Different Clinical Features of Primary and Secondary Tumors in Patients with Multiple Malignancies

2005 ◽  
Vol 91 (4) ◽  
pp. 317-320 ◽  
Author(s):  
Mehmet Artac ◽  
Hakan Bozcuk ◽  
Mustafa Ozdogan ◽  
Ayşe Nur Demiral ◽  
Alpay Sarper ◽  
...  
Keyword(s):  
Clinical Features ◽  
Second Primary ◽  
Multiple Primary Cancer ◽  
Breast Cancers ◽  
Primary Malignancy ◽  
Primary Tumors ◽  
Multiple Malignancies ◽  
Secondary Tumors ◽  
Second Tumors ◽  
Second Primaries

Clinical features of the first and second primaries in patients with multiple malignancies have not been extensively studied. We compared patient and treatment characteristics of the primary malignancy in 48 consequent multiple primary cancer patients with those of the second primary in the same cohort. The second primaries comprised fewer breast cancers; 29.2% of primaries as opposed to 10.4% of second tumors were breast cancer (P = 0.049). In addition, primary tumors tended to be at a lower TNM stage than secondary tumors (P = 0.060). The median overall survival after the diagnosis of the first primary for the whole cohort was 22.3 years (95% CI, 2.0–42.5) and the median time to presentation of the second malignancy was 38 months after the diagnosis of the first primary (range, 0 to 384). Therefore, the prognosis of cancers in the multiple malignancy group appears to be good and they appear to have an indolent clinical behavior. Thus, we recommend a long screening time for secondary tumors after a curative treatment in patients with common cancers, taking into account the different occurrence patterns of second primaries with respect to first primaries.

Concurrent split course hyperfractionated radiotherapy (Hfx RT) with biweekly cisplatin (DDP) and paclitaxel (P) in patients with recurrent, previously irradiated squamous cell carcinoma of the head and neck (SCCHN): The MUSC experience

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 5578-5578
Author(s):  
R. Sawhney ◽  
A. Dragun ◽  
R. K. Stuart ◽  
U. B. Chaudhary ◽  
T. Day ◽  
...  
Keyword(s):  
Performance Status ◽  
Concurrent Chemotherapy ◽  
Second Primary ◽  
Hematologic Toxicity ◽  
Radiation Toxicity ◽  
Primary Malignancy ◽  
Primary Tumors ◽  
Initial Surgery ◽  
Locally Recurrent ◽  
Grade 3

5578 Background: Locally recurrent disease (RD) contributes to the majority of SCCHN-related deaths. In addition, second primary tumors (SPT) develop in approximately 30% of patients (pts) who were cured of their primary malignancy. For pts with disease (RD or SPT) in a previously irradiated region, therapeutic options are limited. Approaches utilizing reirradiation with concurrent chemotherapy (CT) have been investigated, with promising initial results. We retrospectively report the clinical outcome & toxicity of such a regimen. Methods: A cohort of pts with locally recurrent or second primary SCCHN within previous radiation portals were treated with concurrent chemoradiotherapy (CRT). Pts received HFx RT (1.5 Gy/Fx BID × 5 every 2 wks × 4), in combination with DDP 15 mg/m2 IV QD × 5 and P 20 mg/m2 IV QD × 5 q 2 wks × 4. Filgrastim was given on days 6–13 of each 2 wk cycle. Results: Nineteen pts were treated (median age 61; 84% with RD at median of 22 mos, 16% SPT; primary site: oropharynx-32%, larynx-32%, oral cavity 21%). Two pts had treatment discontinued early (due to hemoptysis & declining performance status, respectively). Seventeen pts were evaluable at a median f/u of 13 mos. Acute skin & mucous membrane toxicity (Grade ≥ 2) was seen in 11% and 5% of pt’s, respectively, and 32% of pts developed skin fibrosis as a late radiation toxicity. Most pts (82%) received all 4 scheduled cycles of CT. Grade ≥ 3 hematologic toxicity occurred in 29% of pts (anemia 24%, neutropenia 24%, & thrombocytopenia 12%). Infection was the primary non-hematologic toxicity, with Grade ≥ 3 infection in 29% (4 pneumonia, 1 vascular catheter). There was 1 treatment-related death (hypotension with CVA). Of the 16 pts who completed treatment, 4 had initial surgery, and thus had no measurable disease upon commencing CRT. Objective responses to CRT were noted in all of the remaining 12 pts and 50% achieved a CR. One-year OS rate was 65%, with median survival not yet reached. Conclusions: RD and SPT pts who are not surgical candidates have limited treatment options. Aggressive reirradiation with biweekly CT produces excellent response rates, with acceptable local and systemic toxicities. No significant financial relationships to disclose.

