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Feng Y, Qian K, Guo K, Shi Y, Zhou J, Wang Z. Effectiveness and risk of second primary malignancies after radiotherapy in major salivary gland carcinomas: A retrospective study using SEER database. Head Neck 2024; 46:1201-1209. [PMID: 38284127 DOI: 10.1002/hed.27664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 01/30/2024] Open
Abstract
OBJECTIVE To investigate the effectiveness of radiotherapy and its association with second primary malignancies (SPMs) risk in major salivary gland carcinomas (MSGCs) patients. METHODS Cohort 1 included 7274 surgically treated MSGC patients from the Surveillance, Epidemiology, and End Results database, assessing the effectiveness of radiotherapy. Cohort 2 (n = 4213) comprised patients with ≥5-year survival in Cohort 1 to study SPMs. RESULTS Radiotherapy decreased overall survival in MSGCs patients, but improved it in high-grade MSGCs. Cumulative SPMs incidences at 25 years were 16.5% in the radiotherapy (RT) group compared to 14.5% in the non-radiotherapy (NRT) group. For second head and neck carcinomas (SHNCs), incidences were 3.4% in RT versus 1.6% in NRT. Radiotherapy increased the relative risks of tumors, particularly SHNCs (RR = 1.78). The 10-year OS rates of SHNCs after radiotherapy were significantly lower. CONCLUSION Radiotherapy improves survival in advanced-stage MSGCs but increases the risk of developing SPMs, particularly SHNCs.
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Affiliation(s)
- Yuan Feng
- Department of Head and Neck Surgery, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, China
| | - Kai Qian
- Department of Head and Neck Surgery, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, China
| | - Kai Guo
- Department of Head and Neck Surgery, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, China
| | - Yuan Shi
- Department of Head and Neck Surgery, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, China
| | - Jiaqing Zhou
- Department of Head and Neck Surgery, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, China
| | - Zhuoying Wang
- Department of Head and Neck Surgery, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, China
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Miao X, Dong S, Tao Y, Yang X, Shen S. Second primary malignancy post immunotherapy: A case report of 2 cases. Medicine (Baltimore) 2024; 103:e37434. [PMID: 38457542 PMCID: PMC10919459 DOI: 10.1097/md.0000000000037434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 02/08/2024] [Indexed: 03/10/2024] Open
Abstract
RATIONALE Immune checkpoint inhibitors have shown high efficacies as the first-line treatment of various advanced malignancies. Yet, the effect and practice patterns of immune checkpoint inhibitors on the second primary tumors are still unclear. Second primary malignancy post immunotherapy, there is paucity in such cases being reported. PATIENT CONCERNS We report 2 cases of a 57-year-old woman with nonsmall cell lung cancer and a 69-year-old man with metastatic clear cell renal carcinoma treated with immunotherapy who developed second primary malignancies during the therapy. DIAGNOSIS Second primary malignancy during the therapy. INTERVENTIONS In addition to the treatments of the second primary malignancies, maintenance immunotherapy was continued for the patients. OUTCOMES Overall survival in both patients was longer than 12 months, and the treatments were well tolerated. The adverse reactions mainly included depigmentation of hair and facial and limb skin in patient 1 and diarrhea in patient 2. LESSONS It is necessary to recognize that the second primary malignancy may occur during the immunotherapy, and more clinical studies and practices are still needed for the adjustment of the regimens of immunotherapy. Full diagnosis, timely treatment, and long-term regular follow-up have important significance for patients with malignancies.
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Affiliation(s)
- Xian Miao
- Department of Oncology, Nantong Hospital Affiliated to Nanjing University of Chinese Medicine, Nantong, China
| | - Shu Dong
- Department of Integrative Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Yuhua Tao
- Department of Oncology, Nantong Hospital Affiliated to Nanjing University of Chinese Medicine, Nantong, China
| | - Xiaohui Yang
- Department of Oncology, Nantong Hospital Affiliated to Nanjing University of Chinese Medicine, Nantong, China
| | - Shuijie Shen
- Department of Oncology, Nantong Hospital Affiliated to Nanjing University of Chinese Medicine, Nantong, China
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Han W, Wang S, Su L, Xu J, Wei Y. Prognostic analysis of lung squamous cell carcinoma patients with second primary malignancies: a SEER database study. Front Oncol 2024; 14:1294383. [PMID: 38444672 PMCID: PMC10912175 DOI: 10.3389/fonc.2024.1294383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 01/30/2024] [Indexed: 03/07/2024] Open
Abstract
Background As lung squamous cell carcinoma (LUSC) patients are at increased risk of developing a second primary cancer, this complicates the patient's condition and thus makes prognostic assessment more difficult, posing a significant prognostic challenge for clinicians. Our goal was to assess the prognosis of LUSC patients with a second primary tumor, and provide insights into appropriate therapy and monitoring strategies. Methods Data was obtained for LUSC patients from the Surveillance, Epidemiology, and End Results (SEER) database. The LUSC patients were divided into three groups (LS-SPM, OT-LUSC and LUSC-only). Univariate and stratified analyses were performed for the baseline and clinical characteristics of the participants. Multiple regression and Kaplan-Meier survival analyses were also performed, followed by a final life table analysis. Results In our sample of 101,626 patients, the HR for OS in the LS-SPM group was 0.40 in univariate analysis. Kaplan-Meier survival curves showed that LS-SPM patients had considerably longer lifespans compared to the other groups. The LS-SPM patients had median and mean survival times of 64 months and 89.11 months. Unadjusted and adjusted multiple regression analyses showed that LS-SPM patients had a superior survival compared to LUSC-only and OT-LUSC groups. Conclusion LS-SPM patients have a good prognosis with aggressive therapy and immune monitoring. The present study offers novel insights into the pathophysiological causes and treatments for LS-SPM.
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Affiliation(s)
- Weiqing Han
- Department of Cardiothoracic Surgery, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Silin Wang
- Department of Thoracic Surgery, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Lang Su
- Department of Thoracic Surgery, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Jianjun Xu
- Department of Cardiothoracic Surgery, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Yiping Wei
- Department of Thoracic Surgery, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
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Chalikandy A, Yadav S, Basu S. Differentiation of Discordant Lesions on Dual-Tracer PET/CT ( 68Ga-PSMA-11 and 18F-FDG) in Prostate Carcinoma: Diagnosis of Second Primary Malignancies. J Nucl Med Technol 2023; 51:339-342. [PMID: 37586854 DOI: 10.2967/jnmt.123.265779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/06/2023] [Indexed: 08/18/2023] Open
Abstract
We present 2 cases of metastatic castration-resistant prostate carcinoma with discordant lesions on dual-tracer PET/CT (68Ga-PSMA-11 and 18F-FDG PET/CT), which on subsequent histopathologic evaluation revealed second primary malignancies of combined hepatocellular carcinoma and cholangiocarcinoma and poorly differentiated squamous cell carcinoma. These case illustrations emphasize the need to evaluate discordant lesions on dual-tracer PET/CT, which can lead to early diagnosis of second primary malignancies and thereby can provide better management in these patients.
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Affiliation(s)
- Ashwini Chalikandy
- Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Hospital Annexe, Mumbai, India
- Homi Bhabha National Institute, Mumbai, India; and
| | - Subhash Yadav
- Homi Bhabha National Institute, Mumbai, India; and
- Department of Pathology, Tata Memorial Hospital, Mumbai, India
| | - Sandip Basu
- Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Hospital Annexe, Mumbai, India;
- Homi Bhabha National Institute, Mumbai, India; and
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Liu L, Chen B. Influence factors of the survival in colorectal cancer patients with second primary malignancy after surgery: A SEER database analysis. Medicine (Baltimore) 2023; 102:e35286. [PMID: 37800769 PMCID: PMC10553115 DOI: 10.1097/md.0000000000035286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 08/29/2023] [Indexed: 10/07/2023] Open
Abstract
The survival rate is significantly reduced in patients with colorectal cancer (CRC) who developing a second primary malignancy (SPM), and however, little has known about the factors that contribute to the mortality of SPMs among CRC survivors. This study aims to explore the influence factors in both the all-cause and cancer-specific mortality of patients with SPMs after CRC surgery. Data of adult CRC patients with SPMs were extracted from the Surveillance, Epidemiology, and End Results (SEER) database in this retrospective cohort study. The associations between potential influence factors and all-cause mortality and cancer-specific mortality were explored using univariate and multivariate Cox proportional hazards analyses. The evaluation indexes were hazard ratios (HRs), and 95% confidence intervals (CIs). We also drew pie charts to respectively reflect the distributions of SPMs sites and time interval in study population. A total of 1202 (56.14%) patients died for all-cause, and 464 (21.67%) died due to CRC. The results showed that after adjusting for covariates, age, sex, marital status, T stage of CRC, second primary cancer site, stage of SPMs, grade of SPMs, TNM stage of SPMs, and time interval were associated with all-cause mortality, while marital status, stage of CRC, T stage of CRC, chemotherapy, second primary cancer site, stage of SPMs, grade of SPMs, TNM stage of SPMs, and time interval were associated with cancer-specific mortality in patients with CRC. In addition, colon (23.5%) was the most common site of SPMs, followed by digestive system (19.0%), and the time interval between CRC and SPMs in most patients was over 5 years (28.4%). Our findings may assist clinicians to identify high-risk patients for SPMs after CRC surgery. Also, the postoperative long-term follow-up and close attention on the key systems where the SPMs may occur are of great necessary in patients with CRC.
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Affiliation(s)
- Liyu Liu
- The Second Department of Thoracic Oncology, Hunan Cancer Hospital/the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan Province, P.R. China
| | - Bolin Chen
- The Second Department of Thoracic Oncology, Hunan Cancer Hospital/the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan Province, P.R. China
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Ershadifar S, Ustrell S, Darrow MA, Birkeland A. Synchronous Undetected HPV+ Cancer in a HPV- Tongue Cancer Patient. Ear Nose Throat J 2023; 102:8S-11S. [PMID: 37159392 DOI: 10.1177/01455613231173456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023] Open
Abstract
We report a case of a 63-year-old male who presented with synchronous pT1N1 p16-positive squamous cell carcinoma (SCC) of the left tonsil and pT4N0 p16-negative SCC of the left tongue.
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Affiliation(s)
- Soroush Ershadifar
- Department of Otolaryngology-Head and Neck Surgery, University of California-Davis, Sacramento, CA, USA
| | - Sarah Ustrell
- Cedars Sinai Sinus Center of Excellence, Los Angeles, CA, USA
- St. George's University School of Medicine, St George's, WI, Grenada
| | - Morgan Angus Darrow
- Department of Pathology and Laboratory Medicine, University of California-Davis Medical Center, Sacramento, CA, USA
| | - Andrew Birkeland
- Department of Otolaryngology-Head and Neck Surgery, University of California-Davis, Sacramento, CA, USA
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Avivi I, Vesole DH, Davila-Valls J, Usnarska-Zubkiewicz L, Olszewska-Szopa M, Milunovic V, Baumert B, Osękowska B, Kopińska A, Gentile M, Puertas-Martinez B, Robak P, Crusoe E, Rodriguez-Lobato LG, Gajewska M, Varga G, Delforge M, Cohen Y, Gozzetti A, Pena C, Shustik C, Mikala G, Zalac K, Alexander HD, Barth P, Weisel K, Martínez-López J, Waszczuk-Gajda A, Krzystański M, Jurczyszyn A. Outcome of Second Primary Malignancies Developing in Multiple Myeloma Patients. Cancers (Basel) 2023; 15:4359. [PMID: 37686635 PMCID: PMC10487060 DOI: 10.3390/cancers15174359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 08/15/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND There is an increased risk of second primary malignancies (SMPs) in patients with multiple myeloma (MM). This multinational 'real-world' retrospective study analyzed the characteristics and outcomes of MM patients that developed SPMs. RESULTS 165 patients were analyzed: 62.4% males; 8.5% with a prior cancer; 113 with solid SPMs, mainly ≥stage 2; and 52 with hematological SPM (hemato-SPM), mainly MDS/AML. Patients with hemato-SPM were younger (p = 0.05) and more frequently had a prior AutoHCT (p = 0.012). The time to SPM was shorter in the older (>65 years) and more heavily pretreated patients. One hundred patients were actively treated at the time of SPM detection. Treatment was discontinued in 52, substituted with another anti-MM therapy in 15, and continued in 33 patients. Treatment discontinuation was predominant in the patients diagnosed with hemato-SPM (76%). The median OS following SPM detection was 8.5 months, and the main cause of death was SPM. A poor ECOG status predicted a shorter OS (PS 3 vs. 0, HR = 5.74, 2.32-14.21, p < 0.001), whereas a normal hemoglobin level (HR = 0.43, 0.19-0.95, p = 0.037) predicted longer OS. CONCLUSIONS With the continuing improvement in OS, a higher proportion of MM patients might develop SPM. The OS following SPM diagnosis is poor; hence, frequent surveillance and early detection are imperative to improve outcomes.
