Gastric Carcinoma as Second Malignant Neoplasm in a Survivor From High-risk Neuroblastoma

10562 Background: This study aimed to estimate the incidence of late-occurring VTE among survivors of childhood cancer, and to identify associated demographic and clinical factors that define high-risk subgroups for potential screening and prevention. Methods: Using data from CCSS, a multi-institutional, longitudinal cohort of 5-year survivors of childhood cancer (diagnosed 1970-1999) and their siblings, the primary endpoint of self-reported late VTE (occurring ≥5 years after diagnosis) was estimated using multivariable piecewise exponential models adjusted for age, sex, and race. Generalized estimating equations accounted for potential within-family correlation where applicable. Results: Among 23,601 survivors and 5051 siblings, the incidence of VTE was 1.15 and 0.48 events per 1000 person-years, respectively. For survivors, median age at last follow-up was 28.6 years (range 5.6-58.3) and median follow-up time from diagnosis was 21.2 years (range 5.0-39.3). The adjusted rate ratio (RR) for survivors compared to siblings was 2.2 (95% confidence interval [CI] = 1.7-2.8, P< 0.01). Among survivors, risk factors for VTE included BMI≥30kg/m2 (ref. BMI 18.5-24.5; RR = 1.5, CI = 1.2-2.0, P< 0.01), increasing number of severe or life-threatening (i.e. CTCAE grades 3 or 4) non-VTE chronic conditions (ref. 0 conditions; 1-2 conditions: RR = 2.5, CI = 2.0-3.1, P< 0.01 ; ≥3 conditions: RR = 3.5, CI = 2.5-4.9, P< 0.01), and cancer recurrence or second malignant neoplasm (RR = 3.5, CI = 2.7-4.6, P< 0.01). Incidence of late VTE was associated with increased subsequent mortality, independent of non-VTE chronic conditions (RR 2.2, 95% CI = 1.7-2.8, P< 0.01). Conclusions: Survivors of childhood cancer remain at increased risk for VTE across their lifespan. While typically not causal, late VTE was associated with subsequent mortality. Care providers should be aware of this increased risk and consider interventions that target modifiable co-morbidities such as obesity. Surveillance and education should be directed toward high-risk survivors.

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Cancer screening in adult survivors of childhood cancer: A report from the Childhood Cancer Survivor Study (CCSS)

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.18_suppl.cra6501 ◽

2009 ◽

Vol 27 (18_suppl) ◽

pp. CRA6501-CRA6501 ◽

Cited By ~ 1

Author(s):

P. C. Nathan ◽

K. K. Ness ◽

M. M. Hudson ◽

M. Mahoney ◽

J. S. Ford ◽

...

Keyword(s):

High Risk ◽

Cancer Survivors ◽

Childhood Cancer ◽

Pap Smear ◽

Malignant Neoplasm ◽

Childhood Cancer Survivors ◽

Cancer Center ◽

Second Malignant Neoplasm ◽

Increased Risk ◽

Population Controls

CRA6501 Background: Childhood cancer survivors may develop a second malignant neoplasm (SMN) and require surveillance to detect new cancers. Methods: We surveyed survivors and siblings from the CCSS, a cohort study of patients who have survived ≥5 years after a diagnosis of childhood cancer from 1970–86. We assessed compliance with the American Cancer Society's (ACS) guidelines for surveillance mammography, colonoscopy and PAP smears, and compared them to a matched population comparison group drawn from the 2003 National Health Interview Survey. Further, we examined compliance with the Children's Oncology Group (COG) guidelines for more frequent colonoscopy, mammography and skin exams in survivors at high risk for cancers of the colon (≥30 Gy pelvic, abdominal or spinal radiation), breast (≥ 20 Gy breast radiation in females) or skin (any radiation). Proportions screened were compared between groups with adjusted generalized estimating equations or log-binomial regression models. Results: There were 8318 survivors (50.6% male, mean age at interview 31.2 ± 7.3 years), 2661 siblings and 8318 population controls. 141/829 (17.6%), 592/855 (70.4%) and 3362/3690 (92.6%) eligible survivors reported a colonoscopy, mammogram, or PAP smear per ACS guidelines. Survivors were less likely than siblings (odds ratio [OR] 0.30; 95% confidence interval [CI] 0.18–0.49) and population controls (OR 0.63; CI 0.50–0.80) to have a colonoscopy, and less likely than siblings to have a PAP smear (risk ratio [RR] 0.98; CI 0.97–0.99). However, they were more likely than siblings (RR 1.14; CI 1.03–1.27) and population controls (RR 1.05; CI 1.01–1.10) to have a mammogram. Among survivors at increased risk for a SMN, only 92/809 (11.4%) reported a colonoscopy within the COG recommended 5-year period, 164/537 (30.5%) reported a mammogram within a 1-year period and 1288/4833 (26.7%) reported a skin exam. Care at a cancer center was associated with mammography (RR 1.91; 95% CI 1.02–1.27) and skin exam (RR 1.55; 95% CI 1.22–196) in high-risk patients. Conclusions: Childhood cancer survivors are not screened adequately for SMNs. Surveillance is very poor amongst those at highest risk for colon, breast, or skin cancer. Survivors and their physicians need education about the importance of surveillance. No significant financial relationships to disclose.

