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Conroy T, Castan F, Etienne PL, Rio E, Mesgouez-Nebout N, Evesque L, Vendrely V, Artignan X, Bouché O, Gargot D, Boige V, Bonichon-Lamichhane N, Louvet C, Morand C, de la Fouchardière C, Boilève A, Delaye M, Gourgou S, Pezzella V, Borg C. Total neoadjuvant therapy with mFOLFIRINOX versus preoperative chemoradiotherapy in patients with locally advanced rectal cancer: long-term results of the UNICANCER-PRODIGE 23 trial. Ann Oncol 2024:S0923-7534(24)01012-3. [PMID: 38986769 DOI: 10.1016/j.annonc.2024.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 05/27/2024] [Accepted: 06/28/2024] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND The standard of care for the treatment of locally advanced rectal cancer (LARC) results in an excellent local disease control but the metastasis rates remain high. PRODIGE 23 demonstrated improved disease-free survival (DFS) and metastasis-free survival (MFS) with total neoadjuvant therapy versus standard of care in this population. Long-term analysis of overall survival (OS) is reported here. PATIENTS AND METHODS The study design, participants, and primary endpoint DFS have been reported for this multicenter, randomized, open-label, phase III trial investigating the neoadjuvant chemotherapy with mFOLFIRINOX (6 cycles) followed by chemoradiotherapy, surgery, and adjuvant chemotherapy (6 cycles), versus chemoradiotherapy, surgery, and adjuvant chemotherapy (12 cycles) in patients with locally advanced rectal adenocarcinoma under peritoneal reflection on magnetic resonance imaging, and staged cT3/T4. Key secondary endpoints included OS, MFS, and local and metastatic recurrence rate. RESULTS With a median follow-up of 82.2 months, the 7-year DFS was 67.6% [95% confidence interval (CI) 60.7% to 73.9%] and 62.5% (95% CI 55.6% to 68.6%) [restricted mean survival time (RMST) difference 5.73 months, 95% CI 0.05-11.41 months, P = 0.048] in the neoadjuvant chemotherapy and the standard-of-care groups, respectively. The 7-year MFS was 79.2% (95% CI 73.0% to 84.4%) in the neoadjuvant chemotherapy group and 72.3% (95% CI 65.8% to 77.8%) in the standard-of-care group (RMST difference 6.1 months, 95% CI 0.93-11.37 months, P = 0.021). The 7-year OS was 81.9% (95% CI 75.8% to 86.6%) in the neoadjuvant chemotherapy group and 76.1% (95% CI 69.7% to 81.2%) in the standard-of-care group (RMST difference 4.37 months, 95% CI 0.35-8.38 months, P = 0.033). The safety profile remained unchanged since the previous analysis. CONCLUSIONS Neoadjuvant chemotherapy with mFOLFIRINOX followed by chemoradiotherapy improved OS, confirmed long-term DFS and MFS benefits in LARC patients, and should be considered as one of the best options of care for these patients.
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Affiliation(s)
- T Conroy
- Institut de Cancérologie de Lorraine and INSERM, INSPIIRE, Université de Lorraine, Nancy.
| | - F Castan
- Institut Régional du Cancer de Montpellier, Université de Montpellier, Montpellier
| | - P-L Etienne
- CARIO, Hôpital Privé des côtes d'Armor, Plérin
| | - E Rio
- Institut de Cancérologie de l'Ouest-Site René Gauducheau, Saint-Herblain
| | | | | | - V Vendrely
- Centre Hospitalier et Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac
| | - X Artignan
- Centre Hospitalier Privé Saint-Grégoire, Saint-Grégoire
| | - O Bouché
- CHU Reims, Université de Reims Champagne-Ardenne, Reims
| | - D Gargot
- Centre Hospitalier de Blois, Blois
| | | | | | - C Louvet
- Institut Mutualiste Montsouris, Paris
| | - C Morand
- Centre Hospitalier Départemental Vendée, site de la Roche-sur-Yon, La Roche-sur-Yon
| | | | | | | | - S Gourgou
- Institut Régional du Cancer de Montpellier, Université de Montpellier, Montpellier
| | | | - C Borg
- University Hospital of Besançon, CIC-BT1431, Besançon, France
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Liu Y, Si M, Qian Y, Liu Y, Wang Z, Zhang T, Wang Z, Ye K, Xiang C, Xu L, Zhang Y, Xiao Z. Bidirectional Mendelian randomization analysis investigating the genetic association between primary breast cancer and colorectal cancer. Front Immunol 2024; 14:1260941. [PMID: 38283349 PMCID: PMC10811019 DOI: 10.3389/fimmu.2023.1260941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 12/26/2023] [Indexed: 01/30/2024] Open
Abstract
Purpose With the advancement in early diagnosis and treatment, the prognosis for individuals diagnosed with breast cancer (BC) has improved significantly. The prognosis of primary breast cancer (PBC) survivors can be significantly influenced by the occurrence of colorectal cancer (CRC) as a secondary primary cancer (SPC). The objective of this study is to explore the possible genetic association between PBC and CRC, aiming to lay a groundwork for the development of preventive strategies against SPC-CRC following BC surgery. Methods We employed a bidirectional two-sample Mendelian randomization (MR) approach to thoroughly examine genetic instrumental variables (IVs) derived from genome-wide association studies (GWAS) conducted on PBC and CRC. And applied inverse variance weighted (IVW) and multiple other MR methods (weighted median, simple median, MR-PRESSO and MR-RAPS) to evaluate the association between the two cancers (PBC and CRC) at genetic level. Furthermore, the robustness of the findings was further confirmed through the utilization of the genetic risk score (GRS) method in a secondary analysis. Results Forward MR analysis, a total of 179 BC genetic IVs, 25 estrogen receptor-negative (ER-) genetic IVs and 135 ER-positive (ER+) genetic IVs were screened. Reverse MR analysis, 179 genetic IVs of CRC, 25 genetic IVs of colon cancer, 135 genetic IVs of rectal cancer, 25 genetic IVs of left colon cancer and 135 genetic IVs of right colon cancer were screened. IVW and other MR methods found no significant genetic association between PBC and CRC (P > 0.05). Subgroup analysis also showed that ER- BC and ER+ BC were not correlated with the occurrence of CRC (P > 0.05). The findings of the secondary analysis using GRS were consistent with those obtained from the primary analysis, thereby confirming the robustness and reliability of this study. Conclusions Our findings do not provide any evidence supporting the association between PBC and CRC at the genetic level. Further large-scale prospective studies are warranted to replicate our findings.
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Affiliation(s)
- Yi Liu
- Department of Digestive System, Anqing Municipal Hospital, Anqing, China
| | - Mingxuan Si
- Department of Thoracic Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yawei Qian
- Department of General Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yang Liu
- School of Economics and Management, Wuhan University, Wuhan, China
| | - Zichen Wang
- Department of Thoracic Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Tongyu Zhang
- Department of Thoracic Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Zhenhuan Wang
- Department of Digestive System, Anqing Municipal Hospital, Anqing, China
| | - Kun Ye
- Department of Digestive System, Anqing Municipal Hospital, Anqing, China
| | - Cuijuan Xiang
- Department of Digestive System, Anqing Municipal Hospital, Anqing, China
| | - Linlin Xu
- Department of Digestive System, Anqing Municipal Hospital, Anqing, China
| | - Yanping Zhang
- Department of Digestive System, Anqing Municipal Hospital, Anqing, China
| | - Zhihan Xiao
- Department of Cardiothoracic Surgery, Wuhu Second People’s Hospital, Wuhu, China
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Parhizgar P, Bahadori Monfared A, Mohseny M, Keramatinia A, Hashemi Nazari SS, Rahman SA, Al Marzouqi A, Al-Yateem N, Mosavi Jarrahi A. Risk of second primary cancer among breast cancer patients: A systematic review and meta-analysis. Front Oncol 2023; 12:1094136. [PMID: 36733366 PMCID: PMC9887162 DOI: 10.3389/fonc.2022.1094136] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 12/20/2022] [Indexed: 01/18/2023] Open
Abstract
Objectives The aim of this study was to estimate the extra risk of second primary cancer among breast cancer patients. Methods and materials This is a systematic review. A comprehensive search of literature was performed in PubMed, Web of Science, Cochrane library, and Scopus. The search included all published studies up to October 2022. This systematic review included studies published in the English language that reported the risk of second primary non-breast cancer [i.e., standardized incidence ratio (SIR)] among breast cancer patients older than 15 years. After evaluating the methodological quality of the selected studies, SIRs were pooled with consideration of heterogeneity among studies. The estimates were pooled by age and time since the diagnosis of primary breast cancer for both sexes (male and female). Age was categorized based on before 50 years and after 50 years, and time was categorized as duration of less than and more than 10 years, respectively. Results From 2,484 articles, 30 articles were eligible for inclusion in the systematic review and meta-analysis. The studies varied in terms of population, number of cases, study design, setting, and year of implementation of the research. The estimated SIR for men and women was 1.28 (95% CI: 1.18, 1.38) and 1.27 (95% CI: 1.15, 1.39), respectively. Women diagnosed with breast cancer before menopause [SIR: 1.52 (95% CI: 1.34, 1.71) vs. 1.21 (95% CI: 1.08, 1.34)] as well as women after 10 years since their breast cancer diagnosis [1.33 (95% CI: 1.22, 1.431) vs. 1.24 (95% CI: 1.10, 1.37)] were at a higher risk of developing second primary cancer. Among men, while there were no differences in risk based on age, with the increase of time, the risk of second primary cancer was reduced [SIR: 1.22 (95% CI: 1.12, 1.33) vs. 1.00 (95% CI: 0.79, 1.22)]. Conclusion There is an extra risk of second primary cancer among breast cancer patients. The extra risk should be considered for further screening and preventive measures among this population. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=336062, identifier (CRD42022336062).