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Affiliation(s)
- Irit Avivi
- Department of Hematology, Tel Aviv Sourasky Medical Center and Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - David H. Vesole
- Hackensack University Medical Center, New Jersey Medical School, Rutgers University, Hackensack, NJ 07601, USA
| | | | - Lidia Usnarska-Zubkiewicz
- Department of Hematology, Blood Neoplasms and Bone Marrow Transplantation, Wroclaw Medical University, 50-556 Wroclaw, Poland
| | - Magdalena Olszewska-Szopa
- Department of Hematology, Blood Neoplasms and Bone Marrow Transplantation, Wroclaw Medical University, 50-556 Wroclaw, Poland
| | - Vibor Milunovic
- Division of Hematology, Clinical Hospital Merkur, 10000 Zagreb, Croatia
| | - Bartłomiej Baumert
- Department of General Pathology, Pomeranian Medical University, 70-111 Szczecin, Poland; (B.B.)
| | - Bogumiła Osękowska
- Department of General Pathology, Pomeranian Medical University, 70-111 Szczecin, Poland; (B.B.)
| | - Anna Kopińska
- Department of Hematology and Bone Marrow Transplantation, Medical University of Silesia, 40-032 Katowice, Poland
| | - Massimo Gentile
- Hematology Unit AO of Cosenza, Cosenza and Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Rende, Italy
| | - Borja Puertas-Martinez
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Cancer Research Center-IBMCC (USAL-CSIC), CIBERONC, University Hospital of Salamanca, 37007 Salamanca, Spain
| | - Paweł Robak
- Department of Hematology, Copernicus Memorial Hospital, Medical University of Lodz, 90-752 Lodz, Poland
| | - Edvan Crusoe
- Universidade Federal da Bahia, Hospital Universitário Professor Edgar Santos, Serviço de Hematologia, Salvador 40110-909, BA, Brazil
| | - Luis Gerardo Rodriguez-Lobato
- Amyloidosis and Multiple Myeloma Unit, Department of Hematology, Hospital Clínic of Barcelona, IDIBAPS, 08036 Barcelona, Spain
| | - Małgorzata Gajewska
- Department of Internal Medicine and Hematology, Military Institute of Medicine, 04-141 Warsaw, Poland
| | - Gergely Varga
- Department of Internal Medicine and Haematology, Semmelweis University, 1085 Budapest, Hungary
| | | | - Yael Cohen
- Department of Hematology, Tel Aviv Sourasky Medical Center and Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Alessandro Gozzetti
- Department of Medical Science, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy
| | - Camila Pena
- Sección Hematología, Hospital del Salvador, Santiago 13123, Chile
| | - Chaim Shustik
- Royal Victoria Hospital, McGill University Health Centre, Montreal, QC H4A 3J1, Canada
| | - Gabor Mikala
- Department of Hematology and Stem Cell Transplantation, National Institute for Hematology and Infectious Diseases, South Pest Central Hospital, 1097 Budapest, Hungary;
| | - Klara Zalac
- Department of Hematology, Clinics for Internal Medicine, University Hospital Center “Sestre Milosrdnice”, 10000 Zagreb, Croatia
| | - H. Denis Alexander
- Personalised Medicine Centre, School of Medicine, Ulster University, Derry/Londonderry BT47 6SB, UK;
| | - Peter Barth
- Department of Medicine, Warren Alpert Medical School, Brown University, Providence, RI 02912, USA
| | - Katja Weisel
- Department of Oncology, Hematology and Bone Marrow Transplantation with Section Pneumology, University Medical-Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | | | - Anna Waszczuk-Gajda
- Department of Hematology, Oncology and Internal Diseases, Warsaw Medical University, 02-097 Warsaw, Poland
| | | | - Artur Jurczyszyn
- Department of Hematology, Jagiellonian University Medical College, 31-155 Crakow, Poland;
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Haque E, Mushtaq AH, Alkhatib R, Alhusaini H, Suleman K. An Unexpected Diagnosis of Second Primary Malignancy in a Breast Cancer Survivor: A Case Report. Cureus 2023; 15:e42819. [PMID: 37664269 PMCID: PMC10471315 DOI: 10.7759/cureus.42819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2023] [Indexed: 09/05/2023] Open
Abstract
BACKGROUND Breast cancer survival rates are increasing more than ever with the development of better diagnostic and therapeutic techniques. Survivors of breast cancer have an increased risk of developing second primary malignancies, which may be mistaken for breast cancer recurrence and lead to delayed diagnosis and poor prognosis. CASE REPORT We report a case of a 62-year-old female who presented with shortness of breath and bone pain. She had a history of left triple-positive invasive ductal carcinoma (T1N0M0) treated with bilateral skin-sparing mastectomy, adjuvant Taxotere, and trastuzumab-based therapy and then continued on trastuzumab and letrozole. She underwent imaging to explore the source of her symptoms at which new pulmonary nodules were discovered. During workup, she was found to have elevated tumor markers. They were initially suspected to be breast cancer recurrence metastases based on elevated tumor markers; however, further investigations confirmed that the nodules were a second primary lung adenocarcinoma with a different molecular profile. The patient had disease progression despite chemotherapy and eventually succumbed to her disease. CONCLUSION This case highlights the importance of considering second primary malignancies in breast cancer survivors and utilizing advanced diagnostic modalities to efficiently diagnose such cases.
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Affiliation(s)
- Emaan Haque
- Department of Medicine, Alfaisal University, Riyadh, SAU
| | - Ali H Mushtaq
- Department of Medicine, Cleveland Clinic, Cleveland, USA
- Department of Medicine, Alfaisal University, Riyadh, SAU
| | | | - Hamed Alhusaini
- Department of Oncology, King Faisal Specialist Hospital and Research Centre, Riyadh, SAU
| | - Kausar Suleman
- Department of Oncology, King Faisal Specialist Hospital and Research Centre, Riyadh, SAU
- Department of Medicine, Alfaisal University, Riyadh, SAU
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Ipek Y, Karademir N, Yilmazer O, Yilmaz G. The Effects of Second Primary Malignancies and Frailty on Overall Survival and Mortality in Geriatric Turkish Patients with Multiple Myeloma. Curr Oncol 2023; 30:5615-5630. [PMID: 37366906 DOI: 10.3390/curroncol30060423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/02/2023] [Accepted: 06/07/2023] [Indexed: 06/28/2023] Open
Abstract
The study aims to investigate second primary malignancy (SPM) development and frailty in Turkish geriatric patients with multiple myeloma (MM) and to assess the relationship between overall survival (OS) and various characteristics including SPM and frailty. Seventy-two patients diagnosed with and treated for MM were enrolled in the study. Frailty was determined by the IMWG Frailty Score. Fifty-three participants (73.6%) were found to have clinically-relevant frailty. Seven patients (9.7%) had SPM. Median follow-up was 36.5 (22-48.5) months, and 17 patients died during the follow-up period. Overall (OS) was 49.40 (45.01-53.80) months. Shorter OS was found in patients with SPM (35.29 (19.66-50.91) months) compared to those without (51.05 (46.7-55.4) months) (Kaplan-Meier; p = 0.018). The multivariate cox proportional hazards model revealed that patients with SPM had 4.420-fold higher risk of death than those without (HR: 4.420, 95% CI: 1.371-14.246, p = 0.013). Higher ALT levels were also independently associated with mortality (p = 0.038). The prevalence of SPM and frailty was high in elderly patients with MM in our study. The development of SPM independently reduces survival in MM; however, frailty was not found to be independently associated with survival. Our results suggest the importance of individualized approaches in the management of patients with MM, particularly with regard to SPM development.
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Affiliation(s)
- Yildiz Ipek
- Department of Hematology, Kartal Lutfi Kirdar City Hospital, 34970 Istanbul, Turkey
| | - Nevra Karademir
- Department of Internal Diseases, Kartal Lutfi Kirdar City Hospital, 34970 Istanbul, Turkey
| | - Onur Yilmazer
- Department of Internal Diseases, Kartal Lutfi Kirdar City Hospital, 34970 Istanbul, Turkey
| | - Guven Yilmaz
- Department of Hematology, Kartal Lutfi Kirdar City Hospital, 34970 Istanbul, Turkey
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Xu C, Pei D, Liu Y, Guo J, Liu N, Wang Q, Yu Y, Kang Z. Clinical characteristics and prostate-cancer-specific mortality of competitive risk nomogram in the second primary prostate cancer. Front Oncol 2023; 13:918324. [PMID: 37260974 PMCID: PMC10229042 DOI: 10.3389/fonc.2023.918324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 03/09/2023] [Indexed: 06/02/2023] Open
Abstract
Background With the development of early diagnosis and treatment, the second primary malignancy (SPM) attracts increasing attention. The second primary prostate cancer (spPCa) is an important class of SPM, but remains poorly understood. Methods We retrospectively analyzed 3,322 patients with spPCa diagnosed between 2004 and 2015 in the Surveillance, Epidemiology, and End Results (SEER) database. Chi-square test was applied to compare demographic and clinical variables and analyze causes of death. Multivariate competitive risk regression model was used to identify risk factors associated with prostate-cancer-specific mortality (PCSM), and these factors were enrolled to build a nomogram of competitive risk. The C-index, calibration curve, and decision curve analysis (DCA) were employed to evaluate the discrimination ability of our nomogram. Results The median follow-up (interquartile range, IQR) time was 47 (24-75) months, and the median (IQR) diagnosis interval between the first primary cancer (FPC) and spPCa was 32 (16-57) months. We found that the three most common sites of SPM were the urinary system, digestive system, and skin. Through multivariate competitive risk analysis, we enrolled race (p < 0.05), tumor-node-metastasis (TNM) stage (p < 0.001), Gleason score (p < 0.05), surgery (p = 0.002), and radiotherapy (p = 0.032) to construct the model to predict the outcomes of spPCa. The C-index was 0.856 (95% CI, 0.813-0.899) and 0.905 (95% CI, 0.941-0.868) in the training and validation set, respectively. Moreover, both the calibration curve and DCA illustrated that our nomogram performed well in predicting PCSM. Conclusion In conclusion, we identified four risk factors associated with the prognosis of spPCa and construct a competing risk nomogram, which performed well in predicting the 3-, 5-, and 10-year PCSM.
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Muacevic A, Adler JR, Komnos ID, Litsou EV, Psychogios GV. Management of an Acute Airway Obstruction Due to Tracheal Carcinoma in a Patient With Severe Glottic Stenosis. Cureus 2023; 15:e33203. [PMID: 36733576 PMCID: PMC9888602 DOI: 10.7759/cureus.33203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2022] [Indexed: 01/03/2023] Open
Abstract
In this paper, we present the case of acute airway obstruction due to tracheal carcinoma in a patient with glottic stenosis due to previously treated laryngeal carcinoma. Because of severe dyspnea from the obstructive endotracheal mass, tracheotomy under local anesthesia was immediately performed. Intubation with pediatric size (I.D. 4.5 mm) cuffed endotracheal tube was performed by the surgeon through tracheostomy under endoscopic visualization. Blakesley forceps and electrocautery were used for tumor debulking. Postoperatively there were no complications and the patient was discharged after four days. The histopathology report showed a squamous cell carcinoma. The tumor board decided on adjuvant chemoradiotherapy for the treatment of the patient.
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Huang H, Li Z, Huang Z, Huang L, Liu W, Liu G, Mo Y. Development and validation of nomograms to predict the survival probability and occurrence of a second primary malignancy of male breast cancer patients: a population-based analysis. Front Oncol 2023; 13:1076997. [PMID: 37152061 PMCID: PMC10157191 DOI: 10.3389/fonc.2023.1076997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 03/30/2023] [Indexed: 05/09/2023] Open
Abstract
Background Male breast cancer (MBC) is rare, which has restricted prospective research among MBC patients. With effective treatments, the prognosis of MBC patients has improved and developing a second primary malignancy (SPM) has become a life-threatening event for MBC survivors. However, few studies have focused on the prognosis of MBC patients and looked into the SPM issue in MBC survivors. Method We reviewed MBC patients diagnosed between 1990 and 2016 from the latest Surveillance, Epidemiology, and End Results (SEER) Plus database. Competing risk models and nomograms were conducted for predicting the risk of cancer-specific death and SPM occurrence. C-indexes, calibration curves, ROC curves, and decision curve analysis (DCA) curves were applied for validation. Result A total of 1,843 MBC patients with complete information were finally enrolled and 60 (3.26%) had developed an SPM. Prostate cancer (40%) was the most common SPM. The median OS of all the enrolled patients was 102.41 months, while the median latency from the initial MBC diagnosis to the subsequent diagnosis of SPM was 67.2 months. The patients who suffered from an SPM shared a longer OS than those patients with only one MBC (p = 0.027). The patients were randomly divided into the development cohort and the validation cohort (at a ratio of 7:3). The Fine and Gray competing risk model was used to identify the risk factors. Two nomograms were constructed and validated to predict the 5-year, 8-year, and 10-year survival probability of MBC patients, both of which had good performance in the C-index, ROC curves, calibration plots, and DCA curves, showing the ideal discrimination capability and predictive value clinically. Furthermore, we, for the first time, constructed a nomogram based on the competing risk model to predict the 5-year, 8-year, and 10-year probability of developing an SPM in MBC survivors, which also showed good discrimination, calibration, and clinical effectiveness. Conclusion We, for the first time, included treatment information and clinical parameters to construct a nomogram to predict not only the survival probability of MBC patients but also the probability of developing an SPM in MBC survivors, which were helpful in individual risk estimation, patient follow-up, and counseling in MBC patients.
