated after a range of first primary adult cancers but was not clearly related to treatment. Although surveillance may contribute to elevated short-term risks of PTC, longer-term elevations in regional/distant PTC may be attributable to shared risk factors.
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Affiliation(s)
- Sara J Schonfeld
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Institutes of Health, National Cancer Institute, 9609 Medical Center Drive, MSC 9778 Bethesda, MD, 20892-9778, United States.
| | - Lindsay M Morton
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Institutes of Health, National Cancer Institute, 9609 Medical Center Drive, MSC 9778 Bethesda, MD, 20892-9778, United States
| | - Amy Berrington de González
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Institutes of Health, National Cancer Institute, 9609 Medical Center Drive, MSC 9778 Bethesda, MD, 20892-9778, United States
| | - Rochelle E Curtis
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Institutes of Health, National Cancer Institute, 9609 Medical Center Drive, MSC 9778 Bethesda, MD, 20892-9778, United States
| | - Cari M Kitahara
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Institutes of Health, National Cancer Institute, 9609 Medical Center Drive, MSC 9778 Bethesda, MD, 20892-9778, United States
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Chao C, Bhatia S, Xu L, Cannavale KL, Wong FL, Huang PYS, Cooper R, Armenian SH. Incidence, Risk Factors, and Mortality Associated With Second Malignant Neoplasms Among Survivors of Adolescent and Young Adult Cancer. JAMA Netw Open 2019; 2:e195536. [PMID: 31173129 PMCID: PMC6563559 DOI: 10.1001/jamanetworkopen.2019.5536] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
IMPORTANCE Detailed data describing the epidemiology of second malignant neoplasms (SMN) are needed for survivors of adolescent and young adult (AYA) cancer to inform the development of age-appropriate survivorship care guidelines. OBJECTIVE To describe the incidence, risk factors, and mortality for SMN in survivors of AYA cancer. DESIGN, SETTING, AND PARTICIPANTS This retrospective matched cohort study included 10 574 two-year survivors diagnosed with cancer between January 1, 1990, and December 31, 2012, at age 15 to 39 years in an integrated health care delivery system in Southern California. A comparison cohort without a history of cancer was individually matched 13:1 to survivors of AYA cancer by age, sex, and calendar year. Data analysis was completed in July 2018. EXPOSURES Secondary malignant neoplasm risk factors of interest included age, stage, and calendar year at first cancer diagnosis; sex; race/ethnicity; radiation therapy; and chemotherapy. MAIN OUTCOMES AND MEASURES Diagnoses of SMN were ascertained using cancer registries from the National Cancer Institute Surveillance, Epidemiology, and End Results Program through December 31, 2014. Poisson regression was used to evaluate the association between cancer survivor status and developing SMN and risk factors for SMN, while risk of all-cause mortality by SMN status was examined in Cox regression. RESULTS A total of 10 574 survivors of AYA cancer (6853 [64.8%] female; median [range] age, 33 [15-39] years; 622 with SMN) and 136 683 participants in the comparison cohort (88 513 [64.8%] female; median [range] age, 33 [15-39] years; 3437 with first cancer) were included. In survivors of AYA cancer, 20-year cumulative incidence of SMN was 12.5%. The incidence rate ratio (IRR) of developing SMN in survivors of AYA cancer was 2.6 (95% CI, 2.4-2.9) compared with the comparison cohort. Survivors of breast cancer, melanoma, and testicular cancer had substantially elevated risk for SMN of the same organ (IRR, 5.6 [95% CI, 4.6-6.8], 11.2 [95% CI, 7.3-17.2], and 16.2 [95% CI, 6.8-38.4], respectively). Among survivors of AYA cancer, older age (IRR for age 30-39 years, 1.79 [95% CI, 1.21-2.65]), female sex (IRR, 1.31 [95% CI, 1.09-1.57]), white race/ethnicity (IRR for Asian race, 0.61 [95% CI, 0.43-0.87]), advanced stage at first cancer diagnosis (IRR for stage II, 1.29 [95% CI, 1.11-1.65]), and use of radiotherapy (IRR, 1.50 [95% CI, 1.26-1.79]) were associated with increased risk of SMN. Survivors of AYA cancer who developed SMN had an all-cause mortality rate 7.2 (95% CI, 6.1-8.5) times greater than survivors without SMN. CONCLUSIONS AND RELEVANCE This study suggests that SMN risk is elevated in survivors of AYA cancer and varies across survivor subgroups. Survival following SMN may be significantly compromised. These data may form the basis for identifying individuals at high risk, as well as informing screening for SMN.
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Affiliation(s)
- Chun Chao
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena
| | - Smita Bhatia
- Institute for Cancer Outcomes and Survivorship, School of Medicine, University of Alabama at Birmingham
| | - Lanfang Xu
- MedHealth Statistical Consulting Inc, Solon, Ohio
| | - Kimberly L. Cannavale
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena
| | - F. Lennie Wong
- Department of Population Sciences, City of Hope, Duarte, California
| | - Po-Yin Samuel Huang
- Department of Family Medicine, Los Angeles Medical Center, Kaiser Permanente Southern California, Los Angeles
| | - Robert Cooper
- Department of Pediatric Oncology, Los Angeles Medical Center, Kaiser Permanente Southern California, Los Angeles
| | - Saro H. Armenian
- Department of Population Sciences, City of Hope, Duarte, California
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Min SK, Choi SW, Lim J, Park JY, Jung KW, Won YJ. Second primary cancers in patients with oral cavity cancer included in the Korea Central Cancer Registry. Oral Oncol 2019; 95:16-28. [PMID: 31345385 DOI: 10.1016/j.oraloncology.2019.05.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 05/26/2019] [Accepted: 05/27/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVES The improved survival of patients with oral cavity cancer (OCC) has generated interest in factors affecting survivorship, particularly among second primary cancer (SPC) patients. This study aimed to assess the incidence, patterns, and risk factors for SPC after OCC treatment in the Korean population. MATERIALS AND METHODS Data from 15,261 patients with OCC (ICD-O: C01-C06) identified between 1993 and 2014 were extracted from the Korean Central Cancer Registry. The standardized incidence ratio (SIR) for SPC after index OCC was calculated, and Poisson regression analysis was performed to evaluate the risk factors for SPC among survivors. RESULTS The overall SIR for SPC among OCC survivors was 1.47 (95% confidence interval [CI] 1.39-1.56). SIR differed by sex (male: 1.51 vs. female: 1.37), age at diagnosis (<45 years: 2.47 vs. 45-64 years: 1.68 vs. ≥ 65 years: 1.10), index OCC subsite (floor of mouth: 1.95 vs. gum: 1.30), follow-up duration (6-23 months: 1.64 vs. 24-59 months: 1.51 vs. 60-119 months: 1.48 vs. ≥ 120 months: 1.24), histological OCC type (salivary gland malignancy: 1.77 vs. squamous cell carcinoma: 1.44 vs. others: 1.47), and radiation history (any: 1.94 vs. no radiation: 1.37). The risk factors for SPC development among OCC survivors included younger age at diagnosis and history of radiation therapy. CONCLUSION OCC survivors have significantly increased risks of SPCs, exhibiting distinctive site distributions and chronological patterns. These patients would benefit from an SPC surveillance protocol.
