Therapeutic Outcome of Second Primary Malignancies in Patients with Well-Differentiated Thyroid Cancer

Background.The aims of this study were to analyze the clinical characteristics of SPM in patients with well-differentiated thyroid cancer and to determine the long-term prognosis in patients with double malignancies.Materials and Methods.We retrospectively analyzed 2,864 patients with well-differentiated thyroid cancer and a mean age of44.0±14.4years. Of these, 200 (7.0%) were diagnosed with SPM, 115 of which were diagnosed with metachronous SPM.Results.Of 2,864 patients, 163 (5.7%) patients died of thyroid cancer and 301 (10.5%) died of any cause by the end of the follow-up period. Multivariate analysis identified age, SPM, external radiotherapy, TNM stage, and postoperative serum Tg level to be factors independently associated with decreased survival. Of 200 patients with SPM, 74 (37.0%) died. In comparison to the anachronous and synchronous groups, the metachronous SPM group had a higher mean age; more advanced tumor, node, and metastasis stage; lower remission rate; higher postoperative radioactive iodide (131I) accumulated dose; a higher proportion of patients who underwent external radiotherapy; and higher thyroid cancer and total mortality rates.Conclusions.Patients with well-differentiated thyroid carcinoma and metachronous SPM had worse prognoses compared to patients without SPM.

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Increased risk of certain second primary malignancies in patients treated for well-differentiated thyroid cancer

International Journal of Clinical Oncology ◽

10.1007/s10147-015-0904-6 ◽

2015 ◽

Vol 21 (2) ◽

pp. 231-239 ◽

Cited By ~ 5

Author(s):

Tommi T. Hakala ◽

Juhani A. Sand ◽

Arja Jukkola ◽

Heini S. Huhtala ◽

Saara Metso ◽

...

Keyword(s):

Thyroid Cancer ◽

Differentiated Thyroid Cancer ◽

Second Primary ◽

Increased Risk ◽

Well Differentiated ◽

Second Primary Malignancies

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The Risk of Second Primary Malignancies up to Three Decades after the Treatment of Differentiated Thyroid Cancer

Yearbook of Surgery ◽

10.1016/s0090-3671(09)79426-1 ◽

2009 ◽

Vol 2009 ◽

pp. 158-159

Author(s):

T.J. Fahey

Keyword(s):

Thyroid Cancer ◽

Differentiated Thyroid Cancer ◽

Second Primary ◽

Second Primary Malignancies

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Nonthyroidal second primary malignancies in differentiated thyroid cancer patients: Is the incidence increased comparing to the general population and could it be a radioiodine therapy consequence?

International Journal of Cancer ◽

10.1002/ijc.33116 ◽

2020 ◽

Vol 147 (10) ◽

pp. 2838-2846

Author(s):

Virginia Cappagli ◽

Adele Caldarella ◽

Gianfranco Manneschi ◽

Paolo Piaggi ◽

Valeria Bottici ◽

...

Keyword(s):

Thyroid Cancer ◽

General Population ◽

Cancer Patients ◽

Differentiated Thyroid Cancer ◽

Radioiodine Therapy ◽

Second Primary ◽

Second Primary Malignancies

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The Risk of Second Primary Malignancies up to Three Decades after the Treatment of Differentiated Thyroid Cancer

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2007-1154 ◽

2008 ◽

Vol 93 (2) ◽

pp. 504-515 ◽

Cited By ~ 221

Author(s):

Aaron. P. Brown ◽

Jergin Chen ◽

Ying J. Hitchcock ◽

Aniko Szabo ◽

Dennis C. Shrieve ◽

...

Keyword(s):

Thyroid Cancer ◽

General Population ◽

Differentiated Thyroid Cancer ◽

Second Primary ◽

Second Primary Cancers ◽

Increased Risk ◽

Absolute Excess Risk ◽

Second Primary Malignancies ◽

Radioisotope Therapy

Abstract Background: The 10-yr survival rate of patients with differentiated thyroid cancer exceeds 90%. These patients may be at elevated risk for secondary cancers. Methods: The risk of nonthyroid second primary malignancies after differentiated thyroid cancer was determined in 30,278 patients diagnosed between 1973 and 2002 from centers participating in the National Cancer Institute’s Surveillance, Epidemiology, and End Results program. Median follow-up was 103 months (range, 2–359 months). Risk was further assessed for the addition of radioisotope therapy, gender, latency to development of secondary cancer, and age at thyroid cancer diagnosis. Results: There were 2158 patients who developed a total of 2338 nonthyroid second primary malignancies, significantly more than that expected in the general population [observed/expected (O/E) = 1.09; 95% confidence interval (CI), 1.05–1.14; P < 0.05; absolute excess risk per 10,000 person-years (AER) = 6.39]. A significantly greater risk of second primary malignancies over that expected in the general population was for patients treated with radioisotopes (O/E = 1.20; 95% CI, 1.07–1.33; AER = 11.8) as well as for unirradiated patients (O/E = 1.05; 95% CI, 1.00–1.10; AER = 3.53). However, the increased risk was greater for the irradiated vs. the unirradiated cohort (relative risk = 1.16; 95% CI, 1.05–1.27; P < 0.05). Gender did not affect risk. The greatest risk of second primary cancers occurred within 5 yr of diagnosis and was elevated for younger patients. Conclusions: The overall risk of second primary malignancies is increased for thyroid cancer survivors and varies by radioisotope therapy, latency, and age at diagnosis.

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