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Affiliation(s)
- Haowei Huang
- Department of Radiotherapy, Guangzhou Red Cross Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Zhuoran Li
- Department of Radiology, Guangzhou Red Cross Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Zhisheng Huang
- Department of Rehabilitation, Guangzhou Hospital of Integrated Traditional Chinese and Western Medicine, Guangzhou, Guangdong, China
| | - Lang Huang
- Department of General Office, Guangdong Provincial Hospital of Occupational Disease Prevention and Treatment, Guangzhou, Guangdong, China
| | - Wei Liu
- Department of Breast, Guangzhou Red Cross Hospital, Guangzhou Red Cross Hospital of Jinan University, Guangzhou, Guangdong, China
- *Correspondence: Wei Liu, ; Guolong Liu, ; Yuzhen Mo,
| | - Guolong Liu
- Department of Medical Oncology, Guangzhou First People’s Hospital, Jinan University, Guangzhou, Guangdong, China
- Department of Medical Oncology, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China
- *Correspondence: Wei Liu, ; Guolong Liu, ; Yuzhen Mo,
| | - Yuzhen Mo
- Department of Radiotherapy, Guangzhou Red Cross Hospital of Jinan University, Guangzhou, Guangdong, China
- *Correspondence: Wei Liu, ; Guolong Liu, ; Yuzhen Mo,
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13
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Joshi U, Bhattarai A, Gaire S, Gill S, Agrawal V, Yadav SK, Low SK, Dhakal P, Bhatt VR, Kouides PA. Risk of second primary malignancy in patients with primary myelofibrosis: a SEER database study. Leuk Lymphoma 2022; 63:3456-3461. [PMID: 36120968 DOI: 10.1080/10428194.2022.2123227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Prior studies report a greater incidence of second primary malignancy (SPM) among patients with myeloproliferative neoplasms, although the true risk in primary myelofibrosis (PMF) has not been elucidated. We utilized the Surveillance, Epidemiology, and End Results database to evaluate the risk of SPM in PMF patients and analyzed the effects of sociodemographic factors on the risk of SPM. Out of 5273 patients, 385 patients (7.30%) developed SPM. SPM occurred at SIR of 1.95 (95% CI 1.76-2.15) and AER of 149.01 per 10,000 population. A significantly higher incidence of melanoma (SIR 1.76, 95% CI 1.01-2.86), lymphoma (SIR 3.38, 95% CI 2.28-4.83), and leukemia (SIR 27.19, 95% CI 23.09-31.81) was observed. The risk was significantly higher in patients ≤60 years, males, chemotherapy recipients, within 5 years of PMF diagnosis, and for PMF diagnosed after 2009.
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Affiliation(s)
- Utsav Joshi
- Department of Internal Medicine, Rochester General Hospital, Rochester, NY, USA
| | - Adheesh Bhattarai
- Department of Internal Medicine, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | - Suman Gaire
- Department of Internal Medicine, Mount Sinai Hospital, Chicago, IL, USA
| | - Simrat Gill
- Department of Internal Medicine, Rochester General Hospital, Rochester, NY, USA
| | - Vishakha Agrawal
- Department of Internal Medicine, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | - Sumeet Kumar Yadav
- Department of Hospital Internal Medicine, Mayo Clinic Health System, Mankato, MN, USA
| | - Soon Khai Low
- Department of Internal Medicine, Rochester General Hospital, Rochester, NY, USA
| | - Prajwal Dhakal
- Department of Internal Medicine, Division of Hematology, Oncology, and Blood & Marrow Transplantation, University of Iowa, Iowa City, IA, USA
| | - Vijaya Raj Bhatt
- Department of Internal Medicine, Division of Oncology and Hematology, University of Nebraska Medical Center, Omaha, NE, USA.,Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, USA
| | - Peter A Kouides
- Division of Hematology and Clinical Oncology, Rochester General Hospital, Rochester, NY, USA.,University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
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14
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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15
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Li J, Peng F, Huang H, Cai Z. Trends in the risk of second primary malignances after non-Hodgkin's lymphoma. Am J Cancer Res 2022; 12:2863-2875. [PMID: 35812045 PMCID: PMC9251676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 03/17/2022] [Indexed: 06/15/2023] Open
Abstract
Patients with non-Hodgkin's lymphoma (NHL) have an increased risk of developing second primary malignances (SPMs). In the current study, we aimed to evaluate the trends and relative clinical variables of SPM risk among NHL survivors over the past four decades. Standardized incidence ratio (SIR) and cumulative incidence frequency (CIF) were assessed in patients diagnosed with first primary NHL between 1975-2016 from the Surveillance, Epidemiology, and End Results (SEER) database. As a result, the overall SIR was 1.13 for SPMs of all sites among NHL survivors. Risk factors included male patients, "other" races, chemotherapy and radiation, and younger age at the time of NHL diagnosis. The relative and cumulative risk for both hematological and solid second cancers after NHL increased over time, whereas the increasing trend was more remarkable for hematological malignances compared with solid tumors. For individual cancer sites, the trends of SIRs varied. A significantly increasing trend of SPM risk was observed in the group receiving chemotherapy and those younger than 40 years at the time of NHL diagnosis. Recent calendar years was not an independent risk factor after adjusting age, race, gender, and therapies in the multivariate Cox proportional hazard regression. To conclude, the current study showed that the relative and cumulative risk of developing SPMs significantly increased in patients diagnosed with NHL in recent years. The trend of SPM risk was associated with certain clinical and demographic variables, and might vary according to different cancer types.
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Affiliation(s)
- Jingwen Li
- Bone Marrow Transplantation Center, Department of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang UniversityHangzhou, Zhejiang, China
| | - Fei Peng
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyWuhan, Hubei, China
| | - He Huang
- Bone Marrow Transplantation Center, Department of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang UniversityHangzhou, Zhejiang, China
| | - Zhen Cai
- Bone Marrow Transplantation Center, Department of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang UniversityHangzhou, Zhejiang, China
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16
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Wu Y, Li Y, Han C, Chong Y, Kang K, Liu Z, Zhang F. Risk of second primary malignancies associated with radiotherapy in prostate cancer patients: competing risk analysis. Future Oncol 2022; 18:445-455. [PMID: 35018785 DOI: 10.2217/fon-2021-0332] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background: The effect of radiotherapy (RT) for second primary malignancies (SPMs) among prostate cancer survivors is controversial. Methods: Applying logistic regression, competing risk analysis and propensity score matching method, this study analyzed clinical data from the Surveillance, Epidemiology, and End Results program to compare the risk for SPMs between patients receiving RT and non-RT. Results: In this study, prostate cancer patients treated with RT developed more SPMs in the anus, bladder, rectum, liver, lung and bronchus and lymphoma than non-RT groups. Conclusion: More intensive surveillance should be adopted for these cancers among prostate cancer survivors.
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Affiliation(s)
- Yijun Wu
- Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100730, China.,Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Yunlong Li
- Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Chang Han
- Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Yuming Chong
- Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Kai Kang
- Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100730, China.,Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Zhikai Liu
- Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100730, China
| | - Fuquan Zhang
- Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100730, China
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17
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Abrahão R, Brunson AM, Kahn JM, Li QW, Wun T, Keegan THM. Second primary malignancy risk after Hodgkin lymphoma treatment among HIV-uninfected and HIV-infected survivors. Leuk Lymphoma 2022; 63:1091-1101. [PMID: 34989283 DOI: 10.1080/10428194.2021.2020775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We compared secondary primary malignancy risk (SPM) in HIV-uninfected and HIV-infected Hodgkin lymphoma (HL) survivors. We used data from the California Cancer Registry on patients diagnosed with HL from 1990 to 2015 (all ages included), and standardized incidence ratios (SIRs) and multivariable competing risk models for analyses. Of 19,667 survivors, 735 were HIV-infected. Compared with the general population, the risk of SPM was increased by 2.66-fold in HIV-infected and 1.92-fold in HIV-uninfected survivors. Among HIV-infected survivors, median time to development of SPM was shorter (5.4 years) than in HIV-uninfected patients (8.1 years). Additionally, the highest risk of SPM was observed <2 years after diagnosis in HIV-infected survivors (SIR = 4.47), whereas risk was highest ≥20 years after diagnosis (SIR = 2.39) in HIV-uninfected survivors. The risk of SPMs persisted for decades and was higher among HIV-infected survivors, suggesting that these patients should benefit from long-term surveillance and cancer prevention practices.
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Affiliation(s)
- Renata Abrahão
- Center for Oncology Hematology Outcomes Research and Training (COHORT), Division of Hematology and Oncology, University of California Davis, School of Medicine, Sacramento, CA, USA.,Center for Healthcare Policy and Research, University of California Davis School of Medicine, Sacramento, CA, USA
| | - Ann M Brunson
- Center for Oncology Hematology Outcomes Research and Training (COHORT), Division of Hematology and Oncology, University of California Davis, School of Medicine, Sacramento, CA, USA
| | - Justine M Kahn
- Department of Pediatrics, Division of Hematology, Oncology and Stem Cell Transplantation, Columbia University, New York, NY, USA
| | - Qian W Li
- Center for Oncology Hematology Outcomes Research and Training (COHORT), Division of Hematology and Oncology, University of California Davis, School of Medicine, Sacramento, CA, USA
| | - Ted Wun
- Center for Oncology Hematology Outcomes Research and Training (COHORT), Division of Hematology and Oncology, University of California Davis, School of Medicine, Sacramento, CA, USA
| | - Theresa H M Keegan
- Center for Oncology Hematology Outcomes Research and Training (COHORT), Division of Hematology and Oncology, University of California Davis, School of Medicine, Sacramento, CA, USA
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18
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Tian X, Xu WH, Wu JL, Gan HL, Wang HK, Gu WJ, Qu YY, Zhang HL, Ye DW. Clear Cell Papillary Renal Cell Carcinoma Shares Distinct Molecular Characteristics and may be Significantly Associated With Higher Risk of Developing Second Primary Malignancy. Pathol Oncol Res 2021; 27:1609809. [PMID: 34512202 PMCID: PMC8432294 DOI: 10.3389/pore.2021.1609809] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 08/12/2021] [Indexed: 12/12/2022]
Abstract
Traditionally, clear cell papillary renal cell carcinoma (ccpRCC) was considered to share similar molecular and histological characteristics with clear cell renal cell carcinoma (ccRCC) and papillary renal cell carcinoma (pRCC). Here we aimed to identify somatic and germline variants of ccpRCC. For this purpose, we conducted whole-exome sequencing to detect somatic variants in the tissues of 18 patients with pathologically confirmed ccpRCC, who underwent surgical treatment at Fudan University Shanghai Cancer Center. Targeted sequencing was conducted to detect germline variants in paired tumor or normal tissues or blood. Somatic and germline variants of ccRCC and Renal cell carcinoma included in The Cancer Genome Atlas data and other published data were analyzed as well. The molecular profiles of ccpRCC, ccRCC and pRCC were compared. Among the 387 somatic variants identified, TCEB1 (3/18) and VHL (3/18) variants occurred at the highest frequencies. Germline mutation detection showed that nine variants associated with Fanconi anemia (VAFAs) pathway (FANCA, 6/18; FANCI, 3/18) were identified in 18 ccpRCC patients. Among ccpRCC patients with VAFAs, five out of eight patients had second primary malignancy or family history of cancer. Somatic variants characteristics may distinguish ccpRCC from ccRCC or pRCC and germline VAFAs may be a molecular characterization of ccpRCC. Compared with ccRCC or pRCC, ccpRCC patients may be significantly correlated with higher risk of developing second primary malignancy.
