Prostate Brachytherapy and Second Primary Cancer Risk: A Competitive Risk Analysis

2011 ◽  
Vol 29 (34) ◽  
pp. 4510-4515 ◽  
Author(s):  
Karel A. Hinnen ◽  
Michael Schaapveld ◽  
Marco van Vulpen ◽  
Jan. J. Battermann ◽  
Henk van der Poel ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Rectal Cancer ◽  
General Population ◽  
Lead Time ◽  
Incidence Rates ◽  
Second Primary ◽  
Prostate Brachytherapy ◽  
Primary Cancer ◽  
Second Primary Cancer

Purpose To assess the risk of second primary cancer (SPC) after [125I]iodine prostate cancer brachytherapy compared with prostatectomy and the general population. Patients and Methods In a cohort consisting of 1,888 patients with prostate cancer who received monotherapy with brachytherapy (n = 1,187; 63%) or prostatectomy (n = 701; 37%), SPC incidences were retrieved by linkage with the Dutch Cancer Registry. Standardized incidence rates (SIRs) and absolute excess risks (AERs) were calculated for comparison. Results A total of 223 patients were diagnosed with SPC, 136 (11%) after brachytherapy and 87 (12%) after prostatectomy, with a median follow-up of 7.5 years. The SIR for all malignancies, bladder cancer, and rectal cancer were 0.94 (95% CI, 0.78 to 1.12), 1.69 (95% CI, 0.98 to 2.70), and 0.90 (95% CI, 0.41 to 1.72) for brachytherapy and 1.04 (95% CI, 0.83 to 2.28), 1.82 (95% CI, 0.87 to 3.35), and 1.50 (95% CI, 0.68 to 2.85) for prostatectomy, respectively. Bladder SPC risk was significantly increased after brachytherapy for patients age 60 years or younger (SIR, 5.84; 95% CI, 2.14 to 12.71; AER, 24.03) and in the first 4 years of follow-up (SIR, 2.14; 95% CI, 1.03 to 3.94; AER, 12.24). Adjusted for age, the hazard ratio (brachytherapy v prostatectomy) for all SPCs combined was 0.87 (95% CI, 0.64 to 1.18). Conclusion Overall, we found no difference in SPC incidence between patients with prostate cancer treated with prostatectomy or brachytherapy. Furthermore, no increased tumor incidence was found compared with the general population. We observed a higher than expected incidence of bladder SPC after brachytherapy in the first 4 years of follow-up, probably resulting from lead time or screening bias. Because of power limitations, a small increased SPC risk cannot be formally excluded.

1037 poster PROSTATE BRACHYTHERAPY INDUCED SECOND PRIMARY CANCER: A COMPETITIVE RISK ANALYSIS.

2011 ◽  
Vol 99 ◽  
pp. S387
Author(s):  
M. van Vulpen ◽  
M. Schaapveld ◽  
K. Hinnen ◽  
H. Van der Poel ◽  
I. van Oort ◽  
...  
Keyword(s):  
Risk Analysis ◽  
Second Primary ◽  
Prostate Brachytherapy ◽  
Primary Cancer ◽  
Second Primary Cancer

scholarly journals Healthcare utilisation in general practice and hospitals in the year preceding a diagnosis of cancer recurrence or second primary cancer: a population-based register study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Linda Aagaard Rasmussen ◽  
Henry Jensen ◽  
Line Flytkjær Virgilsen ◽  
Alina Zalounina Falborg ◽  
Henrik Møller ◽  
...  
Keyword(s):  
General Practice ◽  
Cancer Survivors ◽  
Cancer Recurrence ◽  
Healthcare Utilisation ◽  
Healthcare Setting ◽  
Second Primary ◽  
Primary Cancer ◽  
Second Primary Cancer ◽  
Diagnosis Of Cancer