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Affiliation(s)
- Seung-Ki Min
- Oral Oncology Clinic, Research Institute and Hospital, National Cancer Center, Republic of Korea
| | - Sung Weon Choi
- Oral Oncology Clinic, Research Institute and Hospital, National Cancer Center, Republic of Korea
| | - Jiwon Lim
- Cancer Registration and Statistics Branch, National Cancer Center, Goyang, Gyeonggi, Republic of Korea
| | - Joo Yong Park
- Oral Oncology Clinic, Research Institute and Hospital, National Cancer Center, Republic of Korea
| | - Kyu-Won Jung
- Cancer Registration and Statistics Branch, National Cancer Center, Goyang, Gyeonggi, Republic of Korea
| | - Young-Joo Won
- Cancer Registration and Statistics Branch, National Cancer Center, Goyang, Gyeonggi, Republic of Korea.
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Cho YY, Kim SK, Jung JH, Hahm JR, Kim TH, Chung JH, Kim SW. Long-term outcomes of renal function after radioactive iodine therapy for thyroid cancer according to preparation method: thyroid hormone withdrawal vs. recombinant human thyrotropin. Endocrine 2019; 64:293-298. [PMID: 30471053 DOI: 10.1007/s12020-018-1807-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 10/29/2018] [Indexed: 12/21/2022]
Abstract
PURPOSE Long-term effects of iatrogenic hypothyroidism on renal function from thyroid hormone withdrawal during radioactive iodine therapy (RAIT) have not been studied, especially in subjects with mildly impaired renal function. We compared renal function in thyroid cancer subjects according to preparation method of either thyroid hormone withdrawal (THW) or injection of recombinant human thyrotropin (rhTSH). METHODS This retrospective study enrolled 241 thyroidectomized patients (rhTSH group, n = 87 and THW group, n = 154). Changes in glomerular filtration rate (GFR) were measured prior to surgery, at the time of RAIT, and during a regular follow-up at least one year after RAIT. RESULTS Baseline renal function was comparable between the rhTSH group and the THW group (91.4 mL/min/1.73 m2 vs. 92.4 mL/min/1.73 m2). At the time of RAIT, GFR was significantly decreased in the THW group (70.6 mL/min/1.73 m2, -23.6%), whereas renal function was preserved in the rhTSH group (85.4 mL/min/1.73 m2, -6.6%). In the THW group, renal function was fully recovered within 6 months after RAIT and was maintained up to 24 months, even in subjects with baseline GFR less than 90 mL/min/1.73 m2. CONCLUSIONS THW for RAIT preparation induced considerable reduction in renal function, but this change was transient. In contrast, injection of rhTSH did not decrease renal function, making it a good option for RAIT preparation for subjects with renal dysfunction.
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Affiliation(s)
- Yoon Young Cho
- Division of Endocrinology and Metabolism, Department of Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
- Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea
- Sungkyunkwan University, Graduate School of Medicine, Seoul, Korea
| | - Soo Kyoung Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
- Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Jung Hwa Jung
- Division of Endocrinology and Metabolism, Department of Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
- Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Jong Ryeal Hahm
- Division of Endocrinology and Metabolism, Department of Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
- Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Tae Hyuk Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Hoon Chung
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sun Wook Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Li Z, Wang K, Shi Y, Zhang X, Wen J. Incidence of second primary malignancy after breast cancer and related risk factors-Is breast-conserving surgery safe? A nested case-control study. Int J Cancer 2019; 146:352-362. [PMID: 30861567 DOI: 10.1002/ijc.32259] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 02/19/2019] [Accepted: 02/25/2019] [Indexed: 02/05/2023]
Abstract
Risk of second primary malignancy (SPM) is increasing. We aimed to assess the incidence and related risk factors of SPM among breast cancer (BC) patients from this nested case-control study using the SEER database. BC patients with SPM were identified as the case group and SPM-free patients were defined as the control group. Propensity score matching of cases with controls by the year of the first primary BC diagnosis was conducted at the ratio of 1:5, and 97,242 BC patients were enrolled from 1998 to 2013 after the matching. The incidence of SPM in BC patients stratified by age groups and cancer sites was compared to the general population using the adjusted standardized incidence ratio (SIR) and the risk factors for SPM were examined using Cox proportional hazard regressions. Our study showed BC patients had excess risk for SPM than the general population (adjusted SIR for all cancer sites = 12.94, p < 0.001) and the incidence of SPM among them decreased with age. The risk of SPM was significantly related to the following demographical and clinical variables: age (40-59 vs. 18-39, HR = 1.33; 60-79 vs. 18-39, HR = 2.39; ≥80 vs. 18-39, HR = 2.84), race (black vs. white, HR = 1.12), histological type (lobular BC vs. ductal BC, HR = 1.15), radiotherapy (HR = 1.33), marital status (married vs. single, HR = 0.88) and estrogen receptor status (positive vs. negative, HR = 0.85). Consistent results were found in subgroup analysis stratified by contralateral-breast SPMs and nonbreast SPMs.