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Affiliation(s)
- Xi Tian
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Wen-Hao Xu
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jun-Long Wu
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Hua-Lei Gan
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Hong-Kai Wang
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Wei-Jie Gu
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yuan-Yuan Qu
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Hai-Liang Zhang
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Ding-Wei Ye
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
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19
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Wang Z, Yin Y, Wang J, Zhu Y, Li X, Zeng X. Standardized Incidence Rate, Risk and Survival Outcomes of Second Primary Malignancy Among Renal Cell Carcinoma Survivors: A Nested Case-Control Study. Front Oncol 2021; 11:716741. [PMID: 34395291 PMCID: PMC8362854 DOI: 10.3389/fonc.2021.716741] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 07/13/2021] [Indexed: 01/22/2023] Open
Abstract
Purpose Second primary malignancy (SPM) is challenging for treatment and long-term survival. We sought to investigate the standardized incidence rate (SIR), risk factors, and survival outcomes for SPM after renal cell carcinoma (RCC) treatment. Method A nested case-control study was designed, we identified all T1-4N0-1M0 RCC patients diagnosed between 2004 and 2015 in the Surveillance, Epidemiology, and End Results database and followed them for SPM diagnosis for up to 13 years. Patients with SPM diagnosis ≥6 months after treatment of primary T1-4N0-1M0 RCC were identified as the case cohort and SPM-free patients were the control cohort. SIRs and the excess risk were calculated. A competing risks and Cox model were used to evaluate the risk factors of SPM and overall survival (OS). Results A cohort of 6,204 RCC patients with SPM were matched with a control group of 31,020 RCC patients without SPM. The median time-to-SPM interval was 54.5 months in RCC patients with SPM diagnosis. Besides, an SPM of T3/4 or/and M1 stage diagnosis was positively associated with a longer time-to-SPM interval. SIR of SPM increased by follow-up time and decreased with age at diagnosis (Pfor all <0.001). SPM in the kidney had the highest SIR (54.6, P <0.001) among all SPMs. Prostate cancer (29.8%) in males and breast cancer (23.5%) in females were the most common SPM. Older age, black ethnicity, male sex, higher family income, papillary RCC, and lower TNM stage were significant risk factors for SPM diagnosis. The proportion of deaths from SPM exceeds that of deaths from RCC 3 years after the first RCC treatment. Patients with SPM and early time-to-SPM interval shortens the OS compared with SPM-free patients. The 5-year OS was 85.9% and 58.9% from the first RCC and the SPM diagnosis, respectively. Besides, patients with low-grade/early-stage SPM could benefit from aggressive surgical treatment for solid tumors. Conclusions Collectively, our study described the epidemiological characteristics of SPM among RCC survivors and identified the independent predictors of the SPM diagnosis and its survival outcomes. This study highlights the importance of patient education and follow-up after the surgery for RCC.
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Affiliation(s)
- Zhixian Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yisheng Yin
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yunpeng Zhu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xing Li
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoyong Zeng
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Institute of Urology of Hubei Province, Wuhan, China
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20
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Zahnreich S, Schmidberger H. Childhood Cancer: Occurrence, Treatment and Risk of Second Primary Malignancies. Cancers (Basel) 2021; 13:cancers13112607. [PMID: 34073340 PMCID: PMC8198981 DOI: 10.3390/cancers13112607] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/20/2021] [Accepted: 05/22/2021] [Indexed: 12/14/2022] Open
Abstract
Cancer represents the leading cause of disease-related death and treatment-associated morbidity in children with an increasing trend in recent decades worldwide. Nevertheless, the 5-year survival of childhood cancer patients has been raised impressively to more than 80% during the past decades, primarily attributed to improved diagnostic technologies and multiagent cytotoxic regimens. This strong benefit of more efficient tumor control and prolonged survival is compromised by an increased risk of adverse and fatal late sequelae. Long-term survivors of pediatric tumors are at the utmost risk for non-carcinogenic late effects such as cardiomyopathies, neurotoxicity, or pneumopathies, as well as the development of secondary primary malignancies as the most detrimental consequence of genotoxic chemo- and radiotherapy. Promising approaches to reducing the risk of adverse late effects in childhood cancer survivors include high precision irradiation techniques like proton radiotherapy or non-genotoxic targeted therapies and immune-based treatments. However, to date, these therapies are rarely used to treat pediatric cancer patients and survival rates, as well as incidences of late effects, have changed little over the past two decades in this population. Here we provide an overview of the epidemiology and etiology of childhood cancers, current developments for their treatment, and therapy-related adverse late health consequences with a special focus on second primary malignancies.
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21
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Huang D, Huang C, Wang H, He L, Zhang J, Zhong X, Guo Z, Yuan Y, Zhang W. Secondary Nasopharyngeal Mixed Adenoneuroendocrine Carcinoma After Radical Radiotherapy for Nasopharyngeal Carcinoma: A Rare Case and Literature Review. Onco Targets Ther 2021; 14:1367-1376. [PMID: 33658800 PMCID: PMC7920596 DOI: 10.2147/ott.s283071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 12/28/2020] [Indexed: 12/18/2022] Open
Abstract
The incidence of primary mixed adenoneuroendocrine carcinoma (MANEC) is rapidly increasing. MANEC mainly arises from the gastrointestinal tract, but occasionally it occurs as a pathological type of second primary malignancy (SPM). These SPMs can occur in the nasopharynx. Herein we describe the case of a first secondary nasopharyngeal MANEC that was detected 20 years after radical radiotherapy for nasopharyngeal carcinoma. The patient was a 50-year-old man who was admitted to our hospital after experiencing 1 month of left nasal congestion and ipsilateral tinnitus caused by a nasopharyngeal mass that was detected via physical examination and magnetic resonance imaging. A biopsy specimen from this nasopharyngeal lesion led to a histopathological diagnosis of recurrent nasopharyngeal carcinoma. He underwent high-dose palliative radiotherapy, followed by a course of gemcitabine–cisplatin-based adjuvant chemotherapy. These treatments failed to achieve local control of the tumor, and progressive left earache emerged. Another two forceps biopsies of the external auditory canal mass were conducted, and immunohistochemical testing for adenocarcinoma and neuroendocrine carcinoma markers including CK7, CK8, CK18, carcinoembryonic antigen, synaptophysin, chromogranin A, and CD56 was conducted. The diagnosis of MANEC was ultimately confirmed 5 months after the first visit, and one additional cycle of chemotherapy was subsequently performed. The patient died of hepatic metastases 8 months after the final diagnosis. Knowledge of this rare case will raise awareness of MANEC as a new pathological type of SPM originating in the nasopharynx, which will reduce delays and promote early diagnosis.
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Affiliation(s)
- Donglan Huang
- Department of Radiation Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Chunyue Huang
- Department of Radiation Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Hongmei Wang
- Department of Radiation Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Lizhen He
- Department of Radiation Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, People's Republic of China.,Department of Pathology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Jian Zhang
- Department of Radiation Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Xi Zhong
- Department of Radiation Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, People's Republic of China.,Department of Radiology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Ziqian Guo
- Department of Radiation Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, People's Republic of China.,Endoscopy Center, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Yawei Yuan
- Department of Radiation Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Weijun Zhang
- Department of Radiation Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, People's Republic of China
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Abstract
To achieve a deeper understanding of patients who developed esophageal cancer (EC) as a second primary malignancy, which may help guide in clinical practice for these patients in the future.In the primary cohort, EC patients with a prior malignancy were identified from the surveillance, epidemiology, and end result 18 database. The 5 most common types of prior cancers were picked out based on the frequency of occurrence. In addition, Kaplan-Meier and log-rank tests were performed to investigate the survival impacts of prior cancers on EC patients. Besides, a competing-risk model was constructed to explore the relationship between EC-treatment and EC-specific mortality. In the secondary cohort, patients with stage I-III (N0M0) EC from 2004 to 2014 were enrolled. After propensity score matching, univariate and multivariate Cox analyses were developed to determine the prognostic factors for EC patients.A total of 1199 EC patients with a prior cancer were identified in the primary cohort. The 5 most common sites of prior cancers were prostate, female breast, bladder, lung and bronchus, and larynx. Kaplan-Meier analyses revealed that EC patients with prior prostate cancer and bladder cancer had the best overall survival (OS), while those with prior cancers of larynx and lung and bronchus had the worst OS. Fine and Gray competing risks analysis indicated that the administration of surgery was closely associated with better EC-specific survival (P < .001). In the secondary cohort, multivariate Cox analyses found that age at diagnosis, race, tumor grade, tumor extent, nodal status and metastasis stage, histology, and the administration of surgery were prognostic factors for OS and cancer-specific survival in EC patients. Besides, the existence of a prior cancer was an independent prognostic factor for cancer-specific survival.EC remains to be the most important cause of death in EC patients with a prior cancer. EC related treatment should be actively adopted in patients with a prior cancer, as they were more likely to die from EC than the prior cancer. EC patients with a prior cancer had comparable OS than those without.
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Yang J, Wei R, Song X, Sun X, Wang H, Liu Q, Hu L, Yu H, Wang D. Risk of second primary malignancy after minor salivary gland cancer: A Surveillance, Epidemiology, and End Results database analysis. Head Neck 2021; 43:1769-1779. [PMID: 33590552 DOI: 10.1002/hed.26641] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 12/20/2020] [Accepted: 02/02/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Minor salivary gland cancer (MiSGC) is a group of tumors with varied disease course in the head and neck. We evaluated the risk of a second primary malignancy (SPM) in MiSGC patients and identified possible prognostic factors for survival using a large population database. METHODS We used the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) data to evaluate the risk and prognosis of SPM in patients diagnosed with MiSGC. RESULTS The risk of SPM increased in MiSGC patients compared with the endemic rate. The risk of SPM was slightly greater in female patients and who underwent radiotherapy. Age at primary diagnosis, sex, race, year of diagnosis, SEER stage, radiotherapy, SPM, histology, and tumor site were significant survival prognostic indicators of MiSGC patients. CONCLUSION Radiotherapy and female sex were risk factors for SPM after MiSGC. Long-term surveillance for SPM was important in MiSGC patients.
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Affiliation(s)
- Jingyi Yang
- Department of Otolaryngology, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
| | - Ruoyan Wei
- Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
| | - Xiaole Song
- Department of Otolaryngology, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
| | - Xicai Sun
- Department of Otolaryngology, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
| | - Huan Wang
- Department of Otolaryngology, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
| | - Quan Liu
- Department of Otolaryngology, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
| | - Li Hu
- Department of Experimental Center, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
| | - Hongmeng Yu
- Department of Otolaryngology, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China.,Research Units of New Technologies of Endoscopic Surgery in Skull Base Tumor, Chinese Academy of Medical Sciences, Shanghai, China
| | - Dehui Wang
- Department of Otolaryngology, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China
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Lin X, Lin X, Li Y, Zhang Y, Lin J, Zhang G. Differential Second Primary Malignancy Occurrence After Breast Cancer According to HER2 Status: A Population-Based Study. Int J Gen Med 2021; 14:8775-8784. [PMID: 34853531 PMCID: PMC8627860 DOI: 10.2147/ijgm.s338455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 10/22/2021] [Indexed: 02/05/2023] Open
Abstract
PURPOSE Our study aims to analyze the association between HER2 status of breast cancer (BC) and second primary malignancy (SPM) occurrence. MATERIALS AND METHODS Based on BC patients registered between 2010 and 2018 in the NCI SEER database, we utilized standardized incidence ratio (SIR) and Poisson regression to quantify SPM occurrence compared with the general population. Then, adjusted for competing death risk, cumulative incidence function and Gray's test were adopted to estimate the probability of SPM. Subsequent proportional subdistribution hazards regression was executed to identify the HER2 status impact on SPM risk. Finally, survival analysis was performed. RESULTS A total of 409,796 first BC patients were included and 18,283 were identified with at least one SPM. The SIR of SPM after HER2+ BC was significantly lower than HER2- BC (1.03 vs 1.13; RR, 0.92; 95% CI, 0.88-0.96; p<0.001). The predominantly declining SPM risk was only observed for second BC (RR, 0.89; 95% CI, 0.82-0.96; p=0.003) and lung cancer (RR, 0.84; 95% CI, 0.74-0.95; p=0.007). Furthermore, competing risk analysis verified the protective effect of HER2 positivity status on SPM occurrence. The 5-year cumulative incidence of SPM following HER2+ and HER2- BC were 4.09% and 5.16%, respectively (p<0.001). In addition, among patients suffering from SPM, HER2 positivity status contributed to better overall survival. CONCLUSION It is demonstrated that HER2+ BC patients had lower SPM incidence, which was remarkable for second BC and lung cancer.
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Affiliation(s)
- Xiaoyi Lin
- Department of Breast Cancer, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, People’s Republic of China
- Shantou University Medical College, Shantou, Guangdong, People’s Republic of China
| | - Xin Lin
- Department of Breast Cancer, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, People’s Republic of China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, People’s Republic of China
| | - Yingzi Li
- Department of Breast Cancer, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, People’s Republic of China
- Shantou University Medical College, Shantou, Guangdong, People’s Republic of China
| | - Yuchen Zhang
- Department of Breast Cancer, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, People’s Republic of China
- School of Medicine, South China University of Technology, Guangzhou, Guangdong, People’s Republic of China
| | - Jiali Lin
- Department of Breast Cancer, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, People’s Republic of China
| | - Guochun Zhang
- Department of Breast Cancer, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, People’s Republic of China
- Correspondence: Guochun Zhang Department of Breast Cancer, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Yuexiu District, Guangzhou, 510080, Guangdong, People’s Republic of ChinaTel/Fax +86 20-83827812-50910 Email
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25
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Wang Y, Wu Y, Xu Z, Zhou H, Chen Y, Zhan R. Cytogenetic abnormalities in patients with newly diagnosed multiple myeloma as a secondary primary malignancy: a retrospective study. ACTA ACUST UNITED AC 2020; 25:176-180. [PMID: 32345147 DOI: 10.1080/16078454.2020.1757330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Objectives: Multiple myeloma (MM) often develops as a secondary primary malignancy (SPM). The retinoblastoma susceptibility gene (RB1) was the first tumour suppressor gene to be identified. We pooled and analyzed available data to compare the incidence of RB1 gene deletions and other cytogenetic abnormalities in patients with MM alone or as an SPM.Methods: We conducted a retrospective study of 475 patients. The experimental group comprised 18 patients with MM as an SPM, and the control group comprised 457 MM patients. We analyzed the baseline information in both groups, and used the odds ratio (OR), 95% confidence interval (CI), and forest plot to determine the incidence of SPMs with and without cytogenetic abnormalities.Results: The incidence of RB1 gene deletion was higher in the experimental group. There was no significant difference in other cytogenetic abnormalities.Conclusions: RB1 gene deletions appear to be associated with MM that develops as an SPM.