Additional primary malignancies in patients with pancreatic cancer.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 185-185
Author(s):  
Shyam S. Allamaneni ◽  
Rohit Sharma ◽  
Austin Miller ◽  
Saikrishna S. Yendamuri ◽  
John F. Gibbs
Keyword(s):  
Pancreatic Cancer ◽  
Pancreatic Adenocarcinoma ◽  
Cancer Diagnosis ◽  
Life Time ◽  
P Value ◽  
Second Primary ◽  
Seer Database ◽  
Second Primary Malignancy ◽  
Primary Malignancy ◽  
Second Primaries

185 Background: Rates of second primary malignancy have been increasing with increased cancer survivorship. The published literature on second primaries in patients with pancreatic adenocarcinoma is sparse. We addressed this question utilizing the SEER database. Methods: 99,614 patients of primary pancreatic adenocarcinoma diagnosed between 1973-2006 were identified from SEER database. Of these, 8,889 (8.93%) had another primary diagnosed before pancreatic cancer (BPC) and 1813 (1.82%) a second primary diagnosed after pancreatic cancer (APC). SAS was used for statistical analysis and P-value <0.05 was determined to be significant. Results: The most common non-pancreatic primary identified were prostate, breast, lung, colorectal, and urinary bladder. The median age at presentation was 75 and 71 years in the BPC and APC groups respectively. APC patients had higher odds of developing primary cancers of embryonic gut origin (esophagus, stomach, small intestine, hepatobiliary, lung, and thyroid) compared to PBC patients (p<0.05). Patients of BPC compared to APC were more likely to be older than 70 yrs (70.5% vs. 65.3% p=0.01), less likely to undergo surgery for pancreatic cancer (11.2% vs.5.87% p=<0.05) and with decreased median survival (7 vs.3 months). With each passing decade, increasing second primaries were diagnosed, presumably reflecting better overall survival from cancer diagnosis. Conclusions: Approximately 11% of pancreatic adenocarcinoma patients have another cancer in their life time. Identifying common genetic and risk factors in these patients with multiple malignancies may provide the new therapeutic opportunities for patients with pancreatic cancer.

Update of NGS analysis of Italian survey of second tumors in patients with diagnosis of GIST (gastrointestinal stromal tumor).

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e23518-e23518
Author(s):  
Silvia Gasperoni ◽  
Francesca Castiglione ◽  
Margherita Vannucchi ◽  
Laura Papi ◽  
Elena Fumagalli ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Cox Model ◽  
Significant Risk ◽  
Low Risk ◽  
Second Primary ◽  
Primary Tumors ◽  
Molecular Features ◽  
Second Tumors ◽  
Second Primary Tumors

e23518 Background: In patients with GIST, literature reports a risk of second primary tumors between 4.5% and 33% with different distribution in the worldwide. The network of 7 italian EURACAN centers has collected clinical and molecular features of GIST patients with second primary tumors. Methods: We reviewed the clinical characteristics of 201 patients with GIST and second primary tumors in order to evaluate association between risk of dead and each possible factor, using Kaplan meier curve, log-rank test and Cox model for Hazard Ratio and it’s interval Confidence 95% estimation. Furthermore, NGS analysis ( 56 gene onco panel) in 72 patients with GIST was performed. Results: On the basis of the significant correlation previously observed between the Miettinen risk criteria of GIST (low/very low) and the incidence of second primary tumors (gastrointestinal tumors),P < 0.001 (Abstr 11032 ASCO 2019), we observed in these patients a median age of diagnosis of GIST of 68, with prevalent gastric site localization ( KIT exon 11 mutation), NF1 and Lynch (kit/pdgfra WT) syndromes in the low risk subgroup. The more frequent site of second epithelial tumor in gastrointestinal tract was the colon followed by gastric, pancreatic and biliary tract. In patients with GIST with low-very low risk according Miettinen classification, after a median follow-up period of 25 years, we have observed that the gastroenteric site of second tumors occurrence is significantly related to the survival (p < .0003). In the NGS analysis of the GIST we observed the pathogenetic somatic mutations in the following genes: BRCA 2 (p.Thr2125fs), but germline test negative, TP53 (p.Arg192*,p.Gly244Ser,p.His168Leu), RET (p.Lys120Asn, p.His168Leu, p.Thr930Met ), NRAS (p.Gly134Asp), CTNNB1 (p.Ser45Phe), MSH6 (P.Ala164Val), SMARCB1 (p.Arg192), VHL (p.Gly93Val), PTEN(p.Val158Ile, p.Asn323fs), STK1I (p.Arg40Cys), SMO (p.Glu194Lys), EGFR (p.Gly721Asp), ATM (p.Asp2708Asn), ERBB4 (p.Asn181Ile). Conclusions: In our analysis patients with GIST (low-very low classes according to Miettinen) have significant risk to death because of second primary tumors in gastrointestinal tract. Specific attention to gastrointestinal screening during the follow-up of GIST (low and very low risk) is required.