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Affiliation(s)
- Zhuyue Li
- Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu, China.,West China Hospital/West China School of Nursing, Sichuan University, Chengdu, China
| | - Kang Wang
- Department of the Endocrine and Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, China
| | - Yang Shi
- Division of Biostatistics and Data Science, Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Xuemei Zhang
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Jin Wen
- Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu, China
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The efficacy of radioactive iodine for the treatment of well-differentiated thyroid cancer with distant metastasis. Nucl Med Commun 2018; 39:1091-1096. [PMID: 30180044 PMCID: PMC6254782 DOI: 10.1097/mnm.0000000000000897] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Objective Radioactive iodine (131I) has been used as a treatment for high-risk well-differentiated thyroid cancer after thyroidectomy. The aim of this study was to evaluate the long-term follow-up results after using high accumulated doses of 131I (>600 mCi) for the treatment of well-differentiated thyroid cancer. Patients and methods In this study, we retrospectively evaluated prospectively enrolled patients with well-differentiated thyroid cancer who were treated and followed up in Chang Gung Memorial Hospital in Linkou and Keelung, Taiwan. All the patients underwent thyroidectomy between 1979 and 2016. Results For our study, 228 patients with papillary and follicular thyroid carcinoma with distant metastases were enrolled. Of the 228 patients, 71 (31.1%) received 131I therapy with an accumulated dose of at least 600 mCi. Forty-four died because of disease-specific mortality (DSM) after a mean follow-up of 10.6±6.3 years. Compared with the patients in the DSM group, which included 27 survival cases, patients who were younger, and those with a multifocal tumor, more extensive thyroidectomy, and papillary thyroid carcinoma showed better prognosis. The DSM group included a higher percentage of patients who developed a secondary primary cancer after receiving a diagnosis of thyroid cancer than the survival group (18.2 vs. 3.7%). However, the difference did not reach statistical significance (P=0.075). Conclusion 131I provided an effective therapeutic modality for well-differentiated thyroid cancer patients with distant metastasis. After a mean of follow-up 10 years, more than 60% of cases resulted in DSM when high accumulated 131I doses were administered.
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The predictive value for excellent response to initial therapy in differentiated thyroid cancer: preablation-stimulated thyroglobulin better than the TNM stage. Nucl Med Commun 2018; 39:405-410. [PMID: 29557849 DOI: 10.1097/mnm.0000000000000827] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE This study aimed to identify the predictive value of the low preablation-stimulated thyroglobulin (ps-Tg, <2 ng/ml) for excellent response to radioiodine remnant ablation in differentiated thyroid carcinoma. PATIENTS AND METHODS A total of 398 consecutive patients who underwent total thyroidectomy and radioactive iodine remnant ablation therapy were reviewed retrospectively. Each patient was risk-stratified using the American Joint Cancer Committee and risk staging systems and using response to the initial therapy reclassification system. ps-Tg was defined as less than 2 ng/ml with negative thyroglobulin antibody under thyroid-stimulating hormone stimulation. A multivariate analysis was carried out for ps-Tg, TNM stage, and other potential clinical and pathologic factors. RESULTS We followed the patients for a median of 32.7 months. Overall, an excellent rate of response was achieved in 367 (92.2%) of the 398 patients. The only variable found to be associated with excellent response was ps-Tg (odds ratio=2.530, P=0.009) by multivariate analysis. The subgroups with 0<ps-Tg<1 ng/ml had a higher success ablation rate than the patients with 1≤ps-Tg<2 ng/ml. Overall, 31 patients were not achieving an excellent response, and most of them showed an indeterminate response. Only two patients who achieved an excellent response were confirmed to have developed recurrence in the follow-up, both in the local regional lymph nodes. CONCLUSION There is a good probability that most low ps-Tg (<2 ng/ml) patients can achieve an excellent response. ps-Tg is the essential and independent predictor for an excellent response in the patients with ps-Tg less than 2 ng/ml, which is better than TNM stage.
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Park SY, Kim HI, Choi JY, Choe JH, Kim JH, Kim JS, Oh YL, Hahn SY, Shin JH, Ahn SH, Kim K, Jeong JG, Kim SW, Chung JH, Kim TH. Low versus high activity radioiodine remnant ablation for differentiated thyroid carcinoma with gross extrathyroidal extension invading only strap muscles. Oral Oncol 2018; 84:41-45. [PMID: 30115474 DOI: 10.1016/j.oraloncology.2018.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 07/04/2018] [Accepted: 07/09/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The efficacy of radioiodine remnant ablation (RRA) for patients with differentiated thyroid carcinoma (DTC) with gross extrathyroidal extension (ETE) is well described in observational studies. However, its role in gross ETE invading only strap muscles, T3b category in the newly proposed eighth edition of the TNM staging system, is currently unknown. METHODS This study retrospectively analyzed 260 DTC patients with ETE invading only strap muscles who underwent thyroidectomy at a tertiary Korean hospital between 1994 and 2005. Cancer-specific survival (CSS) and recurrence-free survival (RFS) in the no RRA (n = 13), low RRA activity (<3.7 GBq, n = 80), and high RRA activity (≥3.7 GBq, n = 167) groups were studied. RESULTS No significant differences were observed between low and high activity RRA groups in terms of 10-year CSS (97.3% versus 99.3%; HR 0.23, 95% CI 0.02-2.57; p = .235) and RFS (86.8% versus 88.8%; 0.90, 0.40-2.03; p = .804). In the no RRA group, no patients died of cancer, and only one developed structural recurrence. In Cox regression analyses with inverse probability of treatment weighting adjusted for clinicopathologic risk factors, high activity RRA was not related to recurrence outcomes compared to low activity (HR 0.60, 95% CI 0.26-1.35; p = .214). CONCLUSIONS Long term oncologic outcomes did not significantly differ between low versus high activity RRA groups, which suggests that low activity RRA might be sufficient in patients with DTC with gross ETE invading only strap muscles. Further studies are needed to clarify the optimal activity of RRA in these patients.
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Affiliation(s)
- So Young Park
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hye In Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Joon Young Choi
- Department of Nuclear Medicine and Molecular Imaging, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jun-Ho Choe
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jung-Han Kim
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jee Soo Kim
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Young Lyun Oh
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Soo Yeon Hahn
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jung Hee Shin
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Soo Hyun Ahn
- Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Kyunga Kim
- Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Jong Gill Jeong
- Department of Surgery, Yeosu Chonnam Hospital, Yeosu, Republic of Korea
| | - Sun Wook Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jae Hoon Chung
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Tae Hyuk Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
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Súss SKA, Mesa CO, Carvalho GAD, Miasaki FY, Chaves CP, Fuser DC, Corbo R, Momesso D, Bulzico DA, Graf H, Vaisman F. Clinical outcomes of low and intermediate risk differentiated thyroid cancer patients treated with 30mCi for ablation or without radioactive iodine therapy. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2018; 62:149-156. [PMID: 29641738 PMCID: PMC10118992 DOI: 10.20945/2359-3997000000025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 11/08/2017] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To retrospectively evaluate the outcomes of patients with low and intermediate risk thyroid carcinoma treated with total thyroidectomy (TT) and who did not undergo radioiodine remnant ablation (RRA) and to compare them to patients receiving low dose of iodine (30 mCi). SUBJECTS AND METHODS A total of 189 differentiated thyroid cancer (DTC) patients treated with TT followed by 30mCi for RRA or not, followed in two referral centers in Brazil were analyzed. RESULTS From the 189 patients, 68.8% was ATA low-risk, 30.6% intermediate and 0.6% high risk. Eighty-seven patients underwent RRA and 102 did not. The RRA groups tended to be younger and had a higher frequency of extra-thyroidal extension (ETE). RRA did not have and impact on response to initial therapy neither in low (p = 0.24) nor in intermediate risk patients (p = 0.66). It also had no impact on final outcome and most patients had no evidence of disease (NED) at final follow-up. Recurrence/persistence of disease was found in 1.2% of RRA group and 2% in patients treated only with TT (p = 0.59). CONCLUSIONS Our study shows that in low and intermediate-risk patients, RRA with 30 mCi seems to have no major advantage over patients who did not undergo RRA regarding response to initial therapy in each risk group and also in long term outcomes.