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Affiliation(s)
- Parynaz Parhizgar
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ayad Bahadori Monfared
- Department of Social Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Mohseny
- Department of Social Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Aliasghar Keramatinia
- Department of Social Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Saeed Hashemi Nazari
- Department of Social Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Prevention of Cardiovascular Disease Research Center, Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Syed Azizur Rahman
- Department of Health Service Administration, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Amina Al Marzouqi
- Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Nabeel Al-Yateem
- Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates,*Correspondence: Nabeel Al-Yateem, ; Alireza Mosavi Jarrahi,
| | - Alireza Mosavi Jarrahi
- Department of Social Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Cancer and Epidemiology Research Center, West Asia Organization for Cancer Prevention, Sabzevar, Iran,*Correspondence: Nabeel Al-Yateem, ; Alireza Mosavi Jarrahi,
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Du S, Li Y, Sun H, Deng G, Tang S, Zeng F, Zhang B, Cui B. The risk of developing second primary malignancies among colorectal cancer patients. Aging (Albany NY) 2022; 14:6756-6779. [PMID: 36036758 PMCID: PMC9467398 DOI: 10.18632/aging.204250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 08/17/2022] [Indexed: 11/25/2022]
Abstract
Background: The increasing number of young colorectal cancer (CRC) survivors has led to ongoing concerns about the risk of secondary primary malignancies (SPMs). Here, we intended to comprehensively explore the pooled standardized incidence rates (SIRs) for total and site-specific SPMs in CRC survivors with different restriction to lag period. Methods: Pubmed, Embase, Cochrane Library, and Web of science databases were searched to identify any studies reporting the SIRs of SPM following CRC until August 2021. Total and site-specific SIRs with different restriction to lag period were pooled using fixed/random effect models. Results: A total of 42 full-text publications with more than 1, 524, 236 CRC survivors and 166, 210 SPM patients were included in the meta-analysis. Pooled data showed an increased SIRs for all SPMs in CRC survivors with different restriction to lag period (no restriction to lag period, SIR = 1.15, 95% CI = [1.08–1.23]; 1-year lag, 1.16 [1.10–1.23]; 5-year lag, 1.18 [1.09–1.28]; 10-year lag, 1.24 [1.11–1.39]). The conclusions were consistent for neoplasms of colorectum, corpus uteri, and small intestine with different restriction to lag period. However, limited evidence was presented for associations between CRC survivors and SPM for prostate, breast (female), ovarian, stomach, urinary bladder, kidney, thyroid, bone and soft tissue. Conclusion: CRC survivors are associated with an increased risk of SPMs, especially neoplasms of colorectum, corpus uteri, and small intestine. Further studies should explore the risks for these neoplasms in CRC survivors, thus providing the reference for future follow-up care.
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Affiliation(s)
- Songtao Du
- Department of Colorectal Surgical Oncology, The Tumor Hospital of Harbin Medical University, Harbin 150001, China
| | - Yayun Li
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
- National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha, Hunan 410008, China
| | - Huiyan Sun
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
- National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha, Hunan 410008, China
| | - Guangtong Deng
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
- National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha, Hunan 410008, China
| | - Siyuan Tang
- Department of Gastroenterology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Furong Zeng
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
- National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha, Hunan 410008, China
| | - Bomiao Zhang
- Department of Colorectal Surgical Oncology, The Tumor Hospital of Harbin Medical University, Harbin 150001, China
| | - Binbin Cui
- Department of Colorectal Surgical Oncology, The Tumor Hospital of Harbin Medical University, Harbin 150001, China
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Robertson D, Ng SK, Baade PD, Lam AK. Risk of extracolonic second primary cancers following a primary colorectal cancer: a systematic review and meta-analysis. Int J Colorectal Dis 2022; 37:541-551. [PMID: 35152308 PMCID: PMC8885556 DOI: 10.1007/s00384-022-04105-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/02/2022] [Indexed: 02/04/2023]
Abstract
PURPOSE The purpose of the study is to assess the global risk of extracolonic secondary primary cancers (SPCs) in patients with colorectal cancer (CRC). METHODS Studies of SPC in patients with CRC were included if they reported the standardised incidence ratio (SIR) for extracolonic SPCs in patients with CRC compared with the general population. Pooled summary estimates were calculated using a random-effects model. RESULTS A total of 7,716,750 patients with CRC from 13 retrospective cohort studies that reported extracolonic SPC incidence were included. The overall risk of several SPCs was significantly higher in patients with CRC compared with the general population, including cancers of the urinary bladder (pooled SIR 1.19, 95% confidence interval (CI) 1.06-1.33; p = 0.003), female genital tract (1.88, 1.07-3.31; p = 0.03), kidney (1.50, 1.19-1.89; p = 0.0007), thorax (lung, bronchus and mediastinum) (1.16, 1.01-1.32; p = 0.03), small intestine (4.26, 2.58-7.01; p < 0.0001), stomach (1.22, 1.07-1.39; p = 0.003), and thyroid (1.40, 1.28-1.53; p < 0.0001), as well as melanoma (1.28, 1.01-1.62; p = 0.04). There was also a decreased risk of developing cancer of the gall bladder (0.75, 0.60-0.94; p = 0.01). CONCLUSION Patients with CRC had a significantly increased risk of extracolonic SPCs compared with the general population. These findings highlight the need to develop research strategies for the management of second primary cancer in patients with CRC.
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Affiliation(s)
- Dylan Robertson
- School of Medicine and Dentistry, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Shu Kay Ng
- School of Medicine and Dentistry, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Peter D Baade
- School of Medicine and Dentistry, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
- Cancer Council Queensland, Brisbane, QLD, Australia
| | - Alfred K Lam
- School of Medicine and Dentistry, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia.
- Pathology Queensland, Gold Coast University Hospital, Gold Coast, QLD, Australia.
- Pathology, School of Medicine and Dentistry, Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Southport, QLD, 4222, Australia.
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Kosaka T, Iizuka S, Yoneda T, Otsuki Y, Nakamura T. Solitary pulmonary nodule as the initial manifestation of isolated metastasis from prostate cancer without bone involvement: A case report. Int J Surg Case Rep 2022; 90:106681. [PMID: 34953424 PMCID: PMC8715057 DOI: 10.1016/j.ijscr.2021.106681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 12/07/2021] [Indexed: 12/04/2022] Open
Abstract
Introduction Isolated lung metastases from prostate cancer without any other organ involvement are rare. They are commonly in the form of diffuse or multiple lesions and rarely emerge as a solitary pulmonary nodule. Presentation of case A 61-year-old man who had undergone a laparoscopic-assisted radical prostatectomy for prostate cancer 16 months prior presented with a growing solitary pulmonary nodule. Positron emission tomography/computed tomography showed an abnormal uptake in the nodule without any other organ involvement. A surgical specimen by a thoracoscopic wedge resection proved a diagnosis of a metastasis from prostate cancer. He is currently alive only with worsening pulmonary metastases at 7 years after the lung surgery. Discussion A rare entity of isolated pulmonary metastases could be a sole finding of metastatic prostate cancer over the years and its initial manifestation could emerge as a solitary pulmonary nodule. It poses a diagnostic challenge because primary lung cancer is the leading differential diagnosis of solitary pulmonary nodules and is also one of the most frequent second primary malignancies in prostate cancer survivors. Conclusion An aggressive surgical biopsy is essential for definitive histopathological and immunohistochemical analyses of solitary pulmonary nodules to distinguish a rare form of an isolated pulmonary relapse from a second primary lung cancer in prostate cancer survivors. Isolated pulmonary metastasis without bone involvement from prostate cancer may rarely emerge as a solitary pulmonary nodule. Primary lung cancer is a leading differential diagnosis of solitary pulmonary nodules in general and is also one of the most frequent second primary malignancies in prostate cancer survivors. A surgical lung biopsy is a feasible option for a definitive histoimmunological diagnosis of solitary pulmonary nodules to distinguish a rare form of an isolated pulmonary metastasis from a second primary lung cancer in prostate cancer survivors.