Second Primary Tumors in Neurofibromatosis 1 Patients Treated for Optic Glioma: Substantial Risks After Radiotherapy

2006 ◽  
Vol 24 (16) ◽  
pp. 2570-2575 ◽  
Author(s):  
Saba Sharif ◽  
Rosalie Ferner ◽  
Jillian M. Birch ◽  
James E. Gillespie ◽  
H. Rao Gattamaneni ◽  
...  
Keyword(s):  
Nervous System ◽  
Neurofibromatosis 1 ◽  
Optic Glioma ◽  
Second Primary ◽  
Primary Tumors ◽  
Nervous System Tumors ◽  
Increased Risk ◽  
Second Tumors

Purpose Optic pathway gliomas (OPGs) are the most common CNS tumor in neurofibromatosis 1 (NF1) patients. We evaluated the long-term risk of second tumors in NF1-related OPGs after radiotherapy. Patients and Methods We reviewed 80 NF1 OPG patients from two NF1 clinics to evaluate the long-term risk of developing subsequent nervous system tumors, with or without radiotherapy. Results Fifty-eight patients were assessable for second tumors. Nine (50%) of 18 patients who received radiotherapy after their OPGs developed 12 second tumors in 308 person-years of follow-up after radiotherapy. Eight (20%) of 40 patients who were not treated with radiotherapy developed nine tumors in 721 person-years of follow-up after diagnosis of their OPGs. The relative risk of second nervous system tumor after radiotherapy was 3.04 (95% CI, 1.29 to 7.15). Conclusion There is a significantly increased risk of second nervous system tumors in those NF1 patients who received radiotherapy for their OPGs, especially when treated in childhood. Thus radiotherapy should only be used if absolutely essential in children with NF1.

Elevated risk of second malignant neoplasms in pediatric germ cell tumor patients.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 10010-10010
Author(s):  
Maria Clarissa de Faria Soares Rodrigues ◽  
Carlos Rodriguez-Galindo ◽  
Karina Braga Ribeiro ◽  
A. Lindsay Frazier
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumors ◽  
Malignant Neoplasm ◽  
Primary Diagnosis ◽  
Second Primary ◽  
Malignant Neoplasms ◽  
Primary Malignancy ◽  
Second Malignant Neoplasm ◽  
Primary Tumors ◽  
Treatment Type

10010 Background: The probability of cure is very high for children with germ cell tumors (GCT), but late effects from cisplatinum can be quite significant. In addition to the immediate effects of oto-, neuro and nephrotoxicity, data from men treated for testicular cancer shows that the rate of second malignant neoplasm (SMN) is doubled and that a man treated before age 20 has a 50% chance of SMN by age 75. This study was designed to assess the risk of SMN among individuals treated for malignant GCT during childhood. Methods: We included all patients 0-19 years old with a primary diagnosis of malignant GCT registered in the Surveillance, Epidemiology and End Results (SEER) in the period 1973-2008. We analyzed tumors occurring at least 12 months after the first primary. Standardized incidence ratios (SIR) and 95% confidence intervals (CI) were calculated using SEER Stat, version 8.0.1. Results: The cohort comprised 1997 patients (798 women and 1,199 men); 86.3% had primary gonadal tumors (91% in men and 79.5% in women). The median age at diagnosis of the primary malignancy was 17 years (17 for males ; 15 for females), and for second malignancies was 27 (27 for males; 30 for females). Fifty eight SMNs were observed (21 in females; 37 in males). Among women, higher risk was observed to developing breast cancer (n=5; SIR=1.29; 95% CI= 0.42-3.02), thyroid cancer (n=5; SIR= 3.40; 95% CI= 1.1-7.93) and brain cancer (n=3; SIR= 9.19; 95% CI=1.89-26.85). Twenty-seven out of 37 second primary tumors observed in men were contralateral testicular tumors, conferring a 16.2 fold higher risk of developing this neoplasm (95% CI= 10.67-23.58). When the analysis excluded testis as a second site, a higher risk was noted for the development of pancreatic cancer (SIR=19.06; 95% CI=2.31-68.83) and leukemia (SIR=3.55; 95% CI=0.43-12.81). Conclusions: Rates of SMN are elevated in both men and women treated as children for pediatric germ cell tumors. Men need to be made aware of risk in contralateral testicle. The rates of SMN may continue to rise with longer follow up. The attribution of treatment type to risk of SMNs is not possible due to the lack of this information in SEER database.