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Affiliation(s)
- Yiting Wang
- Fujian Institute of Hematology, Fuzhou, People's Republic of China
| | - Yong Wu
- Fujian Institute of Hematology, Fuzhou, People's Republic of China
| | - Zhenshu Xu
- Fujian Institute of Hematology, Fuzhou, People's Republic of China
| | - Huarong Zhou
- Fujian Institute of Hematology, Fuzhou, People's Republic of China
| | - Yuanzhong Chen
- Fujian Institute of Hematology, Fuzhou, People's Republic of China
| | - Rong Zhan
- Fujian Institute of Hematology, Fuzhou, People's Republic of China
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26
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Cherng HJJ, Jain N, Thakral B, Muzzafar T, Miranda RN, Tan D, Rashid A, Kalhor N, Hahn AW, Byers LA, Parseghian CM, Ferrajoli A, Pemmaraju N. Metastatic lung adenocarcinoma mimicking Richter transformation in a patient with chronic lymphocytic leukemia. Leuk Res 2020; 98:106445. [PMID: 32937250 PMCID: PMC9153129 DOI: 10.1016/j.leukres.2020.106445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 09/01/2020] [Accepted: 09/02/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Hua-Jay J Cherng
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Nitin Jain
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Beenu Thakral
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Tariq Muzzafar
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Roberto N Miranda
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Dongfeng Tan
- Department of Anatomical Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Asif Rashid
- Department of Anatomical Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Neda Kalhor
- Department of Anatomical Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Andrew W Hahn
- Department of Thoracic Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Lauren A Byers
- Department of Thoracic Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Christine M Parseghian
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Alessandra Ferrajoli
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Naveen Pemmaraju
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
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27
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Goyal A, O'Leary D, Goyal K, Patel K, Pearson D, Janakiram M. Cutaneous T-cell lymphoma is associated with increased risk of lymphoma, melanoma, lung cancer, and bladder cancer: A systematic review and meta-analysis. J Am Acad Dermatol 2020; 85:1418-1428. [PMID: 32822803 DOI: 10.1016/j.jaad.2020.06.1033] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 06/12/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Patients with cutaneous T-cell lymphoma (CTCL) are at a higher risk of developing second malignancies. However, rates of incidence vary significantly across studies. METHODS A systematic review and meta-analysis of articles published between 1950 and 2019 was performed to evaluate the risk of second malignancies in patients with CTCL. RESULTS We identified 10 eligible studies, including 12 patient cohorts, with 5.9% to 16.8% of patients developing second malignancies. All studies showed a male predominance for patients developing second malignancies. The mean age across the studies ranged from 44.6 to 68.0 years. The time between the diagnosis of CTCL and second malignancy ranged from 2.1 to 5.4 years (mean, 3.29 y; 95% confidence interval [CI], 2.69-5.15). Meta-analysis showed a standardized incidence ratio of 2.18 (95% CI, 1.43-2.93) for all malignancies. The standardized incidence ratios were 15.25 (95% CI, 7.70-22.79) for Hodgkin lymphoma, 4.96 (95% CI, 3.58-6.33) for non-Hodgkin lymphoma, 1.69 (95% CI, 1.18-2.21) for lung cancer, 1.72 (95% CI, 1.18-2.21) for bladder cancer, and 3.09 (95% CI, 1.77-6.43) for melanoma. CONCLUSIONS We find that patients with CTCL are at increased risk of second malignancies, especially Hodgkin and non-Hodgkin lymphoma, lung cancer, bladder cancer, and melanoma. These findings provide evidence of a population at increased risk of malignancy. Early detection may decrease the morbidity burden of second malignancies, thus providing a strong rationale for prospective screening studies.
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Affiliation(s)
- Amrita Goyal
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota
| | - Daniel O'Leary
- Division of Hematology, Oncology, and Transplantation, University of Minnesota, Minneapolis, Minnesota
| | - Kavita Goyal
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota
| | - Krishnan Patel
- Division of Hematology, Oncology, and Transplantation, University of Minnesota, Minneapolis, Minnesota
| | - David Pearson
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota
| | - Murali Janakiram
- Department of Radiation Oncology, University of Minnesota, Minneapolis, Minnesota.
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Ma S, Zhang Y, Li Z, Yan H, Xia L, Shi W, Hu Y. Role of Radiation Therapy Differs Between Stages in Primary Bone Large B-Cell Lymphoma in Rituximab Era: A Population-Based Analysis. Front Oncol 2020; 10:1157. [PMID: 32760674 PMCID: PMC7372636 DOI: 10.3389/fonc.2020.01157] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 06/08/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Primary bone B-cell lymphoma (PB-DLBCL) is a rare entity for which existing data is limited. Whether radiotherapy (RT) should be omitted in the modern treatment of PB-DLBCL is still under debate. We used the SEER database to compare the outcomes among adult patients treated with and without RT in rituximab era. Methods: We included adult patients with PB-DLBCL diagnosed from 2002 to 2016 from SEER 18. The effect of RT on overall survival (OS) using univariate (UVA) and multivariate (MVA) Cox proportional regression and propensity score matching (PSM) was assessed for the entire cohort and subgroups by stages. We calculated the standardized incidence ratio to estimate the short- and long-term risk for second primary malignancies (SPM) from 2002 to 2016 in SEER 18 and 1983-2016 in SEER 9. Results: A total of 1,320 patients were identified, including 856 with early-stage (ES) and 464 with advanced-stage (AS). A decreasing trend was observed in the ES cohort after 2002, while the rate of RT utilization remained stable in the AS cohort over the past three decades. Most patients in ES (63.9%) underwent RT, whereas only 42.2% of AS patients received it. RT significantly improved survival both in UVA and MVA (P < 0.001, P = 0.010, respectively). PSM analysis further validated the survival advantage of RT (P = 0.018). Moreover, a novel web-based prediction model was established to individualize the potential benefit from RT. In subgroup analyses, OS was improved with RT in those who had ES disease (p < 0.001) but not in those who had AS disease (P = 0.776). With short-term follow up in SEER 18, none of the subgroups showed a significantly elevated risk of developing SPMs. However, RT significantly elevated the late toxicities of second malignancies in ES patients diagnosed at the age of 18-39 or those with appendicular sites of bone involvement. Conclusion: This population-based analysis is the largest PB-DLBCL dataset to date and demonstrates a significant survival benefit associated with RT in early stages rather than advanced stages. In the absence of randomized controlled trials, RT should be considered in ES disease with cautions of second cancers in specific subsets of patients.
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Affiliation(s)
- Shengling Ma
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuanyuan Zhang
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ziying Li
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Han Yan
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Linghui Xia
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wei Shi
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Fred Hutchinson Cancer Research Center, Seattle, WA, United States
| | - Yu Hu
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Zhang B, Guo K, Zheng X, Sun L, Shen M, Ruan S. Risk of Second Primary Malignancies in Colon Cancer Patients Treated With Colectomy. Front Oncol 2020; 10:1154. [PMID: 32766153 PMCID: PMC7378742 DOI: 10.3389/fonc.2020.01154] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 06/08/2020] [Indexed: 12/25/2022] Open
Abstract
Background: Second primary malignancy (SPM) attracts a growing attention. However, the clinical features of colon cancer (CC) survivors with SPMs are not clear and could help guide clinicians to develop a better surveillance strategy. Methods: We reviewed 56,930 CC survivors treated with colectomy from the Surveillance, Epidemiology, and End Results (SEER) database during 1998–2011. Competing risk models and nomograms were conducted for predicting the risk of occurring SPMs. The clinical utility of the models was measured by decision curve analysis (DCA) using net benefit approaches. Results: Five thousand thirteen (17.1%) of male patients developed SPMs and sites of SPMs included prostate (32.2%), lung and bronchus (11.6%), urinary bladder and kidney (10.8%), colon (10.0%), and melanoma of the skin (3.9%), while 3,592 (13.0%) of female patients occurred SPMs and sites of SPMs involved breast (25.8%), lung and bronchus (13.6%), colon (11.6%), uterus (8.2%), urinary bladder, and kidney (5.6%). Survivors with a second carcinoma of lung and bronchus showed the worst prognosis. Older age increased the risk of SPMs in both male (Subdistribution hazard ratio =2.85 [95% confidence interval = 2.53–3.21]) and female (1.80 [1.59–2.04]) survivors, especially for the risk of a second prostate carcinoma in male (5.33 [4.03–7.03]). Compared with white race, black male survivors remained at higher risk to develop the second prostate carcinoma (1.98 [1.74–2.26]). Competing-risk nomograms for CC survivors were established to help clinicians predict the probabilities of overall SPMs and prostate carcinoma. Validation of nomograms showed good discrimination and accuracy, and DCAs revealed the clinical effectiveness. Conclusions: We profiled the clinical characteristics of a large population-based cohort of CC survivors with SPMs. These features may improve future follow-up management, especially for the surveillance of second prostate cancer in men and second breast cancer in women.
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Affiliation(s)
- Bo Zhang
- Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China.,Institute of Cancer and Basic Medicine, Chinese Academy of Sciences, Hangzhou, China
| | - Kaibo Guo
- The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China
| | - Xueer Zheng
- The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China
| | - Leitao Sun
- The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China.,Department of Medical Oncology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Minhe Shen
- Department of Medical Oncology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Shanming Ruan
- The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China.,Department of Medical Oncology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
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30
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Asarkar A, Flores JM, Nathan CAO. Comparison of Survival Estimates Following Recurrence, Persistence, or Second Primary Malignancy in Oropharyngeal Squamous Cell Carcinoma. Otolaryngol Head Neck Surg 2020; 163:1209-1217. [PMID: 32633195 DOI: 10.1177/0194599820932872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study investigated survival among patients with oropharyngeal squamous cell carcinoma (OPSCC) after recurrence, persistence, and second primary malignancies (SPMs). STUDY DESIGN Retrospective cohort study. SETTING Patients were treated at a tertiary cancer center. SUBJECTS AND METHODS Patients with OPSCC who had completed treatment between 2001 and 2017 were included. Survival estimates of 4 groups of patients were calculated: (1) patients who were disease free after initial treatment, (2) patients who had persistent disease, (3) those with recurrent disease, and (4) patients with SPMs. Cox proportional hazard models and parametric survival analyses (using Weibull distributions) were used to obtain hazard ratios (HRs) and time ratios (TRs). RESULTS The cohort included 364 patients. The crude overall SPM prevalence was 8.2%. Mean overall survival (OS) time in years for patients who remained disease free after treatment was 4.02 years. Among patients who experienced recurrence, the recurrence-free survival (RFS) was 2.58 years while their mean (SD) OS was 3.67 (2.7) years. Participants who experienced persistence had a mean (SD) OS of 1.67 (1.68) years. Patients with observed SPMs had a mean (SD) OS of 6.39 (4.06) years since their primary cancer but shortened survivals of 1.75 (2.34) years since the secondary diagnosis. Differences were present even after accounting for human papillomavirus (HPV) and smoking status. CONCLUSIONS Our findings stress the importance of active surveillance as per current National Comprehensive Cancer Network guidelines, irrespective of the HPV status or smoking status. Prospective studies with a larger number of SPM cases and longer follow-up are needed to validate survival trends even beyond 5 years.
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Affiliation(s)
- Ameya Asarkar
- Department of Otolaryngology-Head and Neck Surgery, LSU Health, Shreveport, Louisiana, USA.,Surgical Service, Otolaryngology Section, Overton Brooks Veterans Affairs Medical Center, Shreveport, Louisiana, USA
| | | | - Cherie-Ann O Nathan
- Department of Otolaryngology-Head and Neck Surgery, LSU Health, Shreveport, Louisiana, USA.,Surgical Service, Otolaryngology Section, Overton Brooks Veterans Affairs Medical Center, Shreveport, Louisiana, USA
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Maruyama N, Okubo Y, Umikawa M, Matsuzaki A, Hokama A, Hirano F, Maruyama T, Nishihara K, Nakasone T, Makishi S, Nakamura H, Yoshimi N. Quadruple Multiple Primary Malignancies: Early Detection of Second Primary Malignancy by Esophagogastroduodenoscopy/Colonoscopy Is Crucial for Patients with Classic Kaposi's Sarcoma. Diagnostics (Basel) 2020; 10:E218. [PMID: 32295165 DOI: 10.3390/diagnostics10040218] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 04/04/2020] [Accepted: 04/09/2020] [Indexed: 02/06/2023] Open
Abstract
Currently, Kaposi's sarcoma (KS) is treated following the recommendations of international guidelines. These guidelines recommend esophagogastroduodenoscopy/colonoscopy for detecting multicentric KS of visceral lesions. Second primary malignancies (SPMs) are also a common KS complication; however, information on their detection and treatment is unfortunately not yet indicated in these guidelines. This paper reports on an 86-year-old man who suffered from quadruple primary malignancies: skin classic KS with colon adenocarcinoma, oral squamous cell carcinoma (maxilla), and well-differentiated stomach adenocarcinoma. Gastric cancer was incidentally detected during esophagogastroduodenoscopy, which was performed to detect visceral KS. We suggest that esophagogastroduodenoscopy/colonoscopy be routinely performed during the follow-up of patients with KS. As SPMs are crucial complications in patients with KS, these malignancies should be detected as early as possible.