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Affiliation(s)
- Tatsuaki Kosaka
- Department of General Thoracic Surgery, Seirei Hamamatsu General Hospital, 2-12-12, Sumiyoshi, Naka-ku, Hamamatsu-city, Shizuoka 430-8558, Japan.
| | - Shuhei Iizuka
- Department of General Thoracic Surgery, Seirei Hamamatsu General Hospital, 2-12-12, Sumiyoshi, Naka-ku, Hamamatsu-city, Shizuoka 430-8558, Japan.
| | - Tatsuaki Yoneda
- Department of Urology, Seirei Hamamatsu General Hospital, 2-12-12, Sumiyoshi, Naka-ku, Hamamatsu-city, Shizuoka 430-8558, Japan.
| | - Yoshiro Otsuki
- Department of Pathology, Seirei Hamamatsu General Hospital, 2-12-12, Sumiyoshi, Naka-ku, Hamamatsu-city, Shizuoka 430-8558, Japan.
| | - Toru Nakamura
- Department of General Thoracic Surgery, Seirei Hamamatsu General Hospital, 2-12-12, Sumiyoshi, Naka-ku, Hamamatsu-city, Shizuoka 430-8558, Japan.
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Chen C, Xu Y, Huang X, Mao F, Shen S, Xu Y, Sun Q. Clinical characteristics and survival outcomes of patients with both primary breast cancer and primary ovarian cancer. Medicine (Baltimore) 2020; 99:e21560. [PMID: 32769897 PMCID: PMC7593036 DOI: 10.1097/md.0000000000021560] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Breast cancer and ovarian cancer are closely related. The major common risk factors of these 2 types of cancer are likely genetic factors. However, few studies have shown any common characteristics in patients who have both types of these 2 cancers. The purpose of this retrospective study is to explore the clinical characteristics and survival outcomes of patients with both primary breast cancer and primary ovarian cancer.A cohort of patients who had a history of both primary breast cancer and primary ovarian cancer were enrolled, and they received treatment in the Peking Union Medical College Hospital between January 1, 2010, and December 31, 2018. Both descriptive statistics analysis and survival analysis were performed for analysis.A total of 114 patients with both primary breast cancer and primary ovarian cancer were included in the study. The median (range) follow-up was 129.5 (20-492) months. The average interval time between the diagnosis of 2 types of cancer was 79.4 months in patients having ovarian cancer firstly and was 115.9 months in patients having breast cancer firstly. The 5- and 10-year overall survival (OS) rates were 91.5% and 81.7% for patients with ovarian cancer following breast cancer, respectively, and 90.6% and 87.5% for patients with breast cancer following ovarian cancer, respectively. Multivariate analysis revealed that independent predictors of OS were the age of diagnosis of the first tumor and the time interval between two types of tumor in patients with ovarian cancer following breast cancer.Most breast cancer or ovarian cancer occurred within 5 years after being diagnosed with the first tumor, and the interval time was significantly shorter in patients with previous ovarian cancer. The prognosis is likely positively correlated to the interval time between the occurrences of two types of cancer.
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Kim HS, Choi YJ, Shin DW, Han KD, Yoon H, Shin CM, Park YS, Kim N, Lee DH. Secondary Primary Prostate Cancer after Colorectal Cancer: A Nationwide Population-based Cohort Study in Korea. J Cancer Prev 2017; 22:241-247. [PMID: 29302582 PMCID: PMC5751842 DOI: 10.15430/jcp.2017.22.4.241] [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: 11/30/2017] [Revised: 12/15/2017] [Accepted: 12/15/2017] [Indexed: 01/05/2023] Open
Abstract
Background Colorectal cancer (CRC) and prostate cancer frequently occur in developed countries. There are several reports on the association between CRC and prostate cancer; however, the conclusions are inconsistent to investigate the association of the development of secondary primary prostate cancer among patients with prior primary CRC using a nationwide population-based dataset. Methods Patients registered in the Republic of Korea National Health Insurance System database who were diagnosed with CRC between 2007 and 2012 were followed-up until the end of 2015, and we investigated the new diagnosis secondary primary prostate cancer. We compared the incidence of prostate cancer in age-matched controls using the Cox proportional hazards models. Results We analyzed a total of 85,455 first primary CRC survivors. During the follow-up period of 494,222 person-years, 2,005 patients (2.30%) developed secondary primary prostate cancer (incidence rate 4.06/1,000 person-years). The median duration of follow-up was 5.78 years. Compared with the general population, CRC patients had a significantly increased risk of secondary primary prostate cancer (HR = 2.30, 95% CI = 2.18–2.43; P < 0.001). Multivariate analysis (including age, sex, body mass index, hypertension, diabetes mellitus, dyslipidemia, and income) showed that age < 55 years (HR = 20.74, 95% CI = 11.81–36.41; P < 0.001) is a significant independent predictor of secondary primary prostate cancer development. Conclusions Men diagnosed with colorectal cancer are at an increased risk of secondary primary prostate cancer, particularly those aged < 55 years. The data suggests that colorectal cancer patients aged < 55 years require regular screening for prostate cancer.
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Affiliation(s)
- Hyun Soo Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Yoon Jin Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Dong Woo Shin
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Kyung-Do Han
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyuk Yoon
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Cheol Min Shin
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Young Soo Park
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Nayoung Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Dong Ho Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
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Lai JH, Park G, Gerson LB. Association between breast cancer and the risk of colorectal cancer. Gastrointest Endosc 2017; 86:429-441.e1. [PMID: 28433614 DOI: 10.1016/j.gie.2017.04.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 04/10/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND The literature to date has suggested a potential increase in colorectal cancer (CRC) among patients with breast cancer. METHODS We performed a systematic review of the literature and included 37 retrospective cohort studies and 8 case-control studies. The primary aim was to determine the prevalence of CRC. Secondary aims included analysis of adenomatous polyps and analysis of CRC prevalence by age. We calculated pooled prevalence rates and odds ratios (ORs) using random effects models with 95% confidence intervals (CI). RESULTS We identified 1,055,917 individuals with breast cancer among whom 9097 cases of CRC were detected. The pooled event rate for CRC was 0.7% (95% CI, 0.6%-0.9%; I2=97%). Four case-control studies reported prevalence of CRC (N=17,873 patients with breast cancer and 70,366 controls), including 46 cases of CRC in the patients with breast cancer, and 272 CRC in the controls (OR, 1.2; 95% CI, 0.4%-3.7%; P = .7). Six studies reported prevalence of advanced adenomas in patients with breast cancer (N=1087) compared with controls (N=1356) with 62 cases of advanced adenomas in patients compared with 47 in the controls (OR, 1.5; 95% CI, 0.97-2.2; P = .07). In patients with breast cancer <50 years old (4 studies, N=64,706), the pooled OR was increased (OR, 2.5; 95% CI, 1.7-3.5; P =.001). In 3 studies of women <45 years old (N=92,594), the risk was increased (OR, 2.3; 95% CI, 1.7-2.6; P < .001). CONCLUSIONS Patients with breast cancer should not undergo CRC screening at intervals different from the general population. In patients with breast cancer <50 years old, CRC screening should be considered at age 45 years.
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Affiliation(s)
- Jennifer H Lai
- Department of Gastroenterology, California Pacific Medical Center, San Francisco, California, USA
| | - Gavin Park
- Department of Internal Medicine, California Pacific Medical Center, San Francisco, California, USA
| | - Lauren B Gerson
- Department of Gastroenterology, California Pacific Medical Center, San Francisco, California, USA; Department of Medicine, University of California, San Francisco, California, USA
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Gynecological Cancer as a Second Malignancy in Patients With Breast Cancer. Int J Gynecol Cancer 2017; 27:1298-1304. [DOI: 10.1097/igc.0000000000000993] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PurposeThe aim of this study was to determine the incidence and risk factors for gynecological cancer as second malignancy (SM) after treatment of breast cancer (BC).Methods and MaterialsBetween January 1985 and December 2007, a total of 2756 patients with BC were analyzed for gynecological cancers as an SM. Analysis was carried out for patient-, disease-, and treatment-related characteristics. The Cox proportional hazards regression model was used to estimate the relative risk of gynecologic malignancies.ResultsThe median age at BC diagnosis was 49 years and median follow-up of 14 years. In total, 25 cases of gynecological cancer were noted with an incidence of 0.9%. We observed 9 ovarian and endometrium (0.3%) as well as 7 uterine cervix (0.25%) cancers. Family history of BC was the most significant risk factor for SM (relative risk, 7.4; 95% confidence interval, 3.03–18.28; P<0.001). Women with a family history of BC had a higher incidence of endometrial (12%) and ovarian (16%) cancer compared with those who have no family history (0.1%, P = 0.003). Statistically significant higher incidence of endometrial cancer was seen in patients undergoing hormonal therapy (0.4%) as compared with those who are not undergoing hormonal therapy (0.1%, P = 0.001). Most of the endometrial (88.9%) and cervical (71%) cancers were detected at an early stage but ovarian cancers (66.6%) in advanced stage. Chemotherapy and radiotherapy did not increase the risk of gynecological SM.ConclusionsWomen with BC are at risk of developing a second primary gynecological malignancy particularly of endometrium and ovary. Family history of BC was a high risk factor for gynecologic SM. These patients should be followed up for its early detection.