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Affiliation(s)
- Shirlei Kugler Aiçar Súss
- Serviço de Endocrinologia, Instituto Nacional do Câncer (Inca), Rio de Janeiro, RJ, Brasil.,Serviço de Endocrinologia, Hospital das Clínicas, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brasil
| | - Cleo Otaviano Mesa
- Serviço de Endocrinologia, Hospital das Clínicas, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brasil
| | - Gisah Amaral de Carvalho
- Serviço de Endocrinologia, Hospital das Clínicas, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brasil
| | - Fabíola Yukiko Miasaki
- Serviço de Endocrinologia, Hospital das Clínicas, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brasil
| | - Carolina Perez Chaves
- Serviço de Medicina Nuclear, Instituto Nacional do Câncer (Inca), Rio de Janeiro, RJ, Brasil
| | - Dominique Cochat Fuser
- Serviço de Medicina Nuclear, Instituto Nacional do Câncer (Inca), Rio de Janeiro, RJ, Brasil
| | - Rossana Corbo
- Serviço de Endocrinologia, Instituto Nacional do Câncer (Inca), Rio de Janeiro, RJ, Brasil
| | - Denise Momesso
- Serviço de Endocrinologia, Instituto Nacional do Câncer (Inca), Rio de Janeiro, RJ, Brasil
| | - Daniel A Bulzico
- Serviço de Endocrinologia, Instituto Nacional do Câncer (Inca), Rio de Janeiro, RJ, Brasil
| | - Hans Graf
- Serviço de Endocrinologia, Hospital das Clínicas, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brasil
| | - Fernanda Vaisman
- Serviço de Endocrinologia, Instituto Nacional do Câncer (Inca), Rio de Janeiro, RJ, Brasil
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Risk of second malignancies among survivors of pediatric thyroid cancer. Int J Clin Oncol 2018; 23:625-633. [DOI: 10.1007/s10147-018-1256-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 02/24/2018] [Indexed: 01/29/2023]
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Seok JY, An J, Cho HY. Improvement of diagnostic performance of pathologists by reducing the number of pathologists responsible for thyroid fine needle aspiration cytology: An institutional experience. Diagn Cytopathol 2018; 46:561-567. [DOI: 10.1002/dc.23893] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Revised: 01/08/2018] [Accepted: 01/09/2018] [Indexed: 01/16/2023]
Affiliation(s)
- Jae Yeon Seok
- Department of Pathology; Gachon University Gil Medical Center; Incheon Korea
| | - Jungsuk An
- Department of Pathology; Gachon University Gil Medical Center; Incheon Korea
| | - Hyun Yee Cho
- Department of Pathology; Gachon University Gil Medical Center; Incheon Korea
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Joung JY, Kwon WA, Lim J, Oh CM, Jung KW, Kim SH, Seo HK, Park WS, Chung J, Lee KH, Won YJ. Second Primary Cancer Risk among Kidney Cancer Patients in Korea: A Population-Based Cohort Study. Cancer Res Treat 2018; 50:293-301. [PMID: 28421722 PMCID: PMC5784635 DOI: 10.4143/crt.2016.543] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 04/14/2017] [Indexed: 12/23/2022] Open
Abstract
PURPOSE Secondary primary cancers (SPCs) commonly arise in patients with renal cell carcinoma (RCC). We designed the present study to estimate the SPC incidence in Korean patients with RCC. MATERIALS AND METHODS The study cohort was population-based and consisted of 40,347 individuals from the Korean Central Cancer Registry who were diagnosed with primary renal cancer between 1993 and 2013. Standardized incidence ratios (SIRs) for SPCs were estimated for different ages at diagnosis, latencies, diagnostic periods, and treatments. RESULTS For patients with primary RCC, the risk of developing a SPC was higher than the risk of developing cancer in the general population (SIR, 1.13; 95% confidence interval, 1.08 to 1.18). Most cancer types showed higher incidences in patients with RCC than in the general population. However, the relative incidence of gastric cancer as an SPC varied by age. Gastric cancer incidence was elevated in young patients (< 30 years) with RCC, but reduced in older (≥ 30) patients with RCC. Patients with advanced RCC died prematurely, regardless of SPC development. In contrast, those with early-stage RCC survived for longer periods, although SPC development affected their post-RCC survival. After SPC development, women had better survival than men. CONCLUSION In Korean patients with primary RCC, the incidence of SPC was 13% higher than the incidence of cancer in the general population. These findings may play important roles in the conduct of follow-up evaluations and education for patients with RCC.