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Ji F, Yang CQ, Li XL, Zhang LL, Yang M, Li JQ, Gao HF, Zhu T, Cheng MY, Li WP, Wu SY, Zhong AL, Wang K. Risk of breast cancer-related death in women with a prior cancer. Aging (Albany NY) 2020; 12:5894-5906. [PMID: 32250967 PMCID: PMC7185107 DOI: 10.18632/aging.102984] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 03/24/2020] [Indexed: 12/14/2022]
Abstract
The overall risk of developing a second primary cancer is increasing. The purpose of this study was to analyze the survival of patients with breast cancer diagnosed after a prior cancer and identify risk factors of breast cancer death in this population. Using the SEER database, we identified 1,310 woman diagnosed with breast cancer between 2010 and 2015 after a prior cancer as the primary cohort. Clinicopathological characteristics were compared using the Student t-test and chi-square test. Fine and Gray’s regression was used to evaluate the effect of treatments on breast cancer death. After propensity score matching (PSM), 9,845 pairs of patients with breast cancer as the prior or second cancer diagnosed between 2010 and 2011 were included as a second cohort. PSM-adjusted Kaplan-Meier and Cox hazards models were used to evaluate the impact of prior cancer on survival. The results showed that survivors of gynecologic cancers (e.g., ovarian cancer) had a higher risk of developing breast cancer than survivors of gastrointestinal and urinary tract cancers. More patients died of breast cancer than of prior urinary cancer (53.3% vs. 40%, P < 0.05) and melanoma (66.7% vs. 33.3%, P < 0.05). The ratio of breast cancer deaths to prior cancer deaths was significantly higher in patients with diagnoses interval ≥ 3 years than in those with the interval < 3 years (2.67 vs. 0.69, P < 0.001). Breast cancer-specific survival and overall survival rates were significantly lower in women with breast cancer as the second primary cancer than in those with breast cancer as the prior cancer, especially among hormone receptor-positive women. However, breast cancer treatment decreased the risk of breast cancer -specific death (hazard ratio = 0.695, 95% confidence interval: 0.586–0.725, P < 0.001). Breast cancer patients with prior cancers must be carefully considered for clinical trials.
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Affiliation(s)
- Fei Ji
- Department of Breast Cancer, Cancer Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, P.R. China.,School of Medicine, South China University of Technology, Guangzhou 510006, P.R. China
| | - Ci-Qiu Yang
- Department of Breast Cancer, Cancer Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, P.R. China.,School of Medicine, South China University of Technology, Guangzhou 510006, P.R. China
| | - Xiao-Ling Li
- Department of Breast Cancer, Cancer Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, P.R. China.,School of Medicine, South China University of Technology, Guangzhou 510006, P.R. China
| | - Liu-Lu Zhang
- Department of Breast Cancer, Cancer Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, P.R. China.,School of Medicine, South China University of Technology, Guangzhou 510006, P.R. China
| | - Mei Yang
- Department of Breast Cancer, Cancer Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, P.R. China.,School of Medicine, South China University of Technology, Guangzhou 510006, P.R. China
| | - Jie-Qing Li
- Department of Breast Cancer, Cancer Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, P.R. China.,School of Medicine, South China University of Technology, Guangzhou 510006, P.R. China
| | - Hong-Fei Gao
- Department of Breast Cancer, Cancer Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, P.R. China.,School of Medicine, South China University of Technology, Guangzhou 510006, P.R. China
| | - Teng Zhu
- Department of Breast Cancer, Cancer Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, P.R. China.,School of Medicine, South China University of Technology, Guangzhou 510006, P.R. China
| | - Min-Yi Cheng
- Department of Breast Cancer, Cancer Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, P.R. China.,School of Medicine, South China University of Technology, Guangzhou 510006, P.R. China
| | - Wei-Ping Li
- Department of Breast Cancer, Cancer Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, P.R. China.,School of Medicine, South China University of Technology, Guangzhou 510006, P.R. China
| | - Si-Yan Wu
- Department of Operation Room, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, P.R. China.,School of Medicine, South China University of Technology, Guangzhou 510006, P.R. China
| | - Ai-Ling Zhong
- Department of Operation Room, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, P.R. China.,School of Medicine, South China University of Technology, Guangzhou 510006, P.R. China
| | - Kun Wang
- Department of Breast Cancer, Cancer Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, P.R. China.,School of Medicine, South China University of Technology, Guangzhou 510006, P.R. China
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Shi S, Xie H, Yin W, Zhang Y, Peng X, Yu F, Shemanski KA, Kim AW, Wang X. The prognostic significance of the 8th edition AJCC TNM staging system for non-small-cell lung cancer is not applicable to lung cancer as a second primary malignancy. J Surg Oncol 2020; 121:1233-1240. [PMID: 32170977 DOI: 10.1002/jso.25903] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 03/02/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND OBJECTIVES It is unclear whether the prognostic significance of the 8th American Joint Committee on Cancer (AJCC) tumor, node, metastasis (TNM) staging system for non-small-cell lung cancer (NSCLC) is applicable to lung cancer as a second primary malignancy (LCSPM). This study used a population-based database to evaluate this relationship. METHODS Patients diagnosed with second primary lung cancer after a nonpulmonary malignancy were identified from the Surveillance, Epidemiology and End Results (SEER) registry from 2004 to 2015. Cumulative incidence function (CIF) and multivariable CIF regression analyses were performed to estimate the difference in disease-specific mortality (DSM) among different TNM stages. RESULTS Our cohort included 2687 patients from the SEER database. After CIF analysis, although rates of 1-year, 3-year, and 5-year DSM trended higher with increasing TNM stages, the DSM curves overlapped for many subcategories. In a multivariable regression analysis, hazards ratios (HRs) for subcategories of stage Ι demonstrated no significant difference compared with the reference stage ΙA1 ([ΙA2 HR = 1.120; 95% confidence interval [CI], 0.477-2.626]; [ΙA3 HR = 1.762; 95% CI, 0.752-4.126]; [ΙB HR = 2.003; 95% CI, 0.804-4.911]). The following HRs trended higher for increasing TNM stages but with overlapping CIs among adjacent stage groupings. CONCLUSION The 8th edition AJCC TNM staging system fails to provide accurate prognostic value for LCSPM.
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Affiliation(s)
- Shuai Shi
- Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Hui Xie
- Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Wei Yin
- Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yuqian Zhang
- Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xiong Peng
- Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Fenglei Yu
- Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Kimberly A Shemanski
- Department of Surgery, Division of Thoracic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Anthony W Kim
- Department of Surgery, Division of Thoracic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Xiang Wang
- Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
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Mroueh R, Nevala A, Haapaniemi A, Pitkäniemi J, Salo T, Mäkitie AA. Risk of second primary cancer in oral squamous cell carcinoma. Head Neck 2020; 42:1848-1858. [PMID: 32057158 DOI: 10.1002/hed.26107] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 01/06/2020] [Accepted: 01/28/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The incidence and survival of oral squamous cell carcinoma (OSCC) patients have increased in recent years. Understanding their long-term survival aspects is essential for optimal treatment and follow-up planning. Almost one in five cancers diagnosed occurs nowadays in individuals with a previous diagnosis of cancer. METHODS Patients diagnosed with primary OSCC during 1953-2015 were retrieved from the Finnish Cancer Registry. Both standardized incidence ratios (SIR) and excess absolute risk (EAR) per 1000 person-years at risk (PYR) of second primary cancer (SPC) were calculated relative to the general population. RESULTS Among 6602 first primary OSCC patients there were 640 (10%) SPCs. The SIR for SPCs was 1.85 (95% CI: 1.71-1.99, P < .001) corresponding to an EAR of 8.78 (95% CI: 7.29-10.26). CONCLUSIONS Health care professionals should be aware of the second primary cancer risk after management of primary OSCC and patients need to be counseled about this phenomenon.
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Affiliation(s)
- Rayan Mroueh
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland
| | | | - Aaro Haapaniemi
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland
| | - Janne Pitkäniemi
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer and Research, Helsinki, Finland.,Faculty of Social Sciences, University of Tampere, Tampere, Finland.,Department of Public Health, School of Medicine, University of Helsinki, Helsinki, Finland
| | - Tuula Salo
- Cancer and Translational Medicine Unit, University of Oulu, Medical Research Unit, Oulu University Hospital, Helsinki, Finland.,Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.,Haartman Institute, University of Helsinki, Helsinki, Finland
| | - Antti A Mäkitie
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland.,Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska Hospital, Stockholm, Sweden.,Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Ting WC, Lu YCA, Ho WC, Cheewakriangkrai C, Chang HR, Lin CL. Machine Learning in Prediction of Second Primary Cancer and Recurrence in Colorectal Cancer. Int J Med Sci 2020; 17:280-291. [PMID: 32132862 PMCID: PMC7053359 DOI: 10.7150/ijms.37134] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 10/03/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Colorectal cancer (CRC) is the third commonly diagnosed cancer worldwide. Recurrence of CRC (Re) and onset of a second primary malignancy (SPM) are important indicators in treating CRC, but it is often difficult to predict the onset of a SPM. Therefore, we used mechanical learning to identify risk factors that affect Re and SPM. PATIENT AND METHODS CRC patients with cancer registry database at three medical centers were identified. All patients were classified based on Re or no recurrence (NRe) as well as SPM or no SPM (NSPM). Two classifiers, namely A Library for Support Vector Machines (LIBSVM) and Reduced Error Pruning Tree (REPTree), were applied to analyze the relationship between clinical features and Re and/or SPM category by constructing optimized models. RESULTS When Re and SPM were evaluated separately, the accuracy of LIBSVM was 0.878 and that of REPTree was 0.622. When Re and SPM were evaluated in combination, the precision of models for SPM+Re, NSPM+Re, SPM+NRe, and NSPM+NRe was 0.878, 0.662, 0.774, and 0.778, respectively. CONCLUSIONS Machine learning can be used to rank factors affecting tumor Re and SPM. In clinical practice, routine checkups are necessary to ensure early detection of new tumors. The success of prediction and early detection may be enhanced in the future by applying "big data" analysis methods such as machine learning.
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Affiliation(s)
- Wen-Chien Ting
- Division of Colorectal Surgery, Department of Surgery, Chung Shan Medical University Hospital, Taiwan.,Institute of Medicine, Chung Shan Medical University, Taiwan
| | | | - Wei-Chi Ho
- Department of Gastroenterology, Jen-Ai Hospital, Taichung, Taiwan
| | - Chalong Cheewakriangkrai
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Thailand
| | - Horng-Rong Chang
- Division of Nephrology, Department of Internal medicine, Chung Shan Medical University Hospital, Taiwan.,School of Medicine, Chung Shan Medical University
| | - Chia-Ling Lin
- Department of Nutrition, Jen-Ai hospital, Taichung, Taiwan
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Abstract
There have been no studies on implementing effective screening models for esophageal adenocarcinoma and squamous cell carcinoma survivors. We used a proportional subdistribution hazards model to estimate second primary malignancy risks among patients with esophageal adenocarcinoma and squamous cell carcinoma. We validated models using a bootstrap cross-validation method and performed decision curve analysis to evaluate their clinical utility. Age group and SEER historic stage were significantly associated with second primary malignancy risk after diagnosis of esophageal adenocarcinoma and squamous cell carcinoma. Saving positive lymph nodes and distant metastasis were significant factors in the adenocarcinoma group, and marital status, tumor location, and chemotherapy were significant factors in the squamous cell carcinoma group. Calibration plots show good concordance between predicted and actual outcomes except in high-probability areas for the risk of a second primary malignancy in patients with esophageal squamous cell carcinoma. Discrimination performances of the Fine-Gray models were evaluated using c-indices, which were 0.691 and 0.662 for second primary malignancies in patients with esophageal adenocarcinoma and squamous cell carcinoma, respectively. Decision curve analysis yielded a range of threshold probabilities (0.020-0.177 and 0.021-0.133 for patients with esophageal adenocarcinoma and squamous cell carcinoma, respectively) at which the clinical net benefit of the risk model was larger than those of hypothetical all-screening and no-screening scenarios. Our nomograms enable selection of patient populations at high risk for a second primary malignancy and thus will facilitate the design of prevention trials for affected populations.