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Lee JN, Park YH, Han J, Baek JH, Park SW, Lee WS. Clinical and pathological evaluation of patients with prostate and colorectal cancer five or more years after curative resection. SURGICAL PRACTICE 2017. [DOI: 10.1111/1744-1633.12236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Jung Nam Lee
- Department of Surgery; Gachon University; Incheon Korea
| | - Yeon Ho Park
- Department of Surgery; Gachon University; Incheon Korea
| | - Jung Han
- Department of Surgery; Gachon University; Incheon Korea
- Department of Urology; Gachon University; Incheon Korea
| | | | - Sung Won Park
- Department of Surgery; Gachon University; Incheon Korea
| | - Won-Suk Lee
- Department of Surgery; Gachon University; Incheon Korea
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12
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Fan CY, Huang WY, Lin CS, Su YF, Lo CH, Tsao CC, Liu MY, Lin CL, Kao CH. Risk of second primary malignancies among patients with prostate cancer: A population-based cohort study. PLoS One 2017; 12:e0175217. [PMID: 28384363 PMCID: PMC5383246 DOI: 10.1371/journal.pone.0175217] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 03/16/2017] [Indexed: 11/22/2022] Open
Abstract
Purpose The rising incidence and life expectancy associated with prostate cancer (PCa) has led to increasing interest in predicting the risk of second primary malignancies (SPMs) among PCa survivors, although data regarding SPMs after PCa are controversial. Methods We identified 30,964 patients from the National Health Insurance Research Database in Taiwan who had newly diagnosed PCa between 2000 and 2010. Each patient was randomly frequency-matched with an individual without PCa, based on age, comorbidity, and index year. Competing-risks regression models were used to estimate subhazard ratios (SHRs) of SPMs development associated with PCa. The Bonferroni adjustment was used in multiple comparisons. Results Men with PCa had a trend of lower risk of developing overall SPMs compared to those without PCa (adjusted SHR = 0.94, 99.72% confidence interval [CI] = 0.89–1.00, p = 0.06). The risks of lung and liver cancer were significantly lower. In contrast, these patients had a significantly higher risk of thyroid cancer. There is a trend for a higher risk of developing SPMs in the urinary bladder and rectum/anus. Further analyses indicated that PCa patients who received radiation therapy (RT) had an increased risk of overall SPMs, hematologic malignancies, esophageal cancer, liver cancer, lung cancer, and urinary bladder cancer compared with those who did not receive RT. Conclusion Men with PCa tended to have a lower risk of SPMs, but a significantly higher risk of subsequent thyroid cancer. Continued cancer surveillance is required among PCa survivors, especially in specific sites and in individuals who received RT.
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Affiliation(s)
- Chao-Yueh Fan
- Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Wen-Yen Huang
- Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chun-Shu Lin
- Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Fu Su
- Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Cheng-Hsiang Lo
- Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chih-Cheng Tsao
- Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Ming-Yueh Liu
- Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Chia-Hung Kao
- Graduate Institute of Clinical Medical Science, School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
- * E-mail:
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13
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Abstract
Nowadays, the risk of developing second primary cancers among women diagnosed with prior breast cancer represents a public health issue worldwide.Twenty-eight cases of the primary breast cancer with the multiple primary cancers (MPC) between 2008 and 2015 at our hospital were retrospectively analyzed in regards to age of patients, family history, interval time of the 2 cancers, and survival time of these patients.A total 28 cases were analyzed, at the mean age of 44.57 years at the diagnosis of the first primary cancer. The most common primary cancer in these breast cancer patients was contralateral breast cancer. Of 28 patients with breast cancer, 16 developed a second malignant tumor of the opposite breast, there were no significant difference both median age at first breast cancer and second breast cancer (P > .05). The difference of interval time of 2 cancers also had no statistical significance. There was no statistically significant difference in overall survival between the bilateral primary breast cancers (BPBC) group and the group of breast cancer patients who diagnosed with another cancer (P > .05). If we grouped patients age of diagnosed with the first cancer (<45, ≥45 years), no statistical different between 2 groups (P > .05). However, the survival time with positive-node patients was lower than in patients with node-negative, the difference had a notable significant difference (P < .01). And there are 3 cases had a positive family history for malignant tumor in the form of first-degree relative.Multiple primary carcinoma in patients with prior breast cancer is not the influencing factor of prognosis. It is crucial to detect, diagnose, and treat cancers at their early stage for improving the cure rate of cancer and the survival rate of patients.
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Affiliation(s)
- YiHui Liu
- Department of Oncology, The First Affiliated Hospital of Xi’an JiaoTong University, Xi’an, Shaanxi
| | - ChunHui Dong
- Department of Oncology, The First Affiliated Hospital of Xi’an JiaoTong University, Xi’an, Shaanxi
- Department of Oncology, The Ninth Hospital of Xi’an, Xi’an, P.R. China
| | - Ling Chen
- Department of Oncology, The First Affiliated Hospital of Xi’an JiaoTong University, Xi’an, Shaanxi
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14
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Jayasekara H, Reece JC, Buchanan DD, Ahnen DJ, Parry S, Jenkins MA, Win AK. Risk factors for metachronous colorectal cancer or polyp: A systematic review and meta-analysis. J Gastroenterol Hepatol 2017; 32:301-326. [PMID: 27356122 DOI: 10.1111/jgh.13476] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/20/2016] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND AIM We conducted a systematic review and meta-analysis to identify personal, lifestyle, and tumor-related risk factors for metachronous colorectal cancer (CRC) and polyp. METHODS Relevant studies were identified by searching MEDLINE, Web of Science and Cochrane Central Register through 15 May 2016. Estimates for associations were summarized using random effects models. RESULTS Fifty-five studies were included in the review. For individuals who had a CRC resection, having a synchronous polyp was a risk factor for metachronous CRC or polyp (relative risk [RR], 2.04; 95% confidence interval [CI], 1.48-2.82) and having a synchronous CRC (RR, 1.90; 95% CI, 1.25-2.91) and proximally located CRC (RR, 2.12; 95% CI, 1.24-3.64) were risk factors for metachronous CRC. For individuals who had a polypectomy, larger size (RR, 4.26; 95% CI, 2.11-8.57) or severe dysplasia of the initial polyp (RR, 5.15; 95% CI, 2.02-13.14), and having a synchronous polyp (RR, 2.52; 95% CI, 1.35-4.73) were risk factors for metachronous CRC; and a family history of CRC (RR, 1.90; 95% CI, 1.26-2.87), having a synchronous polyp (RR, 2.47; 95% CI, 1.74-3.50) and a larger size (RR, 1.49; 95% CI, 1.03-2.15) and proximal location of the initial polyp (RR, 1.20; 95% CI, 1.02-1.40) were risk factors for metachronous polyp. Meta-regression showed duration of follow-up was not a source of heterogeneity for most associations. There was no evidence that lifestyle factors were associated with metachronous CRC or polyp risk. CONCLUSION A comprehensive list of risk factors identified for metachronous CRC or polyp may have important clinical implications.
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Affiliation(s)
- Harindra Jayasekara
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia.,Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Jeanette C Reece
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Daniel D Buchanan
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia.,Colorectal Oncogenomics Group, Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Parkville, Victoria, Australia
| | - Dennis J Ahnen
- Department of Medicine, University of Colorado School of Medicine, Denver, Colorado, USA
| | - Susan Parry
- New Zealand Familial Gastrointestinal Cancer Service, Auckland, New Zealand
| | - Mark A Jenkins
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Aung Ko Win
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
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15
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Lee YT, Liu CJ, Hu YW, Teng CJ, Tzeng CH, Yeh CM, Chen TJ, Lin JK, Lin CC, Lan YT, Wang HS, Yang SH, Jiang JK, Chen WS, Lin TC, Chang SC, Chen MH, Teng HW, Liu JH, Yen CC. Incidence of Second Primary Malignancies Following Colorectal Cancer: A Distinct Pattern of Occurrence Between Colon and Rectal Cancers and Association of Co-Morbidity with Second Primary Malignancies in a Population-Based Cohort of 98,876 Patients in Taiwan. Medicine (Baltimore) 2015; 94:e1079. [PMID: 26131831 PMCID: PMC4504576 DOI: 10.1097/md.0000000000001079] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The purpose of this study is to determine the features of second primary malignancies (SPMs) among patients with prior colorectal cancer (CRC) using a nationwide population-based dataset.Patients with CRC newly diagnosed between 1996 and 2011, and >1 year of follow-up were recruited from the Taiwan National Health Insurance database. Standardized incidence ratios (SIRs) of SPMs in patients with CRC were calculated.During the 16-year study period, 4259 SPMs developed among 98,876 CRC patients. The median duration of follow-up was 4.03 years. The SIR for all SPMs was 1.13 (95% confidence interval = 1.10-1.17). Compared with the general population, a higher incidence of thyroid, prostate, ovarian, and hematologic malignancies developed among patients with colon cancer, whereas the risk for bone and soft tissue cancers increased among patients with rectal cancer. The risk for breast, bladder, kidney, lung, and uterine cancers was significantly higher in patients with colon and rectal cancers than the general population. The risk for liver and biliary tract cancers declined in patients with rectal cancer. Based on multivariate analysis among patients with CRC, age ≥70 years, men, chronic obstructive pulmonary disease (COPD), cirrhosis, and dyslipidemia were independent predictors of an SPM.In conclusion, patients with CRC were at increased risk for a second cancer. The pattern of SPMs was distinct between patients with colon and rectal cancer. Age, men, COPD, cirrhosis, and dyslipidemia were independent risk factors for SPMs. Surveillance and education should be provided for survivors with respect to risk for SPMs.