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Affiliation(s)
- Jae Young Joung
- Center for Prostate Cancer, National Cancer Center, Goyang, Korea
| | - Whi-An Kwon
- Department of Urology, Institute of Wonkwang Medical Science, Wonkwang University Sanbon Hospital, Wonkwang University School of Medicine, Gunpo, Korea
| | - Jiwon Lim
- Cancer Registration and Statistics Branch, National Cancer Center, Goyang, Korea
| | - Chang-Mo Oh
- Cancer Registration and Statistics Branch, National Cancer Center, Goyang, Korea
| | - Kyu-Won Jung
- Cancer Registration and Statistics Branch, National Cancer Center, Goyang, Korea
| | - Sung Han Kim
- Center for Prostate Cancer, National Cancer Center, Goyang, Korea
| | - Ho Kyung Seo
- Center for Prostate Cancer, National Cancer Center, Goyang, Korea
| | - Weon Seo Park
- Center for Prostate Cancer, National Cancer Center, Goyang, Korea
| | - Jinsoo Chung
- Center for Prostate Cancer, National Cancer Center, Goyang, Korea
| | - Kang Hyun Lee
- Center for Prostate Cancer, National Cancer Center, Goyang, Korea
| | - Young-Joo Won
- Cancer Registration and Statistics Branch, National Cancer Center, Goyang, Korea
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Sohn SY, Kim YN, Kim HI, Kim TH, Kim SW, Chung JH. Validation of dynamic risk stratification in pediatric differentiated thyroid cancer. Endocrine 2017; 58:167-175. [PMID: 28822062 DOI: 10.1007/s12020-017-1381-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 07/21/2017] [Indexed: 01/12/2023]
Abstract
PURPOSE There has been increasing interest in a risk-adopted management strategy known as dynamic risk stratification following the revised American Thyroid Association guidelines for differentiated thyroid cancer. We aimed to evaluate the usefulness of dynamic risk stratification for predicting structural disease in pediatric differentiated thyroid cancer patients. METHODS We retrospectively reviewed 130 pediatric differentiated thyroid cancer patients (≤19 years) who were treated between 1996 and 2015 at Samsung Medical Center. Patients were stratified according to three American Thyroid Association initial risk group (low, intermediate, or high risk) and four dynamic risk stratification group (excellent, indeterminate, biochemical incomplete, or structural incomplete). RESULTS Based on dynamic risk stratification strategy, structural disease was identified 3.9% in the excellent group, 9.7% in the indeterminate group, 76.9% in the biochemical incomplete group, and 100% in the structural incomplete group. The hazard ratios of the structural disease were 18.10 (P < 0.001) in the biochemical incomplete group, and 19.583 (P < 0.001) in the structural incomplete group compared to the excellent group. The prevalence of structural disease also increased as American Thyroid Association initial risk classification increased (5.9% in the low-risk group, 13.6% in the intermediate-risk group, and 45% in the high-risk group). The hazard ratios of structural disease in the high-risk group was 10.296 (P < 0.001) in compared to the low-risk group. CONCLUSION Dynamic risk stratification based on patient responses to initial therapy was able to effectively predict the risk of structural disease in a pediatric population, and as a follow-up strategy, may work as well in pediatric differentiated thyroid cancer patients as it does in adult differentiated thyroid cancer patients.
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Affiliation(s)
- Seo Young Sohn
- Department of Endocrinology and Metabolism, Seonam University, Myongji Hospital, Goyang, Korea
| | - Young Nam Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hye In Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Tae Hyuk Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sun Wook Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Hoon Chung
- Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Cabibi D, Pipitone G, Porcasi R, Ingrao S, Benza I, Porrello C, Cajozzo M, Giannone AG. Pleural epithelioid angiosarcoma with lymphatic differentiation arisen after radiometabolic therapy for thyroid carcinoma: immunohistochemical findings and review of the literature. Diagn Pathol 2017; 12:60. [PMID: 28810922 PMCID: PMC5558755 DOI: 10.1186/s13000-017-0652-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Accepted: 08/08/2017] [Indexed: 11/10/2022] Open
Abstract
Background Pleural angiosarcoma is a rare tumor that causes diffuse pleural thickening and effusion, mimicking mesothelioma. Immunohistochemistry is needed to highlight endothelial differentiation. We describe the first case of pleural angiosarcoma with lymphatic differentiation following radiometabolic therapy for thyroid carcinoma. Case presentation A 50-year-old man showed diffuse pleural thickening and effusion. Nine years earlier, he underwent thyroidectomy and radiometabolic therapy for thyroid carcinoma with lymph node metastases. Histologically, the tumor consisted of a solid proliferation of atypical epithelioid cells and anastomosed vascular spaces, lacking of red blood cells and containing Alcian blue positive material. The tumor showed positive immunostaining for Vimentin, CD31, CK7, D2–40, c-MYC, Ki67, focal positivity for PanCK, and negative immunostaining for Factor VIII, CD34, WT1, CK5/6, Calretinin, EMA, HBME-1, CEA, p63, EpCAM, Bcl-2, TTF1 and Thyroglobulin. CD99 showed a granular/paranuclear pattern of positivity. The histological and immunohistochemical features were consistent with “pleural angiosarcoma with lymphatic differentiation, epithelioid variant”. Discussion and conclusions Epithelioid angiosarcoma with lymphatic differentiation is very rare and aggressive. Moreover, the positivity for c-MYC suggests the relationship with radiometabolic therapy. To our knowledge, this is the first case of pleural c-MYC-positive angiosarcoma with lymphatic differentiation reported in the literature and the first one arisen after radiometabolic therapy for thyroid carcinoma.
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Affiliation(s)
- Daniela Cabibi
- Department of Sciences for the Promotion of Health and Mother and Child Care, Anatomic Pathology, University of Palermo, Palermo, Italy. .,Anatomia Patologica, A.O.U. Policlinico 'P. Giaccone', Via del Vespro 129, 90127, Palermo, Italy.
| | - Giulia Pipitone
- Department of Sciences for the Promotion of Health and Mother and Child Care, Anatomic Pathology, University of Palermo, Palermo, Italy
| | - Rossana Porcasi
- Department of Sciences for the Promotion of Health and Mother and Child Care, Anatomic Pathology, University of Palermo, Palermo, Italy
| | - Sabrina Ingrao
- Department of Sciences for the Promotion of Health and Mother and Child Care, Anatomic Pathology, University of Palermo, Palermo, Italy
| | - Ignazio Benza
- Buccheri La Ferla Hospital, Unit of Radiology, Palermo, Italy
| | - Calogero Porrello
- Department of Surgical and Oncological Sciences, University of Palermo, Palermo, Italy
| | - Massimo Cajozzo
- Department of Surgical and Oncological Sciences, University of Palermo, Palermo, Italy
| | - Antonino Giulio Giannone
- Department of Sciences for the Promotion of Health and Mother and Child Care, Anatomic Pathology, University of Palermo, Palermo, Italy
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Izkhakov E, Barchana M, Liphshitz I, Silverman BG, Stern N, Keinan-Boker L. Trends of Second Primary Malignancy in Patients with Thyroid Cancer: A Population-Based Cohort Study in Israel. Thyroid 2017; 27:793-801. [PMID: 28338430 DOI: 10.1089/thy.2016.0481] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Thyroid cancer (TC) is the most common endocrine malignancy. TC patients have a good prognosis and a low disease-related mortality rate. Since such patients are often young, they may be at a higher risk for a second primary malignancy (SPM). This study sought to determine the incidence, risk, and types of SPM between 1980 and 2011, and to assess SPM trends over time among Israeli TC patients. METHODS Data were derived from the Israel National Cancer Registry. Primary TC patients diagnosed during 1980-2009 were followed up for SPM incidence until December 31, 2011. Standardized incidence ratios (SIRs) of observed to expected SPM (based on the general population rates) were calculated using Poisson regression. Analyses were stratified by time period of initial TC diagnosis (1980-1995 and 1996-2009). RESULTS A total of 11,538 TC patients were identified. After exclusion of 107 duplicate cases, records of 1032 patients with SPM were analyzed (an SPM incidence of 8.9%). SIRs for all-site SPMs were 1.23 [confidence interval 1.08-1.35] for males and 1.19 [confidence interval 1.10-1.27] for females. SIRs for tumors of the urinary system and prostate were significantly elevated in males, as were SIRs for tumors of the brain, urinary system, breast, and lung in females. Variables associated with increased risk of developing SPMs included a younger age at TC diagnosis, a shorter latency period, being born in Asia/Africa for both sexes, and being born in Israel for females. Compared with the general population, a subanalysis by TC diagnosis during 1980-1995 and 1996-2009 disclosed a higher SPM incidence for the latter time period in males and for both time periods, with a slightly higher SIR for the latter time period in females. CONCLUSIONS The overall risk of SPM in Israeli TC patients was significantly greater for both sexes compared with the general population, thus identifying TC patients as a high-risk group and calling for caretakers to apply specific follow-up guidelines.