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Abstract
INTRODUCTION Second primary malignancy (SPM) is associated with decreased overall survival (OS) in laryngeal carcinomas (LC). METHODS One hundred eighty three LC patients were analyzed retrospectively. The primary and secondary endpoints were the incidence of SPM and the OS difference between patients with and without SPM. RESULTS SPM developed in 22 (12.0%) patients at median 52 months (range, 4-131 months), with a yearly 2.8% incidence, of which 19 (10.4%) and 3 (1.6%) were metachronous and synchronous, respectively. Lung was the commonest SPM (72.7%). Of 47 deaths, 12 (25.5%) were SPM related. Comparatively SPM patients had significantly shorter median OS (68.0 months vs. median not reached; P = 0.005), with lower 5-year (67.0% vs. 78.9%) and 8-year (32.6 vs. 69.8%) survival rates. CONCLUSION The present findings suggested the SPM as a competing risk factor for death in index LC patients with its annual incidence rate of 2.8% and for accounting one of every four deaths in this patients group. Emergence of lung carcinoma as the most frequent type of SPM and the ability to treat >50% of them with an estimated long-term outcomes emphasizes the importance of early diagnosis and curative treatment of SPMs.
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Affiliation(s)
- Yurday Ozdemir
- Department of Radiation Oncology, Baskent University Adana Treatment and Research Center, Adana, Turkey
| | - Erkan Topkan
- Department of Radiation Oncology, Baskent University Adana Treatment and Research Center, Adana, Turkey
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Wang W. Increased incidence of second primary malignancy in patients with malignant astrocytoma: a population-based study. Biosci Rep 2019; 39:BSR20181968. [PMID: 31138756 DOI: 10.1042/BSR20181968] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Revised: 04/17/2019] [Accepted: 05/06/2019] [Indexed: 11/18/2022] Open
Abstract
We identified patients diagnosed with malignant astrocytoma (MA) as the first of two or more primary malignancies between 1973 and 2015 from Surveillance, Epidemiology and End Results (SEER) database. Multiple primaries-standardized incidence ratio (MP-SIR) was calculated to quantitate the risk of second primary malignancy (SPM). We further identified the risk factors of developing SPM and factors affecting overall survival (OS) in MA patients with SPM. Our results revealed that overall risk of SPM among MA patients was significantly higher than that in general population (SIR: 1.09, 95% confidence interval (CI): 1–1.18, P<0.05). Specific sites where the risk of SPM increased included salivary gland, bone and joints, soft tissue including heart, brain, cranial nerves other nervous system, thyroid, acute non-lymphocytic leukemia and acute myeloid leukemia. Overall risk of SPM in patients aged ≤29 and 30–59 years significantly increased (4.34- and 1.41-fold respectively). Whereas patients aged ≥60 years had a significantly decreased risk of SPM. Patients in the group of latency at 36–59, 60–119 and ≥120 months carried significantly increased overall risk of SPM. Multivariate analysis revealed that age, race, marital status, WHO grade, differentiated grade of cancer tissues, latency was independent predictor of OS in MA patients with SPM, which were all selected into the nomogram. The calibration curve for probability of survival showed good agreement between prediction by nomogram and actual observation. In conclusion, MA survivors should be advised of their increased risk for developing certain cancers in their lifetime. Our study had clinical implications for the surveillance of MA survivors at risk of developing SPM.
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Brown AL, Arroyo VM, Agrusa JE, Scheurer ME, Gramatges MM, Lupo PJ. Survival disparities for second primary malignancies diagnosed among childhood cancer survivors: A population-based assessment. Cancer 2019; 125:3623-3630. [PMID: 31251393 DOI: 10.1002/cncr.32356] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 05/02/2019] [Accepted: 05/03/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Curative therapy places childhood cancer survivors at increased risk for second primary malignancies (SPMs). However, there have been few population-based attempts to characterize differences between outcomes of SPMs in childhood cancer survivors and outcomes of first primary malignancies (FPMs). METHODS Clinical and demographic information about childhood cancer survivors who developed SPMs and individuals with comparable FPMs was extracted from the Surveillance, Epidemiology, and End Results program. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated with Cox proportional hazards models comparing the overall survival (OS) of individuals with and without a history of childhood cancer. OS was evaluated both overall and for specific cancers diagnosed in 50 or more childhood cancer survivors. Models accounted for potential confounders, including sex, race, age, treatment decade, histology, and disease stage. RESULTS Compared with individuals with FPMs (n = 1,332,203), childhood cancer survivors (n = 1409) with an SPM experienced poorer OS (HR, 1.86; 95% CI, 1.72-2.02) after the study had accounted for cancer type, age, sex, race, and decade of diagnosis. A history of childhood cancer remained a poor prognostic factor for all specific cancers evaluated, including breast cancer (HR, 2.07; 95% CI, 1.63-2.62), thyroid cancer (HR, 3.59; 95% CI, 2.08-6.19), acute myeloid leukemia (HR, 2.38; 95% CI, 1.87-3.05), brain cancer (HR, 2.09; 95% CI, 1.72-2.55), melanoma (HR, 2.57; 95% CI, 1.55-4.27), bone cancer (HR, 1.88; 95% CI, 1.37-2.57), and soft-tissue sarcoma (HR, 2.44; 95% CI, 1.78-3.33). CONCLUSIONS Compared with individuals without a prior cancer diagnosis, survivors of childhood cancer with an SPM experienced inferior outcomes. Survival disparities were observed for the most frequent SPMs diagnosed in childhood cancer survivors.
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Affiliation(s)
- Austin L Brown
- Hematology-Oncology Section, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Vidal M Arroyo
- Hematology-Oncology Section, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Jennifer E Agrusa
- Hematology-Oncology Section, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Michael E Scheurer
- Hematology-Oncology Section, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - M Monica Gramatges
- Hematology-Oncology Section, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Philip J Lupo
- Hematology-Oncology Section, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Abstract
Background A population-based estimate of risk of second primary malignancy (SPM) in patients with cholangiocarcinoma (CCA) is still lacking. Objectives To investigate the overall and site-specific risk of SPM in patients with CCA. To identify risk factors of SPM and further evaluate the impact of SPM on overall survival (OS) and disease specific survival (DSS) in patients with CCA. Methods Patients with histologically diagnosed CCA between 1973 and 2015 were identified from the Surveillance, Epidemiology and End Results database. Standardized incidence ratio (SIR) was calculated. Risk factors for SPM and CCA survival were evaluated by logistic, Cox, and nomogram methods. Results We found that the overall risk of SPM in patients with CCA was significantly higher than that in the general population (SIR =1.27, 95% CI =1.03–1.55, P<0.05). The risk of SPM was significantly increased at specific sites, including transverse colon, intrahepatic bile duct, other biliary, and thyroid. A significant increase in overall risk was characterized in the subgroups of patients aged ≤29, patients aged 30–59 years, females, whites, and patients with latency ≤11 months (63.41, 2.45, 1.4, 1.3, and 2.6-fold, respectively). In patients with CCA, not having undergone surgery for the first primary malignancy (vs having undergone surgery for the first primary malignancy; HR =0.269; 95% CI =0.211–0.342; P<0.001) was associated with significantly decreased risk of SPM. Patients with SPM had better OS and DSS than those without SPM (Log rank P<0.001). Absence of SPM was an independent risk factor for poorer OS and DSS. Conclusion Although the risk of SPM in patients with CCA was significantly increased, the presence of SPM did not shorten OS and DSS of patients with CCA, possibly due to the relatively poorer survival of patients with CCA.
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Affiliation(s)
- Liping Zhuang
- Department of Integrative Oncology, Fudan University Shanghai Cancer Center, Shanghai, China, .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China,
| | - Xia Yan
- Department of Integrative Oncology, Fudan University Shanghai Cancer Center, Shanghai, China, .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China,
| | - Zhiqiang Meng
- Department of Integrative Oncology, Fudan University Shanghai Cancer Center, Shanghai, China, .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China,
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Adjei Boakye E, Buchanan P, Hinyard L, Stamatakis K, Osazuwa-Peters N, Simpson MC, Schootman M, Piccirillo JF. Risk and outcomes for second primary human papillomavirus-related and -unrelated head and neck malignancy. Laryngoscope 2018; 129:1828-1835. [PMID: 30582167 DOI: 10.1002/lary.27634] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 09/12/2018] [Accepted: 10/03/2018] [Indexed: 11/07/2022]
Abstract
OBJECTIVES/HYPOTHESIS To 1) examine the characteristics of patients who develop second primary malignancies (SPMs) from an index human papillomavirus (HPV)-related head and neck squamous cell carcinoma (HNSCC) and HPV-unrelated HNSCC and to 2) compare overall survival between those with HPV-related and HPV-unrelated index HNSCC among patients who develop SPM. STUDY DESIGN Retrospective cohort analysis. METHODS A retrospective study was conducted of 113,259 patients who were diagnosed with HNSCC from 2000 to 2014. SPM was defined as the first subsequent primary cancer occurring at least 2 months after index cancer diagnosis, and HPV-relatedness was based on whether patients' index HNSCC was potentially HPV-related or HPV-unrelated. Multivariable Fine and Gray (FG) competing-risks regression models were used to estimate factors associated with risk of SPM by HPV-relatedness. Among patients with SPM, an adjusted Cox proportional hazards (PH) regression model was used to assess the association between HPV-relatedness and survival. RESULTS Approximately 13,900 patients (12.3%) developed SPM. In the FG model, patients with HPV-unrelated HNSCC had a 15% higher risk of developing SPM (adjusted hazard ratio: 1.15, 95% confidence interval: 1.10-1.20) than those with potentially HPV-related HNSCC, but the same characteristics were associated with SPM development. In the Cox PH model, patients with SPM whose index HNSCC was HPV-unrelated had higher risk of death than those whose index HNSCC was potentially HPV-related (adjusted hazard ratio: 1.06; 95% confidence interval: 1.02-1.11). CONCLUSIONS Patients with HPV-unrelated HNSCC have a higher risk of SPM development than do those with HPV-related HNSCC. Effective secondary disease-prevention strategies should be established to improve long-term patient outcomes. LEVEL OF EVIDENCE NA Laryngoscope, 129:1828-1835, 2019.
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Affiliation(s)
- Eric Adjei Boakye
- Department of Population Science and Policy, Southern Illinois University School of Medicine, Springfield, Illinois.,Department of Internal Medicine, Southern Illinois University School of Medicine, Springfield, Illinois
| | - Paula Buchanan
- Saint Louis University Center for Health Outcomes Research, St. Louis, Missouri
| | - Leslie Hinyard
- Saint Louis University Center for Health Outcomes Research, St. Louis, Missouri
| | - Katie Stamatakis
- Department of Epidemiology and Biostatistics, Saint Louis University College for Public Health and Social Justice, St. Louis, Missouri
| | - Nosayaba Osazuwa-Peters
- Department of Epidemiology and Biostatistics, Saint Louis University College for Public Health and Social Justice, St. Louis, Missouri.,Saint Louis University Cancer Center, St. Louis, Missouri.,Department of Otolaryngology-Head and Neck Surgery, Saint Louis University School of Medicine, St. Louis, Missouri
| | - Matthew C Simpson
- Department of Otolaryngology-Head and Neck Surgery, Saint Louis University School of Medicine, St. Louis, Missouri
| | - Mario Schootman
- Department of Epidemiology and Biostatistics, Saint Louis University College for Public Health and Social Justice, St. Louis, Missouri
| | - Jay F Piccirillo
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri
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Huang NS, Chen XX, Wei WJ, Mo M, Chen JY, Ma B, Yang SW, Xu WB, Wu J, Ji QH, Guo XM, Liu GY, Shao ZM, Wang Y. Association between breast cancer and thyroid cancer: A study based on 13 978 patients with breast cancer. Cancer Med 2018; 7:6393-6400. [PMID: 30480382 PMCID: PMC6308067 DOI: 10.1002/cam4.1856] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Revised: 10/14/2018] [Accepted: 10/15/2018] [Indexed: 12/19/2022] Open
Abstract
Background Thyroid cancer (TC) is one of the most commonly seen secondary malignancy in breast cancer (BC) survivors. Materials and methods A retrospective study was conducted in BC patients in our center from 1999 to 2013. Patients were divided into BC‐TC group and BC‐alone group. Results In total, 13 978 BC patients were identified, among whom 247 (1.8%) had TC. The standardized incidence ratio (SIR) of TC was 4.48 compared with Chinese females, and up to 98.0% of cases were thyroid papillary carcinomas. A family history of malignancy was the only independent risk factor (odds ratio = 1.457, P = 0.025) for development of TC in patients with BC. We also identified inferior survival in patients with synchronous versus metachronous BC‐TC (P = 0.016). Synchronous BC‐TC (risk ratio = 5.597, P = 0.018) was an independent prognostic factor for inferior RFS. Conclusions We observed high co‐occurrence of TC in patients with BC. There might be different mechanisms behind synchronous and metachronous BC‐TC.