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Newly-detected solitary bony lytic/sclerotic lesion with soft tissue mass in a previously treated case of high-risk medulloblastoma: importance of contemporary pathology techniques to differentiate second malignant neoplasm from extra-neuraxial metastasis

Journal of Brain and Spinal Cancer ◽

10.14302/issn.2576-182x.jbsc-14-576 ◽

2015 ◽

Vol 1 (1) ◽

pp. 7-14

Keyword(s):

High Risk ◽

Soft Tissue ◽

Soft Tissue Mass ◽

Malignant Neoplasm ◽

Second Malignant Neoplasm ◽

Tissue Mass ◽

Sclerotic Lesion ◽

Previously Treated

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Biologics and risk of second malignant neoplasm

Nature Reviews Rheumatology ◽

10.1038/nrrheum.2017.209 ◽

2017 ◽

Vol 14 (2) ◽

pp. 62-62

Author(s):

Sarah Onuora

Keyword(s):

Malignant Neoplasm ◽

Second Malignant Neoplasm

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A nomogram based on Psoas muscle index and prognostic nutritional index predicts the prognosis of intrahepatic cholangiocarcinoma after surgery: a multi-center cohort study

10.21203/rs.3.rs-753676/v1 ◽

2021 ◽

Author(s):

Wenming Bao ◽

Liming Deng ◽

haitao Yu ◽

bangjie He ◽

Zixia Lin ◽

...

Keyword(s):

High Risk ◽

Intrahepatic Cholangiocarcinoma ◽

Poor Prognosis ◽

High Risk Patient ◽

Malignant Neoplasm ◽

Psoas Muscle ◽

Prognostic Nutritional Index ◽

Nutritional Index ◽

Risk Patients ◽

Patient Prognosis

Abstract Background Intrahepatic cholangiocarcinoma (ICC) is a malignant neoplasm with a poor prognosis. Prediction of prognosis is critical for the individualized clinical management of patients with ICC. The purpose of this study is to establish a nomogram based on the psoas muscle index (PMI) and prognostic nutritional index (PNI) to identify the high risk-patient with ICC after curative resection. Methods ICC Patients after hepatectomy in multi-hospital from August 2012 to October 2019 were enrolled. The overall survival (OS) and recurrence-free survival (RFS) rates were analyzed by Kaplan-Meier. The independent factors were identified by univariate and multivariate Cox regression analyses. A nomogram based on independent factors was established to predict ICC patient prognosis. Results 178 ICC patients were included. The OS was worst in the patients with a combination of low PMI combined low PNI (p < 0.01). PMI, PNI, lymph node metastasis and tumor differentiation were the independent prognostic risk factors; these factors were used to establish the nomogram was established by it. The calibration curve revealed that the nomogram survival probability prediction model was in good agreement with the actual observation results. The nomogram has good reliability in predicting ICC patient prognosis (OS C-index = 0.692). The area under the receiver operating characteristic curve (AUC) for the nomogram's 3-year predicted survival was 0.752. Based on the stratified by nomogram, the median survival for low-risk patients was 59.8 months, compared with 16.2 months for high-risk patients (p༜0.001). Conclusion The nomogram based on the PMI and PNI can identify patients with the highest risk of poor prognosis after curative hepatectomy. It is a good decision-making tool for individualized treatment.

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