scholarly journals Incidence of adrenal gland tumor as a second primary malignancy: SEER-based study

2018 ◽  
Vol 7 (10) ◽  
pp. 1040-1048 ◽  
Author(s):  
Wafaa M Rashed ◽  
Anas Saad ◽  
Muneer Al-Husseini ◽  
Ahmed Mahmoud Galal ◽  
Assem Mohamed Ismael ◽  
...  
Keyword(s):  
Adrenal Gland ◽  
Cancer Treatment ◽  
The United States ◽  
Adrenal Tumors ◽  
Second Primary ◽  
Gland Tumor ◽  
Second Primary Malignancy ◽  
Primary Malignancy ◽  
Primary Tumors ◽  
Cancer Networks

Purpose Advances in cancer treatment achieved during the past decades have resulted in increased survival of most pediatric and adult patients that suffered from different adrenal tumor types. This article reviews the incidence and survival of adrenal gland tumors as second primary tumors, according to data from the Surveillance, Epidemiology, and End Results (SEER) database. Methods The SEER 13 Registries Database from 1992 to 2013 was used. All primary cancer sites were selected using the multiple primary standardized incidence ratios (MP-SIR) session. Results Data for a total of 2,887,468 persons with cancer were reviewed; 117 of whom had suffered second primary adrenal tumors. The overall SIR of adrenal gland tumor as a second primary was 1.5. A high incidence ratio of the event was detected in specific primary tumor sites: hypopharynx (observed/expected (O/E) = 44.6); other endocrine tissue (including the thymus) (O/E = 38.3); small intestine (O/E = 8.9); liver (O/E = 8.7); stomach (O/E = 5); nodal NHL (O/E = 3.8); kidney and renal pelvis (O/E = 3.2) and breast (O/E = 1.8). Conclusion The underlying shared mechanisms should be investigated between adrenal tumors and hypopharyngeal, endocrine and other tumors. Racial disparity is an important challenge in cancer treatment at the United States and should be taken into consideration in the design of cancer prevention programs. This could be achieved through follow-up programs at specialized national cancer networks, especially for rare tumors like adrenal gland.

Multiple primary cancer in adults (MPCA)

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 16027-16027 ◽  
Author(s):  
S. L. Ares ◽  
S. Polo ◽  
L. Ezcurdia ◽  
F. Tognelli ◽  
S. Mussini ◽  
...  
Keyword(s):  
Clinical Findings ◽  
Second Primary ◽  
Multiple Primary Cancer ◽  
Second Cancer ◽  
Primary Tumors ◽  
History Of ◽  
Frequent Site ◽  
The Moment ◽  
Second Tumor ◽  
Oncologic Diseases

16027 Background: As a result of the improvement in oncological treatments, MPCA could arise as a more frequent problem in Public Health. The purpose of this retrospective review was to estimate both the incidence and medical features of MPCA pts treated at the Instituto Oncológico Henry Moore (IOHM). Methods: We analyzed 17,100 medical charts from our database since 1987 and identified 378 MPC (2,21%). Then we retrieved data over the last eight years (1997–2005). Those pts with at least two second primary tumors were included in this analysis. They were categorized as synchronous (second tumor diagnosis within the first six months from the first one) and metachronous (all the remaining). Pts with skin cancer different from melanoma were excluded. Results: One hundred and seventy eight (M:73; F:105) out of 8,500 cancer pts (2.09%) had at least two primary cancers. Median age was 59, 64 and 68 yo at the moment of the first, second and third diagnosis, respectively. In 138 (78%) pts, the diagnosis of the second cancer was suspected by clinical findings, while in 40 (22%) pts, it was discovered because of medical screening in an otherwise asymptomatic pt. (See Table below) The most frequent site combination was breast-breast (n = 21). A total of 57 pts (32%) had a family history of oncologic diseases. With a median follow-up of 31 mo (range: 0,57–311) after the second cancer diagnosis, 127 pts are still alive (71,35%) and 51 (28,65%) are dead. Conclusions: In the last eight years, 178 (2.09%) pts had developed MPC, being breast, prostate, colon and lung the most frequent (first and later) localizations, and breast-breast the most frequent site combination. The so-called “screening effect” seems to have a low impact on the studied population. [Table: see text] No significant financial relationships to disclose.