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Affiliation(s)
- Nai-Si Huang
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xing-Xing Chen
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Wen-Jun Wei
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Miao Mo
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Department of Clinical Statistics, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Jia-Ying Chen
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Ben Ma
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Shu-Wen Yang
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Wei-Bo Xu
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jiong Wu
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Qing-Hai Ji
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xiao-Mao Guo
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Guang-Yu Liu
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Zhi-Min Shao
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Yu Wang
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
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45
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Shin DW, Choi YJ, Kim HS, Han KD, Yoon H, Park YS, Kim N, Lee DH. Secondary Breast, Ovarian, and Uterine Cancers After Colorectal Cancer: A Nationwide Population-Based Cohort Study in Korea. Dis Colon Rectum 2018; 61:1250-7. [PMID: 30239394 DOI: 10.1097/DCR.0000000000001203] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND The risk of a second primary cancer has increased along with the increasing life expectancies of colorectal cancer survivors. OBJECTIVE We aimed to evaluate the incidence rate and risk factors of breast and gynecological (ovarian, uterine cervix/corpus) cancers among female colorectal cancer survivors. DESIGN This is a retrospective population-based cohort study. SETTINGS This study used data from the National Health Insurance Corporation of Korea. PATIENTS Each patient with colorectal cancer diagnosed from 2007 to 2012 was followed until 2015 and compared with age-matched women without colorectal cancer at a 1:5 ratio. MAIN OUTCOME MEASURES The primary outcome was de novo breast/gynecological cancer. Patients with available medical checkup data were included in an additional analysis. RESULTS We analyzed 56,682 patients with colorectal cancer and 288,119 age-matched noncolorectal cancer controls. The risk of breast/gynecological cancer was higher among patients with colorectal cancer than among controls (HR, 2.91; p < 0.001). The association with colorectal cancer was the highest for ovarian cancer (HR, 6.72), followed by uterine corpus cancer (HR, 3.99), cervical cancer (HR, 2.82), and breast cancer (HR, 1.85). This association remained consistent in the subgroup analysis of medical checkup data (14,190 patients with colorectal cancer, 71,933 controls). Among patients with colorectal cancer, those aged <55 years had a higher risk of breast/gynecological cancers than those aged >55 years (HR, 3.51 vs 2.59), and those with dyslipidemia had a higher risk of breast cancer than those without dyslipidemia (HR, 2.66 vs 2.06). LIMITATIONS This was a retrospective, population-based study. A prospectively designed study is needed to validate our conclusions. CONCLUSIONS Compared with the general population, patients with colorectal cancer carry a higher risk of developing secondary breast, ovarian, and uterine cancers. See Video Abstract at http://links.lww.com/DCR/A731.
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Kosmidis C, Varsamis N, Anthimidis G, Baka S, Valoukas D, Koletsa T, Zarampouka K, Koimtzis G, Georgakoudi E, Zarogoulidis P, Efthymiadis C. Primary hepatocellular carcinoma in a patient with history of treated breast cancer: a case report with challenging diagnosis and treatment. Int J Gen Med 2018; 11:399-403. [PMID: 30349348 PMCID: PMC6188071 DOI: 10.2147/ijgm.s176052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Breast cancer is the most common malignancy in women worldwide. Long-term survivors among patients treated for breast cancer are at a high risk for developing a second primary malignancy. Hepatocellular carcinoma is the most frequent primary hepatic malignancy and should be ruled out in breast cancer patients who are diagnosed with solitary hepatic lesions. False diagnosis may lead to inappropriate oncologic staging and treatment of the disease. Case presentation We present the case of a 73-year-old female patient who had been treated for invasive ductal breast cancer 7 years ago and was diagnosed with a solid hepatic lesion at segments VI and VII and a small, calcified lesion at the tail of the pancreas on follow-up with an abdominal computed tomography. Oncology council decided that both lesions could be resected after determining whether they were metastatic or second primary malignancies. The patient underwent laparotomy and rapid biopsy which showed primary hepatocellular carcinoma and fibrosis of the pancreas. We performed hepatic segmentectomy (VI–VII) and cholecystectomy, while the pancreatic lesion was left intact. The postoperative course of the patient was uncomplicated and she remains disease free 2 years after the operation without any adjuvant therapy. Conclusion All hepatic lesions detected in breast cancer patients should be evaluated with open mind and liver biopsy should be performed to get a definitive diagnosis and implement the proper treatment strategy.
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Affiliation(s)
| | - Nikolaos Varsamis
- Department of Surgery, Interbalkan European Medical Center, Thessaloniki, Greece
| | - Georgios Anthimidis
- Department of Surgery, Interbalkan European Medical Center, Thessaloniki, Greece
| | - Sofia Baka
- Department of Oncology, Interbalkan European Medical Center, Thessaloniki, Greece
| | - Dimitrios Valoukas
- Department of Oncology, General Hospital of Ptolemaida, Ptolemaida, Greece
| | - Triantafyllia Koletsa
- Pathology Department, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Katerina Zarampouka
- Pathology Department, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Georgios Koimtzis
- Third Surgical Department, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Paul Zarogoulidis
- Pulmonary-Oncology Unit, "Theageneio" Cancer Hospital, Thessaloniki, Greece,
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Ozguler Y, Yazici Y, Hatemi G, Tascilar K, Yazici H. Assessing the possible association of anti-TNF use with new malignancies: A neglected methodological consideration. Pharmacoepidemiol Drug Saf 2018; 27:894-901. [PMID: 29920843 DOI: 10.1002/pds.4579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 04/29/2018] [Accepted: 05/25/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Yesim Ozguler
- Division of Rheumatology, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Yusuf Yazici
- New York University School of Medicine, New York, NY, USA
| | - Gulen Hatemi
- Division of Rheumatology, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Koray Tascilar
- Okmeydani Research and Training Hospital, Istanbul, Turkey
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Mou H, Liao Q, Hou X, Chen T, Zhu Y. Clinical characteristics, risk factors, and outcomes after adjuvant radiotherapy for patients with thymoma in the United States: analysis of the Surveillance, Epidemiology, and End Results (SEER) Registry (1988-2013). Int J Radiat Biol 2018; 94:495-502. [PMID: 29553917 DOI: 10.1080/09553002.2018.1454618] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE The surgery with adjuvant radiation for the treatment of thymoma is still debated. The aim of this study was to examine the efficacy of postoperative radiotherapy (PORT) in a population-based registry of patients with thymoma. MATERIALS AND METHODS We conducted a retrospective analysis of the Surveillance, Epidemiology, and End Results database to compare the outcomes of patients with thymoma who received surgery with or without PORT. RESULTS Among the 2234 patients of this study, the surgery with PORT group had a longer mean overall survival (OS) and cancer-specific survival (CSS) than did the surgery without PORT group (OS: 172.3 vs. 155.3 months, p = .005; CSS: 247.3 vs. 241.8 months, p = .04). PORT significantly improved OS and CSS of patients with stage III/IV disease, but decreased CSS for those with stage I/IIA disease. Although the surgery with PORT group had a higher rate of secondary cancers, the between-group difference in the disease-free interval was not significant. CONCLUSIONS PORT provides a significant benefit for patients with thymoma, particularly those with advanced disease. However, it also increases the risk of a second malignancy. We suggest that treatment guidelines should adopt a more positive stance on the use of PORT.
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Affiliation(s)
- Haibo Mou
- a Department of Oncology , Zhejiang University International Hospital (Shulan Hospital) , Hangzhou , China
| | - Qin Liao
- a Department of Oncology , Zhejiang University International Hospital (Shulan Hospital) , Hangzhou , China
| | - Xuehua Hou
- a Department of Oncology , Zhejiang University International Hospital (Shulan Hospital) , Hangzhou , China
| | - Te Chen
- a Department of Oncology , Zhejiang University International Hospital (Shulan Hospital) , Hangzhou , China
| | - Yuping Zhu
- a Department of Oncology , Zhejiang University International Hospital (Shulan Hospital) , Hangzhou , China
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49
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Nimura F, Nakasone T, Matsumoto H, Maruyama T, Matayoshi A, Maruyama N, Yoshimi N, Arasaki A, Nishihara K. Dedifferentiated liposarcoma of the oral floor: A case study and literature review of 50 cases of head and neck neoplasm. Oncol Lett 2018; 15:7681-7688. [PMID: 29740489 PMCID: PMC5934721 DOI: 10.3892/ol.2018.8274] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 02/23/2018] [Indexed: 12/23/2022] Open
Abstract
Dedifferentiated liposarcoma (DDLS) has a relatively poor prognosis, however this neoplasm rarely occurs in the head and neck. To date, no definite protocol has been established for the diagnosis and treatment of head and neck DDLS. The present study reports the case of a 69-year-old male patient with DDLS of the oral floor. To the best of our knowledge, this is the first documented case of oral floor DDLS. In addition, this is the first reported case with the development of a second primary malignancy following the treatment of head and neck DDLS. A literature review of 50 cases of head and neck DDLS revealed that preoperative biopsy is not reliable for the diagnosis of these tumors and an accurate pathological diagnosis with total resection is preferred.
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Affiliation(s)
- Fumikazu Nimura
- Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0215, Japan
| | - Toshiyuki Nakasone
- Department of Oral and Maxillofacial Surgery, University Hospital of the Ryukyus, Nishihara, Okinawa 903-0215, Japan
| | - Hirofumi Matsumoto
- Department of Pathology, University Hospital of the Ryukyus, Nishihara, Okinawa 903-0215, Japan
| | - Tessho Maruyama
- Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0215, Japan.,Department of Oral and Maxillofacial Surgery, University Hospital of the Ryukyus, Nishihara, Okinawa 903-0215, Japan
| | - Akira Matayoshi
- Department of Oral and Maxillofacial Surgery, University Hospital of the Ryukyus, Nishihara, Okinawa 903-0215, Japan
| | - Nobuyuki Maruyama
- Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0215, Japan.,Department of Oral and Maxillofacial Surgery, University Hospital of the Ryukyus, Nishihara, Okinawa 903-0215, Japan
| | - Naoki Yoshimi
- Department of Pathology, University Hospital of the Ryukyus, Nishihara, Okinawa 903-0215, Japan.,Department of Pathology and Oncology, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0215, Japan
| | - Akira Arasaki
- Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0215, Japan.,Department of Oral and Maxillofacial Surgery, University Hospital of the Ryukyus, Nishihara, Okinawa 903-0215, Japan
| | - Kazuhide Nishihara
- Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0215, Japan.,Department of Oral and Maxillofacial Surgery, University Hospital of the Ryukyus, Nishihara, Okinawa 903-0215, Japan
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50
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Chaudhary P, Gupta S, Leekha N, Tandon R, Nandy M, De S. Pattern of occurrence and treatment outcome of second primary malignancies: A single center experience. South Asian J Cancer 2017; 6:137-138. [PMID: 28975126 PMCID: PMC5615887 DOI: 10.4103/2278-330x.214583] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Background: The incidence of cancer survivors is increasing, but these individuals, unfortunately, face the risk of second primary malignancies (SPMs). This increasing incidence can be credited to increased survival rates of cancer patients, environmental factors, host factors, and genetic predispositions. Hence, vigilance on the part of the patient as well as clinician for the development of new signs and symptoms is mandatory. Aims: Retrospective analysis of the pattern of incidence and clinical outcome of patients diagnosed with SPM and to review the literature. Settings and Design: A hospital-based retrospective collection of prospective data of patients diagnosed with SPM. Materials and Methods: Thirty-six patients with histopathologically proven SPM from January 2009 to July 2015 were included in this study. Factors such as age, sex, site, stage, histology, treatment received, and outcome were recorded. Statistical Analysis Used: Basic statistical tools have been used for analyzing the data. Results and Conclusions: The likelihood of occurrence of second malignancy, either synchronous or metachronous, should always be kept in mind while evaluating a cancer patient. Appearance of new signs and symptoms during the initial evaluation as well as during follow-up should raise a suspicion, and both patient and oncologist should have a low threshold for further assessment. Early diagnosis and treatment will reduce morbidity and mortality and lead to better survival outcome.
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Affiliation(s)
- Prekshi Chaudhary
- Department of Radiation Oncology, Max Super Speciality Hospital, Ghaziabad, Uttar Pradesh, India
| | - Sweety Gupta
- Department of Radiation Oncology, Max Super Speciality Hospital, Ghaziabad, Uttar Pradesh, India
| | - Nitin Leekha
- Department of Surgical Oncology, Max Super Speciality Hospital, Ghaziabad, Uttar Pradesh, India
| | - Ruchir Tandon
- Department of Medical Oncology, Max Super Speciality Hospital, Ghaziabad, Uttar Pradesh, India
| | - Malay Nandy
- Department of Medical Oncology, Max Super Speciality Hospital, Ghaziabad, Uttar Pradesh, India
| | - Sudarsan De
- Department of Radiation Oncology, Max Super Speciality Hospital, Ghaziabad, Uttar Pradesh, India
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