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Affiliation(s)
- Elena Izkhakov
- 1 Institute of Endocrinology , Metabolism, and Hypertension, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- 2 Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel
- 3 School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa , Haifa, Israel
| | - Micha Barchana
- 3 School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa , Haifa, Israel
| | - Irena Liphshitz
- 4 Israel National Cancer Registry, Israel Center for Disease Control , Ministry of Health, Ramat Gan, Israel
| | - Barbara G Silverman
- 2 Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel
- 4 Israel National Cancer Registry, Israel Center for Disease Control , Ministry of Health, Ramat Gan, Israel
| | - Naftali Stern
- 1 Institute of Endocrinology , Metabolism, and Hypertension, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- 2 Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel
| | - Lital Keinan-Boker
- 3 School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa , Haifa, Israel
- 4 Israel National Cancer Registry, Israel Center for Disease Control , Ministry of Health, Ramat Gan, Israel
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Abdel-Rahman O. Risk of Subsequent Primary Kidney Cancer After Another Malignancy: A Population-based Study. Clin Genitourin Cancer 2017; 15:e747-e754. [PMID: 28314541 DOI: 10.1016/j.clgc.2017.02.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 02/13/2017] [Accepted: 02/19/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND Population-based data on the development of kidney cancer as a second malignant neoplasm following the diagnosis of other common malignancies are rare. This clinical scenario has been evaluated within the Surveillance, Epidemiology, and End Results (SEER) database. MATERIALS AND METHODS The SEER-9 database (1973-2013) was queried using the SEER*Stat program to determine the standardized incidence ratios (SIRs) of kidney cancer development following each one of 10 common invasive malignancies (colorectal, breast, prostate, lung, thyroid, corpus uteri, urinary bladder, kidney/renal pelvis, cutaneous melanoma, and non-Hodgkin lymphoma). The following data were collected for patients with a second renal cancer: age at diagnosis of the second renal cancer; gender, race, and histology of the second primary renal cancer; SEER historic stage of the second primary renal cancer; and method of diagnostic confirmation of the second primary cancer. RESULTS A total of 10,145 kidney cancers were observed. Elevated SIRs for kidney cancer were noted for all 10 evaluated malignancies in the initial 12 months after diagnosis. The SIRs remained elevated 12 to 59 months after diagnosis for all cancers except breast and prostate cancers. Increased risks persisted 60 to 119 months beyond diagnosis for renal cancer (SIR, 4.13), thyroid cancer (SIR, 2.30), and non-Hodgkin lymphoma (SIR, 1.40); and 120+ months for renal cancer (SIR, 3.60), thyroid cancer (SIR, 1.90), and non-Hodgkin lymphoma (SIR, 1.27). Increased kidney cancer risk after non-Hodgkin lymphoma was not related to radiation therapy. Papillary renal cell carcinoma has the highest SIRs for subsequent kidney cancers. CONCLUSION Many common cancers are associated with an increased risk of kidney cancer development within the first 5 years after their diagnosis. Although this can be partly interpreted by increased rates of surveillance tests, radiotherapy effects, or genetic associations for some cancers, additional research is required to explain the persistently increased risk beyond 5 years associated with some cancers.
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Affiliation(s)
- Omar Abdel-Rahman
- Clinical Oncology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
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Kim SY, Kim HR, Kim CH, Koh JS, Baek HJ, Choi CM, Song JS, Lee JC, Na II. Association between thyroid cancer and epidermal growth factor receptor mutation in female with nonsmall cell lung cancer. Ann Thorac Med 2017; 12:36-41. [PMID: 28197220 PMCID: PMC5264171 DOI: 10.4103/1817-1737.197774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The aim of this study was to investigate the association between epidermal growth factor receptor (EGFR) mutation and thyroid cancer in female patients with nonsmall-cell lung cancer (NSCLC). METHODS In a retrospective study, we examined 835 female patients who were diagnosed with NSCLC and underwent an EGFR mutation test between June 2003 and August 2013. The associations of EGFR mutation with thyroid cancer and a family history of thyroid cancer were evaluated using logistic regression models. RESULTS EGFR mutation was found in 378 of 835 patients. In addition to adenocarcinoma (P < 0.001), EGFR mutations were positively associated with a personal history of thyroid cancer (5.8% versus 2.6%; P = 0.020), while showing a trend toward inverse association with a personal history of nonthyroid cancer (5.8% vs. 9.0%; P = 0.086). Likewise, the incidence of EGFR mutations was associated with a family history of thyroid cancer (2.9% vs. 0.9%; P = 0.028), while showing a trend toward inverse association with a family history of nonthyroid cancer (27.8% vs. 33.7%; P = 0.066). Multivariate logistic regression showed that the incidence of EGFR mutations was different in women with thyroid or nonthyroid cancer (P = 0.035) and in women with a family history of thyroid or nonthyroid cancer (P = 0.023). CONCLUSIONS Our data suggest that thyroid cancer and a family history of thyroid cancer are associated with EGFR-mutated NSCLC in female patients. The differences in the incidence of thyroid cancer and a family history of thyroid cancer by EGFR mutational status provide new insight into pathogenesis of this genetic change.