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Affiliation(s)
- Yu-Ting Lee
- From the Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan (Y-TL, C-JL, C-HT, M-HC, H-WT, C-CY); National Yang-Ming University School of Medicine, Taipei, Taiwan (Y-TL, C-JL, , Y-WH, C-JT, C-HT, T-JC, J-KL, C-CL, Y-TL, H-SW, S-HY, J-KJ, W-SC, T-CL, S-CC, M-HC, H-WT, J-HL, C-CY); Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan (Y-WH, J-HL); Division of Oncology and Hematology, Department of Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan (C-JT); Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan (C-MY, T-JC); and Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan (J-KL, C-CL, Y-TL, H-SW, S-HY, J-KJ, W-SC, T-CL, S-CC)
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16
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Risk of second cancers cancer after a first primary breast cancer: a systematic review and meta-analysis. Gynecol Oncol 2014; 136:158-71. [PMID: 25448459 DOI: 10.1016/j.ygyno.2014.10.029] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 10/28/2014] [Accepted: 10/29/2014] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To examine the scientific evidence and the risk of second primary cancers in women diagnosed with a first primary breast cancer. METHODS The literature was searched in Pubmed and Embase and included studies published up to June 2013, using population-based data and IARC/AICR codification rules for multiple primary cancers. A qualitative synthesis was carried out and the methodological quality of the studies evaluated. Standardised incidence ratios (SIRs) on second cancer risk, weighted by the standard error of each study, were pooled using fixed and random effects models. SIRs were also pooled by age at diagnosis (<50 and ≥ 50 years), and time since diagnosis of the first breast cancer (<10 and ≥ 10 years). RESULTS 15 out of 710 articles fulfilled the inclusion criteria. All of them were retrospective cohort studies either population-based (13 studies) or hospital-based studies (2 studies). The studies varied with respect to number of cases, selection criteria, definition of multiple primary cancers, and the second cancer sites included. SIRs reported in these studies for all cancers combined varied from 1.0 to 1.4. The pooled SIR estimate for second cancer risk was 1.17 (95% CI: 1.10-1.25). By age groups, SIR estimates were 1.51 (95% CI: 1.35-1.70) for women younger than 50 years and 1.11 (95% CI: 1.02-1.21) for those who were older. Women with breast cancer are at risk of second cancers within the first 10 years after the first breast cancer diagnosis (SIR: 1.19; 95% CI: 1.06-1.33), and thereafter (SIR: 1.26; 95% CI: 1.05-1.52). CONCLUSION This higher risk of second cancers in women diagnosed with a first primary breast cancer with respect to the general population emphasises the importance of prevention and control policies aimed at reducing incidence of second cancers.
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Gibson TM, Park Y, Robien K, Shiels MS, Black A, Sampson JN, Purdue MP, Freeman LEB, Andreotti G, Weinstein SJ, Albanes D, Fraumeni JF, Curtis RE, Berrington de Gonzalez A, Morton LM. Body mass index and risk of second obesity-associated cancers after colorectal cancer: a pooled analysis of prospective cohort studies. J Clin Oncol 2014; 32:4004-11. [PMID: 25267739 DOI: 10.1200/jco.2014.56.8444] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
PURPOSE To determine whether prediagnostic body mass index (BMI) is associated with risk of second obesity-associated cancers in colorectal cancer (CRC) survivors, and whether CRC survivors have increased susceptibility to obesity-associated cancer compared with cancer-free individuals. PATIENTS AND METHODS Incident first primary CRC cases (N = 11,598) were identified from five prospective cohort studies. We used Cox proportional hazards regression models to examine associations between baseline (prediagnostic) BMI and risk of second obesity-associated cancers (postmenopausal breast, kidney, pancreas, esophageal adenocarcinoma, endometrium) in CRC survivors, and compared associations to those for first obesity-associated cancers in the full cohort. RESULTS Compared with survivors with normal prediagnostic BMI (18.5-24.9 kg/m(2)), those who were overweight (25-29.9 kg/m(2)) or obese (30+ kg/m(2)) had greater risk of a second obesity-associated cancer (n = 224; overweight hazard ratio [HR], 1.39; 95% CI, 1.01 to 1.92; obese HR, 1.47; 95% CI, 1.02 to 2.12; per 5-unit change in BMI HR, 1.12; 95% CI, 0.98 to 1.29). The magnitude of risk for developing a first primary obesity-associated cancer was similar (overweight HR, 1.18; 95% CI, 1.14 to 1.21; obese HR, 1.61; 95% CI, 1.56 to 1.66; per 5-unit change in BMI HR, 1.23; 95% CI, 1.21 to 1.24). Before diagnosis CRC patients were somewhat more likely than the overall cohort to be overweight (44% v 41%) or obese (25% v 21%). CONCLUSION CRC survivors who were overweight or obese before diagnosis had increased risk of second obesity-associated cancers compared with survivors with normal weight. The risks were similar in magnitude to those observed for first cancers in this population, suggesting increased prevalence of overweight or obesity, rather than increased susceptibility, may contribute to elevated second cancer risks in colorectal cancer survivors compared with the general population. These results support emphasis of existing weight guidelines for this high-risk group.
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Affiliation(s)
- Todd M Gibson
- Todd M. Gibson, Yikyung Park, Meredith S. Shiels, Amanda Black, Joshua N. Sampson, Mark P. Purdue, Laura E. Beane Freeman, Gabriella Andreotti, Stephanie J. Weinstein, Demetrius Albanes, Joseph F. Fraumeni Jr, Rochelle E. Curtis, Amy Berrington de Gonzalez, Lindsay M. Morton, National Cancer Institute, Bethesda, MD; and Kim Robien, Milken Institute School of Public Health, George Washington University, Washington, DC.
| | - Yikyung Park
- Todd M. Gibson, Yikyung Park, Meredith S. Shiels, Amanda Black, Joshua N. Sampson, Mark P. Purdue, Laura E. Beane Freeman, Gabriella Andreotti, Stephanie J. Weinstein, Demetrius Albanes, Joseph F. Fraumeni Jr, Rochelle E. Curtis, Amy Berrington de Gonzalez, Lindsay M. Morton, National Cancer Institute, Bethesda, MD; and Kim Robien, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Kim Robien
- Todd M. Gibson, Yikyung Park, Meredith S. Shiels, Amanda Black, Joshua N. Sampson, Mark P. Purdue, Laura E. Beane Freeman, Gabriella Andreotti, Stephanie J. Weinstein, Demetrius Albanes, Joseph F. Fraumeni Jr, Rochelle E. Curtis, Amy Berrington de Gonzalez, Lindsay M. Morton, National Cancer Institute, Bethesda, MD; and Kim Robien, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Meredith S Shiels
- Todd M. Gibson, Yikyung Park, Meredith S. Shiels, Amanda Black, Joshua N. Sampson, Mark P. Purdue, Laura E. Beane Freeman, Gabriella Andreotti, Stephanie J. Weinstein, Demetrius Albanes, Joseph F. Fraumeni Jr, Rochelle E. Curtis, Amy Berrington de Gonzalez, Lindsay M. Morton, National Cancer Institute, Bethesda, MD; and Kim Robien, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Amanda Black
- Todd M. Gibson, Yikyung Park, Meredith S. Shiels, Amanda Black, Joshua N. Sampson, Mark P. Purdue, Laura E. Beane Freeman, Gabriella Andreotti, Stephanie J. Weinstein, Demetrius Albanes, Joseph F. Fraumeni Jr, Rochelle E. Curtis, Amy Berrington de Gonzalez, Lindsay M. Morton, National Cancer Institute, Bethesda, MD; and Kim Robien, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Joshua N Sampson
- Todd M. Gibson, Yikyung Park, Meredith S. Shiels, Amanda Black, Joshua N. Sampson, Mark P. Purdue, Laura E. Beane Freeman, Gabriella Andreotti, Stephanie J. Weinstein, Demetrius Albanes, Joseph F. Fraumeni Jr, Rochelle E. Curtis, Amy Berrington de Gonzalez, Lindsay M. Morton, National Cancer Institute, Bethesda, MD; and Kim Robien, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Mark P Purdue