Multiple Primary Tumors in Patients Diagnosed with Hypopharyngeal Cancer

2003 ◽  
Vol 128 (3) ◽  
pp. 419-425 ◽  
Author(s):  
Ullas Raghavan ◽  
Shahed Quraishi ◽  
Patrick James Bradley
Keyword(s):  
Family Health ◽  
Hypopharyngeal Cancer ◽  
Second Primary ◽  
Primary Malignancy ◽  
Primary Tumors ◽  
Multiple Primary Tumors ◽  
Tertiary Center ◽  
The Family ◽  
Multiple Primary ◽  
Second Primary Tumors

OBJECTIVE: There have been few series to report on the incidence of multiple primary tumors associated with hypopharyngeal cancer. A unique consecutive patient group in a closed community who were treated by a single surgeon was available. The incidence and effect of multiple primary tumors were unknown. STUDY DESIGN: We sought to assess (1) the incidence of multiple primary tumors among patients with hypopharyngeal cancer who were treated at a tertiary center, (2) the incidence of synchronous and metachronous tumors, and (3) the location of these multiple primary tumors and their effect on patient survival. METHODS: We conducted a retrospective study of case notes of 150 consecutive patients with hypopharyngeal malignancy treated by a single surgeon between 1983 and 1998. Information was compiled from the patients' medical records and death data from the Family Health Services Authority. RESULTS: Thirty-four patients had multiple primary tumors (22.6%). There were 22 men and 12 women; piriform fossa tumor was seen in 21 men and 6 women, and postcricoid space tumor was seen in 6 women and 1 man. Second primary tumors were synchronous in 7 patients, subsequent to hypopharyngeal tumor in 5 patients, and antecedent to hypopharyngeal tumor in 14 patients. Eight patients had 2 primary tumors, of which 4 were synchronous, 4 were subsequent, and 8 were antecedent to hypopharyngeal malignancy. On the last review (2001), 3 patients were alive, and 31 had died: 17 had died from primary malignancy, 11 from another malignancy, and 3 from unrelated causes. CONCLUSION: The presence of second primary tumors in hypopharyngeal cancer is higher than previously reported, and their presence had a significant effect on the patients' survival.

Occurrence of second primary malignancy in medullary thyroid cancer (MTC) patients

2019 ◽  
Author(s):  
George Simeakis ◽  
Katerina Saltiki ◽  
Evangelia Zapanti ◽  
Evanthia Kassis ◽  
Maria Alevizaki
Keyword(s):  
Thyroid Cancer ◽  
Medullary Thyroid Cancer ◽  
Second Primary ◽  
Second Primary Malignancy ◽  
Primary Malignancy ◽  
Medullary Thyroid

Spinal meningioma after treatment for Hodgkin disease

2001 ◽  
Vol 95 (2) ◽  
pp. 232-235 ◽  
Author(s):  
Andrew J. Martin ◽  
Christopher J. Hammond ◽  
H. Jane Dobbs ◽  
Safa Al-Sarraj ◽  
Nicholas W. M. Thomas
Keyword(s):  
Hodgkin Disease ◽  
Second Primary ◽  
Combined Modality Treatment ◽  
Spinal Meningioma ◽  
Primary Tumors ◽  
Content Type ◽  
Radiation Induced ◽  
Mutagenic Effects ◽  
Long Term Survivors

✓ Long-term survivors of Hodgkin disease may develop second primary tumors caused by the mutagenic effects of radio- and chemotherapy. The authors describe the case of a 35-year-old woman who presented with an unusual meningioma of the cervical spine 9 years after undergoing combined-modality treatment for Hodgkin disease. To the authors' knowledge, this is the first report of spinal meningioma as a complication of such therapy. Whereas radiation-induced intracranial meningiomas are well described in the literature, treatment-induced meningiomas of the spine have not been widely recognized.

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