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Affiliation(s)
- Seo Yun Kim
- Department of Internal Medicine, Division of Pulmonology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Hye-Ryoun Kim
- Department of Internal Medicine, Division of Pulmonology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Cheol Hyeon Kim
- Department of Internal Medicine, Division of Pulmonology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Jae Soo Koh
- Department of Pathology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Hee Jong Baek
- Department of Thoracic Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Chang-Min Choi
- Department of Pulmonology and Critical Care Medicine, University of Ulsan, Ulsan, Republic of Korea; Department of Oncology, Asan Medical Center, College of Medicine, University of Ulsan, Ulsan, Republic of Korea
| | - Joon Seon Song
- Department of Pathology, Asan Medical Center, College of Medicine, University of Ulsan, Ulsan, Republic of Korea
| | - Jae Cheol Lee
- Department of Oncology, Asan Medical Center, College of Medicine, University of Ulsan, Ulsan, Republic of Korea
| | - Im Ii Na
- Department of Internal Medicine, Division of Hematology/Oncology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
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Al-Qahtani KH, Al-Asiri M, Tunio MA, Aljohani NJ, Bayoumi Y, Al-Hussain H, Maklad AM. Prevalence and treatment outcomes of second primary malignancies in Saudi patients with differentiated thyroid cancers. Saudi Med J 2016; 36:442-8. [PMID: 25828281 PMCID: PMC4404478 DOI: 10.15537/smj.2015.4.10341] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To evaluate the clinicopathologic features, and explore the treatment outcomes of synchronous, or metachronous second primary malignancies (SPM) in conjunction with differentiated thyroid cancers (DTC). METHODS This retrospective study was conducted on 823 DTC patients treated between 2000 and 2012 at 2 tertiary care hospitals (King Fahad Medical City and King Khalid University Hospital) in Riyadh, Kingdom of Saudi Arabia. Forty-one (5%) DTC patients were found to have SPM (61% metachronous and 39% synchronous). These patients with SPM were studied for clinicopathological features and treatment outcomes. RESULTS The patients with DTC and SPM were older (median age: 54.3 years) than those without SPM (median age: 43.2 years); p=0.04. The frequency of SPM was breast (51.2%), colon (12.2%), kidney (7.3%), astrocytoma (7.3%), parotid (7.3%), rectum (4.9%), lymphoma (4.9%), nasopharynx (2.4%), and stomach (2.4%). Median follow-up was 8.05 years. Ten-year disease free survival, and overall survival (OS) rates were lower in DTC patients with SPM (56.1% for 10-year survival, and 71.7% for OS) than without SPM (95.5% for 10-year survival, and 97.8% for OS); p=0.0001. Metachronous SPM had better 10-year disease free survival rates (60.2%) than synchronous SPM (45%). CONCLUSION The co-occurrence of SPM with DTC affects long-term disease free survival and OS rates.
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Affiliation(s)
- Khalid H Al-Qahtani
- Department of Otolaryngology-Head & Neck Surgery, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail.
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Ye Y, Neil AL, Wills KE, Venn AJ. Temporal trends in the risk of developing multiple primary cancers: a systematic review. BMC Cancer 2016; 16:849. [PMID: 27814758 PMCID: PMC5097442 DOI: 10.1186/s12885-016-2876-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 10/24/2016] [Indexed: 01/21/2023] Open
Abstract
Background Cancer survivors are at risk of developing second and subsequent primary cancers, referred to as multiple primary cancers (MPCs). It is not clear whether the risk of MPCs has increased over recent decades, but increasing use of radiological imaging and potentially harmful effects of certain cancer treatments raise this possibility. A systematic review was undertaken to assess whether there has been a temporal change in the risk of developing MPCs. Methods A systematic search to identify population-based studies of MPCs was performed in Medline/PubMed and Embase databases from inception to August 2016. Included studies were those reporting risk of MPCs for all sites combined following a first cancer at any site or a specific site, using standard incidence ratios (SIRs) or equivalent, and with analysis stratified by calendar years. Results We identified 28 articles eligible for inclusion, comprising 26 population-based studies and two monographs. MPC incidence was reported in nearly 6.5 million cancer survivors. For all first cancer sites combined, a higher rate of MPCs was reported in more recent than earlier calendar periods in four of the six relevant studies. The SIRs ranged from 1.14 for a first cancer diagnosis in the early 1980s to 1.21–1.46 in the late 1990s in the USA and Australia. Two studies from Italy and France showed no significant difference in SIRs across time periods 1978–2010 and 1989–2004. The remaining 22 studies reported various temporal trends in the risk of developing MPCs after a first cancer at a specific site, but most showed little change. Conclusion Overall, the risk of developing MPCs appears to have increased since the 1980s when considering studies of all primary cancer sites combined from the USA and Australia but not from Europe. With the introduction of more routine nuclear medical imaging over the last 15 years, more studies are needed to confirm recent trends of MPC risk in adult cancer survivors. Electronic supplementary material The online version of this article (doi:10.1186/s12885-016-2876-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yuanzi Ye
- Menzies Institute for Medical Research, Univeristy of Tasmania, Private Bag 23, Hobart, Tasmania, 7000, Australia
| | - Amanda L Neil
- Menzies Institute for Medical Research, Univeristy of Tasmania, Private Bag 23, Hobart, Tasmania, 7000, Australia
| | - Karen E Wills
- Menzies Institute for Medical Research, Univeristy of Tasmania, Private Bag 23, Hobart, Tasmania, 7000, Australia
| | - Alison J Venn
- Menzies Institute for Medical Research, Univeristy of Tasmania, Private Bag 23, Hobart, Tasmania, 7000, Australia.
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Lee YB, Cho YY, Jang JY, Kim TH, Jang HW, Chung JH, Oh YL, Kim SW. Current status and diagnostic values of the Bethesda system for reporting thyroid cytopathology in a papillary thyroid carcinoma-prevalent area. Head Neck 2016; 39:269-274. [PMID: 27617626 DOI: 10.1002/hed.24578] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 07/08/2016] [Accepted: 08/02/2016] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Most studies validating the Bethesda system for reporting thyroid cytopathology (TBSRTC) have been conducted in Western countries. We explored the current status of TBSRTC in an area where most thyroid malignancies are papillary carcinomas. METHODS Fine-needle aspirations (FNAs) of thyroid nodules performed in 2013 were retrospectively analyzed and the results were compared to final pathology on resection. RESULTS Of 1947 FNAs, 1925 (98.9%) were reported using TBSRTC. Among 381 resected lesions, 27.3% of nondiagnostic, 19.6% of benign, 56.0% of atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS), 33.3% of follicular neoplasm/suspicious for a follicular neoplasm (FN/SFN), 97.7% of suspicious for malignancy, and 100.0% of malignant lesions were malignant on pathology. The sensitivity and specificity of FNA using TBSRTC were 96.7% and 84.1%, respectively. CONCLUSION TBSRTC works well in an area in which papillary thyroid cancer is prevalent; however, it may underestimate malignancy rates in AUS/FLUS, benign, and nondiagnostic categories. © 2016 Wiley Periodicals, Inc. Head Neck 39: 269-274, 2017.