- Todd M. Gibson, Yikyung Park, Meredith S. Shiels, Amanda Black, Joshua N. Sampson, Mark P. Purdue, Laura E. Beane Freeman, Gabriella Andreotti, Stephanie J. Weinstein, Demetrius Albanes, Joseph F. Fraumeni Jr, Rochelle E. Curtis, Amy Berrington de Gonzalez, Lindsay M. Morton, National Cancer Institute, Bethesda, MD; and Kim Robien, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Laura E Beane Freeman
- Todd M. Gibson, Yikyung Park, Meredith S. Shiels, Amanda Black, Joshua N. Sampson, Mark P. Purdue, Laura E. Beane Freeman, Gabriella Andreotti, Stephanie J. Weinstein, Demetrius Albanes, Joseph F. Fraumeni Jr, Rochelle E. Curtis, Amy Berrington de Gonzalez, Lindsay M. Morton, National Cancer Institute, Bethesda, MD; and Kim Robien, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Gabriella Andreotti
- Todd M. Gibson, Yikyung Park, Meredith S. Shiels, Amanda Black, Joshua N. Sampson, Mark P. Purdue, Laura E. Beane Freeman, Gabriella Andreotti, Stephanie J. Weinstein, Demetrius Albanes, Joseph F. Fraumeni Jr, Rochelle E. Curtis, Amy Berrington de Gonzalez, Lindsay M. Morton, National Cancer Institute, Bethesda, MD; and Kim Robien, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Stephanie J Weinstein
- Todd M. Gibson, Yikyung Park, Meredith S. Shiels, Amanda Black, Joshua N. Sampson, Mark P. Purdue, Laura E. Beane Freeman, Gabriella Andreotti, Stephanie J. Weinstein, Demetrius Albanes, Joseph F. Fraumeni Jr, Rochelle E. Curtis, Amy Berrington de Gonzalez, Lindsay M. Morton, National Cancer Institute, Bethesda, MD; and Kim Robien, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Demetrius Albanes
- Todd M. Gibson, Yikyung Park, Meredith S. Shiels, Amanda Black, Joshua N. Sampson, Mark P. Purdue, Laura E. Beane Freeman, Gabriella Andreotti, Stephanie J. Weinstein, Demetrius Albanes, Joseph F. Fraumeni Jr, Rochelle E. Curtis, Amy Berrington de Gonzalez, Lindsay M. Morton, National Cancer Institute, Bethesda, MD; and Kim Robien, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Joseph F Fraumeni
- Todd M. Gibson, Yikyung Park, Meredith S. Shiels, Amanda Black, Joshua N. Sampson, Mark P. Purdue, Laura E. Beane Freeman, Gabriella Andreotti, Stephanie J. Weinstein, Demetrius Albanes, Joseph F. Fraumeni Jr, Rochelle E. Curtis, Amy Berrington de Gonzalez, Lindsay M. Morton, National Cancer Institute, Bethesda, MD; and Kim Robien, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Rochelle E Curtis
- Todd M. Gibson, Yikyung Park, Meredith S. Shiels, Amanda Black, Joshua N. Sampson, Mark P. Purdue, Laura E. Beane Freeman, Gabriella Andreotti, Stephanie J. Weinstein, Demetrius Albanes, Joseph F. Fraumeni Jr, Rochelle E. Curtis, Amy Berrington de Gonzalez, Lindsay M. Morton, National Cancer Institute, Bethesda, MD; and Kim Robien, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Amy Berrington de Gonzalez
- Todd M. Gibson, Yikyung Park, Meredith S. Shiels, Amanda Black, Joshua N. Sampson, Mark P. Purdue, Laura E. Beane Freeman, Gabriella Andreotti, Stephanie J. Weinstein, Demetrius Albanes, Joseph F. Fraumeni Jr, Rochelle E. Curtis, Amy Berrington de Gonzalez, Lindsay M. Morton, National Cancer Institute, Bethesda, MD; and Kim Robien, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Lindsay M Morton
- Todd M. Gibson, Yikyung Park, Meredith S. Shiels, Amanda Black, Joshua N. Sampson, Mark P. Purdue, Laura E. Beane Freeman, Gabriella Andreotti, Stephanie J. Weinstein, Demetrius Albanes, Joseph F. Fraumeni Jr, Rochelle E. Curtis, Amy Berrington de Gonzalez, Lindsay M. Morton, National Cancer Institute, Bethesda, MD; and Kim Robien, Milken Institute School of Public Health, George Washington University, Washington, DC
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Jégu J, Colonna M, Daubisse-Marliac L, Trétarre B, Ganry O, Guizard AV, Bara S, Troussard X, Bouvier V, Woronoff AS, Velten M. The effect of patient characteristics on second primary cancer risk in France. BMC Cancer 2014; 14:94. [PMID: 24528929 PMCID: PMC3927622 DOI: 10.1186/1471-2407-14-94] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Accepted: 02/12/2014] [Indexed: 01/07/2023] Open
Abstract
Background Although cancer survivors are known to be at greater risk of developing second primary cancer (SPC), SPC incidence estimates in France are thus far lacking. We used a multivariate approach to compute these estimates and analyzed the effect of patient characteristics (gender, age at diagnosis, first cancer site, year of diagnosis and follow-up) on SPC risk. Methods Data from ten French population-based cancer registries were used to establish a cohort of all patients diagnosed with a first cancer between 1989 and 2004 and followed up until December 31, 2007. The person-year approach was used to estimate standardized incidence ratios (SIRs) and excess absolute risks (EARs) of metachronous SPC. Multivariate Poisson regression models were then used to model SIRs and EARs separately by gender, adjusting for age, year of diagnosis, follow-up and first cancer site. Results Among the 289,967 followed-up patients with a first primary cancer, 21,226 developed a SPC. The SIR was of 1.36 (95% CI, 1.35-1.38) and the EAR was of 39.4 excess cancers per 10,000 person-years (95% CI, 37.4-41.3). Among male and female patients, multivariate analyses showed that age, year of diagnosis, follow-up and first cancer site were often independently associated with SIRs and EARs. Moreover, the EAR of SPC remained elevated during patient follow-up. Conclusions French cancer survivors face a dramatically increased risk of SPC which is probably related to the high rate of tobacco and alcohol consumption in France. Multivariate modeling of SPC risk will facilitate the construction of a tailored prediction tool to optimize SPC prevention and early detection strategies.
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Affiliation(s)
- Jérémie Jégu
- Registre des cancers du Bas-Rhin, Laboratoire d'Épidémiologie et de Santé Publique, EA3430, FMTS, Université de Strasbourg, 4 rue Kirschleger, Strasbourg, CEDEX 67085, France.
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Baena-Cañada JM, Ramírez-Daffós P, Cortés-Carmona C, Rosado-Varela P, Nieto-Vera J, Benítez-Rodríguez E. Follow-up of long-term survivors of breast cancer in primary care versus specialist attention. Fam Pract 2013; 30:525-32. [PMID: 23813864 DOI: 10.1093/fampra/cmt030] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Hospitals have traditionally been the place where the follow-up of breast cancer patients occurs in Spain. OBJECTIVE To describe the evolution of long-term survivors of breast cancer according to type of follow-up received (in primary or specialist/hospital care), measuring impact of care type on health, cost, health-related quality of life (HRQL) and satisfaction results. METHOD Retrospective study of cohorts with disease-free patients followed up for at least 5 years in Oncology. Using personal questionnaires, the type and cost of the follow-up, events, HRQL and satisfaction were analysed. RESULTS Ninety-eight women were surveyed, 60 in primary and 38 in specialist care. There were no differences between groups in diagnosis of metastasis or new primary tumours. The number of annual visits per patient was 0.98 (0.48) in primary and 1.11 (0.38) in specialist care (P = 0.19). In primary, 44.6% were programmed and 55.4% on demand; in specialist, 94.6% were programmed and 5.4% on demand (P = 0.0001). The costs of follow-up in primary care were lower--€112.86 (77.54) versus €184.61 (85.87) per patient and year (P = 0.0001). No differences were reported in HRQL. Preference for specialist care was expressed by 80%, versus 10% for primary, with 10% indifferent. Patients showed greater satisfaction with specialist care in all questionnaire dimensions. CONCLUSIONS Compliance with follow-up protocol was high in both groups. In specialist care nearly all the visits were programmed and in primary almost half were on demand. In our locality, primary is more cost-effective than specialist care, but patients express greater satisfaction with specialist follow-up and hence prefer it.
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Yu XQ, Clements M, O’Connell D. Projections of cancer prevalence by phase of care: a potential tool for planning future health service needs. J Cancer Surviv 2013; 7:641-51. [DOI: 10.1007/s11764-013-0303-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Accepted: 07/22/2013] [Indexed: 10/26/2022]
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Molina-Montes E, Pollán M, Payer T, Molina E, Dávila-Arias C, Sánchez MJ. Risk of second primary cancer among women with breast cancer: a population-based study in Granada (Spain). Gynecol Oncol 2013; 130:340-5. [PMID: 23648471 DOI: 10.1016/j.ygyno.2013.04.057] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Revised: 04/23/2013] [Accepted: 04/25/2013] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The higher risk of developing new cancers in breast cancer survivors is a public health concern. Our aim was to examine risk of second primary cancers among women diagnosed with breast cancer. METHODS We studied two cohorts of female cancer patients identified in a population-based cancer registry in Granada (Spain): women first diagnosed with a primary breast cancer (n=5897) and those with a primary cancer in another site (n=22,814), followed during 1985-2007 for second cancers and breast cancer occurrence, respectively. We used Standardized Incidence Ratios (SIRs) to estimate second cancer risk by age (<50y, ≥50y), time since diagnosis (≤5y, >5y) and calendar periods (≤1995, >1996). SIR for breast cancer was calculated in the second cohort. RESULTS The risk of developing second cancers (n=314) was 39% higher (95% CI=1.23-1.54) among breast cancer patients, and particularly high among women under 50 (SIR=1.96, 95% CI=1.48-2.44). Excess risk for endometrial cancer (SIR=3.04, 95% CI=2.14-3.94) was statistically significant and remained so in women over 50. Younger women were at higher risk of second ovarian cancer (SIR=4.90, 95% CI=1.27-8.53). Increased SIRs were observed during the first five years after breast cancer diagnosis, whereas SIRs decreased thereafter. Breast cancer incidence (n=171) was not higher among women previously diagnosed with other cancer types (SIR=0.86, 95% CI=0.74-1.00). CONCLUSION Women diagnosed with breast cancer have a higher incidence of second primary cancers, particularly of endometrial cancer in women over 50 at diagnosis, and ovarian cancer in younger women. These findings may be explained by treatment-related effects or shared risk factors.
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Affiliation(s)
- Esther Molina-Montes
- Andalusian School of Public Health, Granada Cancer Registry, Campus Universitario de Cartuja, Cuesta del Observatorio 4, E-18080 Granada, Spain
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Shukla A, Shukla S, Osowo A, Mashtare T, Bhutani MS, Guha S. Risk of colorectal adenomas in women with prior breast cancer. Dig Dis Sci 2012; 57:3240-5. [PMID: 23065089 DOI: 10.1007/s10620-012-2432-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Accepted: 09/21/2012] [Indexed: 01/23/2023]
Abstract
BACKGROUND AND AIMS Longer life expectancy in patients with prior breast cancer may increase their risk of developing other primary cancers, including colorectal cancer (CRC). Whether the risk of developing CRC in this patient population is higher in comparison to those with no prior cancer remains unclear. The purpose of this study was to compare the prevalence of colorectal adenomas and any CRC in breast cancer survivors with those who have no history of prior cancer and assess any difference with use of antiestrogen therapy. METHODS We compared the prevalence of colorectal cancer and adenomas in breast cancer survivors with that of a group of matched controls. Eligible survivors were ≤85 years of age; had initially been diagnosed with stage 0, I, II, or III breast cancer; had completed all cancer treatments with the exception of adjuvant antiestrogen therapy; and had no evidence of recurrence on follow-up. We used the screening colonoscopy database at our institution to identify age-, sex-, and race-matched controls with no history of cancer. RESULTS We identified 302 study-eligible breast cancer survivors and 302 matched controls. No colorectal cancers were found in either group. Forty-one breast cancer survivors and 30 controls had tubular adenomas; four survivors and three controls had villous adenoma; and eight survivors and ten controls had advanced adenoma. Multivariate regression analysis revealed that adjuvant antiestrogen therapy was not significantly associated with an increased risk of advanced adenoma. CONCLUSIONS The prevalence of colorectal adenomas in breast cancer survivors and controls was similar. Breast cancer survivors, including those receiving adjuvant antiestrogen therapies may follow the colorectal screening guidelines used for average-risk population.
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Affiliation(s)
- Ashish Shukla
- Department of Medicine, University at Buffalo, 462 Grider Street, Buffalo, NY 14215, USA.
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Cardoso F, Loibl S, Pagani O, Graziottin A, Panizza P, Martincich L, Gentilini O, Peccatori F, Fourquet A, Delaloge S, Marotti L, Penault-Llorca F, Kotti-Kitromilidou AM, Rodger A, Harbeck N. The European Society of Breast Cancer Specialists recommendations for the management of young women with breast cancer. Eur J Cancer 2012; 48:3355-77. [PMID: 23116682 DOI: 10.1016/j.ejca.2012.10.004] [Citation(s) in RCA: 173] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2011] [Revised: 10/02/2012] [Accepted: 10/02/2012] [Indexed: 12/22/2022]
Abstract
EUSOMA (The European Society of Breast Cancer Specialists) is committed to writing recommendations on different topics of breast cancer care which can be easily adopted and used by health professionals dedicated to the care of patients with breast cancer in their daily practice. In 2011, EUSOMA identified the management of young women with breast cancer as one of the hot topics for which a consensus among European experts was needed. Therefore, the society recently organised a workshop to define such recommendations. Thirteen experts from the different disciplines met for two days to discuss the topic. This international and multidisciplinary panel thoroughly reviewed the literature in order to prepare evidence-based recommendations. During the meeting, two working groups were set up to discuss in detail diagnosis and loco-regional and systemic treatments, including both group aspects of psychology and sexuality. The conclusions reached by the working groups were then discussed in a plenary session to reach panel consensus. Whenever possible, a measure of the level of evidence (LoE) from 1 (the highest) to 4 (the lowest) degree, based on the methodology proposed by the US Agency for Healthcare Research and Quality (AHRQ), was assigned to each recommendation. The present manuscript presents the recommendations of this consensus group for the management of young women with breast cancer in daily clinical practice.
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Affiliation(s)
- Fatima Cardoso
- Breast Unit, Champalimaud Cancer Center, Lisbon, Portugal.
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Levi F, Randimbison L, Blanc-Moya R, Maspoli-Conconi M, Rosato V, Bosetti C, La Vecchia C. High constant incidence of second primary colorectal cancer. Int J Cancer 2012; 132:1679-82. [PMID: 22903312 DOI: 10.1002/ijc.27780] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Accepted: 07/12/2012] [Indexed: 12/13/2022]
Abstract
Patients who had a colorectal cancer have a 1.5- to 2-fold excess risk of a second colorectal cancer as compared to the general population, the excess being higher at younger age at diagnosis. To further investigate the risk and the age-relation of the incidence of second primary colorectal cancer, we considered 9,389 first colon and rectal cancers registered in the Vaud Cancer Registry, Switzerland, between 1974 and 2008, and followed-up to the end of 2008 for a total of 44,113 person-years. There were 136 second colorectal cancers versus 90.5 expected, corresponding to a standardized incidence ratio (SIR) of 1.5 (95% confidence interval, CI, 1.3-1.8). The SIRs were not heterogeneous between men and women, and in strata of calendar year at diagnosis, duration of follow-up, and subsite. However, the SIR was 7.5 (95% CI 4.2-12.4) for subjects diagnosed below age 50 and declined thereafter to reach 1.0 (95% CI 0.6-1.6) at age 80 or over. Consequently, the incidence of second primary colorectal cancer was stable, and exceedingly high, around 300-400/100,000 between age 30-39 and 70 or over. This age pattern is consistent with the existence of a single mutational event in a population of highly susceptible individuals.
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Affiliation(s)
- Fabio Levi
- Cancer Epidemiology Unit and Registre Vaudois des Tumeurs, Institute of Social and Preventive Medicine, IUMSP, Lausanne University Hospital, Biopôle 2, Route de la Corniche 10, Lausanne, Switzerland.
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Dasgupta P, Youlden DR, Baade PD. Multiple primary cancers among colorectal cancer survivors in Queensland, Australia, 1996-2007. Cancer Causes Control 2012; 23:1387-98. [PMID: 22729930 DOI: 10.1007/s10552-012-9990-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2012] [Accepted: 05/03/2012] [Indexed: 01/04/2023]
Abstract
PURPOSE To quantify the demographic and clinical factors associated with an increased risk of multiple primary cancers (MPCs) among colorectal cancer survivors. METHODS Standardized incidence ratios for MPCs were calculated for residents of Queensland, Australia, who were diagnosed with a first primary colorectal cancer between 1996 and 2005 and survived for at least 2 months. Relative risk ratios were calculated for all MPCs combined and selected individual sites using multivariate Poisson models. RESULTS A total of 1,615 MPCs were observed among 15,755 study patients. The cohort had a significant excess risk of developing subsequent colorectal (SIR = 1.47, 95 % CI 1.30-1.66) or non-colorectal (SIR = 1.24, 95 % CI 1.18-1.31) cancers relative to the incidence of cancer in the general population. Age at initial diagnosis, follow-up time, initial colorectal subsite, and surgical treatment were independently associated (p < 0.01) with the overall risk of developing MPCs after adjustment. The relative risk ratio was 1.23 (95 % CI 1.07-1.41) for those aged 20-59 years compared with the 70-79 age group and 0.82 (95 % CI 0.72-0.92) for 1-5-year follow-up relative to the first year. The likelihood of being diagnosed with a MPC was 33 % higher (95 % CI 1.12-1.56) for surgically treated patients and 45 % higher (95 % CI 1.29-1.64) after proximal colon cancers relative to rectal cancer. CONCLUSIONS While these population-based results do not incorporate all possible risk factors, they form an important foundation from which to further investigate the etiological causes that result in the development of MPCs among colorectal cancer survivors.