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Affiliation(s)
- You-Bin Lee
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yoon Young Cho
- Division of Endocrinology and Metabolism, Department of Medicine, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Ju Young Jang
- Division of Endocrinology and Metabolism, Department of Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Tae Hyuk Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hye Won Jang
- Department of Medical Education, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Hoon Chung
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young Lyun Oh
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sun Wook Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Hirsch D, Shohat T, Gorshtein A, Robenshtok E, Shimon I, Benbassat C. Incidence of Nonthyroidal Primary Malignancy and the Association with (131)I Treatment in Patients with Differentiated Thyroid Cancer. Thyroid 2016; 26:1110-6. [PMID: 27302111 DOI: 10.1089/thy.2016.0037] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND The occurrence of nonthyroidal primary malignancy (NTPM) and the potential association of with radioiodine (RAI) treatment are important concerns in patients with differentiated thyroid cancer (DTC), but incidence data are conflicting. The aims of the present study were to investigate the incidence of NTPM and its association with RAI treatment in a cohort of DTC patients treated at a single tertiary medical center. METHODS The data of 1943 patients with DTC recorded in the Rabin Medical Center Thyroid Cancer Registry were cross-matched with data from the Israeli National Cancer Registry to identify those diagnosed with an NTPM. Patient medical files were reviewed. Second primary malignancy (SPM) was defined as new malignancy diagnosed at least two years after DTC diagnosis. RESULTS For 1434 of the 1943 patients (73.8%), the American Joint Committee on Cancer TNM stage was 1-2. The mean follow-up was 9.3 years. Of the 1943 patients, 1574 (81%) were treated with RAI, and 1467 were followed for at least 2 years, and of these, 1145 patients (78%) received a cumulative dose of ≤200 mCi. A total of 409 NTPMs were diagnosed in 368/1943 patients with DTC (18.9%; 265 female, mean age 53.9 ± 15 years), including 173 SPMs (42.3%) in 166/368 patients. The most common NTPM and SPM was breast cancer followed by hematologic malignancies. In patients followed for ≥2 years, SPMs were diagnosed in 9% of RAI-treated patients and 10.5% of non-RAI-treated patients. SPM rates were 10.2% and 7.8% for a cumulative RAI dose of ≤100 mCi and >100 mCi respectively. Hazard ratios for SPM in patients that received/did not receive RAI treatment was 1.27 (95% confidence interval 0.88-1.82; p = 0.1). There was no correlation between first or cumulative RAI dose and diagnosis of SPM. CONCLUSIONS NTPMs are not uncommon in patients with DTC and usually antecede the DTC. In a population of mostly low-risk DTC patients, in whom limited activities of RAI are usually administered, this treatment is apparently not associated with an overall increased risk of SPMs compared with subjects not receiving RAI treatment.
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Affiliation(s)
- Dania Hirsch
- 1 Institute of Endocrinology , Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel
- 2 Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel
| | - Tzippy Shohat
- 3 Statistics Unit , Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel
| | - Alex Gorshtein
- 1 Institute of Endocrinology , Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel
- 2 Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel
| | - Eyal Robenshtok
- 1 Institute of Endocrinology , Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel
- 2 Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel
| | - Ilan Shimon
- 1 Institute of Endocrinology , Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel
- 2 Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel
| | - Carlos Benbassat
- 2 Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel
- 4 Endocrine Institute , Assaf Harofeh Medical Center, Zerifin, Israel
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Wen CT, Fu JY, Wu CF, Hsieh MJ, Liu YH, Wu YC, Tsai YH, Wu CY. Survival impact of locoregional metachronous malignancy in survival of lung cancer patients who received curative treatment. J Thorac Dis 2016; 8:1139-48. [PMID: 27293830 DOI: 10.21037/jtd.2016.04.45] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Metachronous malignancy is also found in the lung cancer population and may be identified before or after diagnosis of lung cancer. No prior studies have documented lung cancer patients with metachronous malignancy and its survival impact in this population. The aim of this study was to try to clarify the survival impact of locoregional metachronous malignancy in the lung cancer population with resectable disease from a pathology point of view. METHODS From January 2005 to December 2009, 199 lung cancer patients received curative treatment in Chang Gung Memorial Hospital, of which 34 were identified as having lung cancer and metachronous malignancy and 165 patients as having lung cancer only. Clinico-pathologic factors were collected from the medical records. Differences in clinical presentations between the two groups and survival impact were further analyzed. RESULTS Of these patients, 165 patients (82.9%) had lung cancer only (lung cancer group), and the remaining 34 patients (17.1%) had lung cancer and metachronous malignancy (metachronous malignancy group). There were no significant differences in clinical characteristics between the two groups. The disease free survival (P=0.3199) and overall survival (P=0.71) between these two groups showed no statistically significant difference. Metachronous malignancy only showed survival impact in lung cancer patients with pathologic stage IIIA (P=0.0389). CONCLUSIONS Metachronous malignancy is also seen in the lung cancer population and may be identified before or after diagnosis of lung cancer. Locoregional metachronous malignancy has no survival impact on lung cancer patients who receive curative treatment. Anatomic resection with regional lymph node (LN) dissection is recommended if different tumor cell type and resectable disease are confirmed.
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Affiliation(s)
- Chi-Tsung Wen
- 1 Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, Linkou, Taiwan ; 2 Division of Chest and Critical Care, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan ; 3 Division of Chest and Critical Care, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Chiayi, Taiwan
| | - Jui-Ying Fu
- 1 Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, Linkou, Taiwan ; 2 Division of Chest and Critical Care, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan ; 3 Division of Chest and Critical Care, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Chiayi, Taiwan
| | - Ching-Feng Wu
- 1 Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, Linkou, Taiwan ; 2 Division of Chest and Critical Care, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan ; 3 Division of Chest and Critical Care, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Chiayi, Taiwan
| | - Ming-Ju Hsieh
- 1 Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, Linkou, Taiwan ; 2 Division of Chest and Critical Care, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan ; 3 Division of Chest and Critical Care, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Chiayi, Taiwan
| | - Yun-Hen Liu
- 1 Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, Linkou, Taiwan ; 2 Division of Chest and Critical Care, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan ; 3 Division of Chest and Critical Care, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Chiayi, Taiwan
| | - Yi-Cheng Wu
- 1 Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, Linkou, Taiwan ; 2 Division of Chest and Critical Care, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan ; 3 Division of Chest and Critical Care, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Chiayi, Taiwan
| | - Ying-Huang Tsai
- 1 Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, Linkou, Taiwan ; 2 Division of Chest and Critical Care, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan ; 3 Division of Chest and Critical Care, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Chiayi, Taiwan
| | - Ching-Yang Wu
- 1 Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, Linkou, Taiwan ; 2 Division of Chest and Critical Care, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan ; 3 Division of Chest and Critical Care, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Chiayi, Taiwan
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