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Affiliation(s)
- Paramita Dasgupta
- Viertel Centre for Research in Cancer Control, Cancer Council Queensland, Spring Hill, Brisbane, QLD 4001, Australia
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Cardoso F, Harbeck N. Breast Cancer in Young Women a Clinical Challenge to Be Addressed in a Multidisciplinary Setting. Breast Care (Basel) 2012. [DOI: 10.1159/000341098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Incidence of acute myeloid leukemia after breast cancer. Mediterr J Hematol Infect Dis 2011; 3:e2011069. [PMID: 22220266 PMCID: PMC3248346 DOI: 10.4084/mjhid.2011.069] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2011] [Accepted: 12/17/2011] [Indexed: 01/13/2023] Open
Abstract
Breast cancer is the most frequent cancer among women and the leading cause of death among middle-aged women. Early detection by mammography screening and improvement of therapeutic options have increased breast cancer survival rates, with the consequence that late side effects of cancer treatment become increasingly important. In particular, patients treated with adjuvant chemotherapy regimens, commonly including alkylating agents and anthracyclines, are at increased risk of developing leukemia, further enhanced by the use of radiotherapy. In the last few years also the use of growth factors seems to increase the risk of secondary leukemia. The purpose of this review is to update epidemiology of therapy-related myeloid neoplasms occurring in breast cancer patients.
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Abstract
PURPOSE OF REVIEW The purpose of this review is to update knowledge on therapy-related myeloid neoplasms (t-MN), taking into account the new 2008 WHO classification, new genome-wide approaches for the definition of susceptibility towards t-MN and the introduction of new more aggressive treatments in cancer patients. RECENT FINDINGS t-MN are an increasing matter in cancer survivors treated with chemoradiotherapy. One of the major concerns in hematologic malignancies is childhood acute lymphoblastic leukemia, in which the leukemogenic role of extended etoposide/teniposide treatment, concomitant intensive antimetabolite and asparaginase, granulocyte colony-stimulating factor (G-CSF) and prophylactic cranial radiotherapy use have been established. In high-risk Hodgkin lymphoma, 3% t-MN have been observed at 10-year follow-up with the escalated bleomycin/etoposide/doxorubicin/cyclophosphamide/vincristine/procarbazine/prednisone (BEACOPP) schedule, versus 0.4% with doxorubicin/bleomycin/vinblastine/dacarbazine (ABVD). In lymphoproliferative diseases the new drugs fludarabine and lenalidomide may increase the risk of second tumors, when associated to other cytotoxic therapies. Among solid tumors, breast cancer is most frequently associated to t-MN. The risk is correlated to higher chemotherapy doses, radiotherapy, use of G-CSF, but also independent from treatment, suggesting a genetic predisposition to both diseases. Radiotherapy plays a role also in female pelvic tumors and in testicular cancer, when associated to cisplatin. SUMMARY The risk of t-MN is not negligible, although below 2% in most series. This is particularly significant for younger cancer patients and during the first 5 years after the primary malignancies. Efforts should be maximized to identify susceptibility factors to identify patients at risk, in whom more leukemogenic drugs and schedules should be avoided.
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Kamigaki Y, Kawakami K. Risk of second cancer after initial treatment of breast cancer: An Osaka Cancer Registry Database study. Oncol Lett 2011; 2:963-973. [PMID: 22866158 DOI: 10.3892/ol.2011.339] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2010] [Accepted: 06/16/2011] [Indexed: 12/15/2022] Open
Abstract
In the present study, the association between the incidence of second cancer and initial treatment for primary breast cancer was investigated using the Osaka Cancer Registry in Japan. We selected 45,575 patients diagnosed with breast cancer between January 1975 and December 2003. Information on initial cancer treatment and second cancer was obtained from the Osaka Cancer Registry. Patients were classified according to initial treatment (chemo-, hormone, or radiotherapy, or no treatment). We calculated the incidence rate ratio of second cancers in patients classified by treatment for the first cancer. The effects of treatment adjusted for covariates on second cancers were examined using stratified analyses and a Cox proportional hazard model. The final number of 33,043 subjects had a mean duration of follow-up of 5.2±4.3 years, during which 1,857 second cancers were diagnosed. For hormone therapy, the incidence rate ratio (IRR) of all second cancers was 0.64 [95% confidence interval (CI), 0.58-0.70], and that of corpus uteri cancer was 3.04 (95% CI, 1.78-5.19). The multivariate analysis revealed that the IRR of corpus uteri cancer associated with hormone therapy was 2.53 (95% CI, 1.41‑4.55). The incidence rate of all second cancers associated with initial treatment was lower than that associated with no treatment. Only second corpus uteri cancer may be related to hormone therapy.
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Affiliation(s)
- Yumi Kamigaki
- Department of Biostatistics, Kyoto University School of Public Health, Kyoto University, Kyoto, Japan
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Antonelli A, Calza S, Arrighi N, Zani D, Corti S, Cozzoli A, Zanotelli T, Cunico SC, Simeone C. Clinical features and prognosis of patients with renal cancer and a second malignancy. Urol Oncol 2010; 30:294-300. [PMID: 20843710 DOI: 10.1016/j.urolonc.2010.04.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2010] [Revised: 04/08/2010] [Accepted: 04/28/2010] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To evaluate the epidemiologic aspects, the clinical features, and the prognosis of patients with renal cancer affected by a second malignancy. MATERIALS AND METHODS Since 1983, at our institution, a database concerning all the patients who underwent surgery for renal neoplasia has been prospectively compiled. In the present study, we compared patients with renal cancer and a second primary malignancy, diagnosed before, at the same time, or after the renal cancer, to those affected only by a renal malignancy. RESULTS Out of 1,673 patients with renal cancer, 285 (17%) were diagnosed with a second malignancy. The follow-up lasted on average 71 months after the treatment of renal neoplasia. The second neoplasia was antecedent in 115 patients (average latency period 8.5 years), synchronous in 97 patients, and subsequent in 103 patients (average latency period 4.4 years). The sites of associated neoplasia were, in descending order of frequency, prostate, bladder, and bowel for men and breast, gynecologic organs, thyroid, and bladder for women. Compared with the patients not affected by a second neoplasm, those with multiple malignancies generally were older and had a smaller, low-grade, low-stage, and asymptomatic renal tumor. Comparing patients with associated neoplasia with a group without associated neoplasia matched for gender, mode of diagnosis, dimension, grade, stage, and histologic subtype of renal cancer, at survival analysis, no significant differences were noticed in renal cancer-related survival. However, among patients with multiple malignancies, the contemporaneous diagnosis of renal and associated cancer had an independent negative impact on survival. CONCLUSIONS The association between renal cancer and other malignancies is a frequent event with an unremarkable impact on prognosis, and it shall not limit surgical indication to treat renal cancer, even if the negative prognostic impact of synchronous occurrence of multiple neoplasias should be regarded, especially in older or unhealthy patients, since ablative therapies or active surveillance could be considered as viable alternative options.
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Affiliation(s)
- Alessandro Antonelli
- Departments of Urology, Biomedical Sciences, and Biotechnology University of Brescia, Brescia, Italy.
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Bedrosian I, Hu CY, Chang GJ. Response: Re: Population-Based Study of Contralateral Prophylactic Mastectomy and Survival Outcomes of Breast Cancer Patients. J Natl Cancer Inst 2010. [DOI: 10.1093/jnci/djq299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Secondary hematological malignancies following breast cancer treatment. Oncol Rev 2010. [DOI: 10.1007/s12156-010-0037-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Armand P, Kim HT, Mayer E, Cutler CS, Ho VT, Koreth J, Alyea EP, Antin JH, Soiffer RJ. Outcome of allo-SCT for women with MDS or AML occurring after breast cancer therapy. Bone Marrow Transplant 2010; 45:1611-7. [PMID: 20154738 DOI: 10.1038/bmt.2010.20] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Women with breast cancer who receive adjuvant therapy are at risk for developing therapy-related myelodysplastic syndrome (MDS) or AML (tMDS/AML). Patients with tMDS/AML are often referred for consideration of allogeneic hematopoietic SCT (HSCT). However, the outcomes of HSCT in such patients have not been well described. We report a retrospective study of all women who were treated with HSCT for MDS or AML at our institution between 1991 and 2008. We compared the transplantation outcomes for 24 women with a history of breast cancer with those for 271 women with de novo disease. Three-year OS and disease-free survival (DFS) for patients with a history of breast cancer were 41 and 45%, respectively. The cumulative incidences of tMDS/AML relapse and non-relapse mortality (NRM) were 38 and 17%, respectively. Those outcomes were very similar to those of patients with de novo disease. In multivariable analyses, a history of breast cancer had no impact on OS, DFS, relapse or NRM. A significant proportion of women with tAML/MDS after breast cancer treatment experience DFS after HSCT, similar to that of patients with de novo MDS or AML. This justifies consideration of HSCT for selected patients in this setting.
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Affiliation(s)
- P Armand
- Department of Medical Oncology, Dana-Farber Cancer Institute, 44 Binney Street, Boston, MA 02115, USA.
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