Abstract Background The organisation of cancer follow-up is under scrutiny in many countries, and general practice is suggested to become more involved. A central focus is timely detection of recurring previous cancer and new second primary cancer. More knowledge on the patient pathway before cancer recurrence and second primary cancer is warranted to ensure the best possible organisation of follow-up. We aimed to describe the healthcare utilisation in the year preceding a diagnosis of cancer recurrence or second primary cancer. Methods This nationwide register study comprises patients diagnosed with bladder, breast, colorectal, endometrial, lung, malignant melanoma and ovarian cancer in Denmark in 2008–2016. The frequency of healthcare contacts during the 12 months preceding a cancer recurrence or second primary cancer was estimated and compared to the frequency of cancer survivors in cancer remission. The main analyses were stratified on sex and healthcare setting. Furthermore, two sub-analyses were stratified on 1) sex, healthcare setting and age group and on 2) sex, healthcare setting and comorbidity status. Results The study population consisted of 7832 patients with recurrence and 2703 patients with second primary cancer. On average, the patients were in contact with general practice one time per month in the 12th month preceding a new cancer diagnosis (recurrence or second primary cancer). Increasing contact rates were seen from 7 months before diagnosis in general practice and from 12 months before diagnosis in hospitals. This pattern was more pronounced in patients with cancer recurrence, younger patients and patients with no comorbidity. For instance, the contact rate ratios for hospital contacts in non-comorbid women with recurrence demonstrated 30% more contacts in the 12th month before recurrence and 127% more contacts in the 2nd month before recurrence. Conclusions The results show that cancer survivors are already seen in general practice on a regular basis. The increasing contact rates before a diagnosis of cancer recurrence or second primary cancer indicate that a window of opportunity exists for more timely diagnosis; this is seen in both general practice and in hospitals. Thus, cancer survivors may benefit from improvements in the organisation of cancer follow-up.

scholarly journals Second primary cancers and recurrence in patients after resection of colorectal cancer: An integrated analysis of trials by Japan Clinical Oncology Group: JCOG1702A

2020 ◽  
Author(s):  
Kiyo Tanaka ◽  
Gakuto Ogawa ◽  
Junki Mizusawa ◽  
Tomohiro Kadota ◽  
Kenichi Nakamura ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
General Population ◽  
Cumulative Incidence ◽  
National Database ◽  
Integrated Analysis ◽  
Second Primary ◽  
Primary Cancer ◽  
Second Primary Cancer ◽  
Surveillance Strategy ◽  
Second Primary Cancers

Abstract Background Improvements in early detection and treatment have resulted in an increasing number of long-term survivors of colorectal cancer (CRC). For the survivors, second primary cancer and recurrence are important issues; however, evidence for an appropriate surveillance strategy remains limited. This study aimed to investigate the frequency and timing of second primary cancer in patients after surgery for exploring an appropriate surveillance strategy by using an integrated analysis of three large-scale randomized controlled trials in Japan. Methods The eligibility criteria of three trials included histologically confirmed CRC and having received surgery. The timing, site and frequency of second primary cancers and recurrence were investigated. Risk factors associated with second primary cancers were also examined. The standardized incidence ratio (SIR) of second primary cancers compared with the national database of the Japan Cancer Registry was estimated. Results A total of 2824 patients were included in this study. The cumulative incidence of second primary cancer increased over time. The SIR of any second primary cancer was 1.07 (95% CI: 0.94–1.21). The SIR for second primary cancers of colon was 1.09 (95% CI: 0.79–1.47). The cumulative incidence of recurrence almost reached plateau at 3 years. Conclusions A common surveillance strategy for the general population can be applied even for curatively resected CRC patients, as the risk of second primary cancers was almost the same as that of the general population.

scholarly journals Second Cancer Incidence Among Chronic Lymphocytic Leukemia (CLL) Patients: A French Population-Based Study

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 3303-3303 ◽  
Author(s):  
Edouard Cornet ◽  
Jérémie Jégu ◽  
Morgane Mounier ◽  
Marc Maynadié ◽  
Alain Monnereau ◽  
...  
Keyword(s):  
Hodgkin's Disease ◽  
Hodgkin’S Disease ◽  
Absolute Risk ◽  
Population Based ◽  
Second Primary ◽  
Primary Cancer ◽  
Second Primary Cancer ◽  
Male And Female ◽  
Excess Absolute Risk

Abstract Introduction. The risk of developing a second primary cancer (SPC) is increased in patients with CLL. The mechanisms explaining this association could be related to lifestyle, environment, host factors or interactions or other influences. We conducted an epidemiological study based on 10 French registries and evaluated the risk of developing SPC in patients with CLL. Methods. Data from French population-based registries were used to establish a cohort of all patients diagnosed with a first cancer between 1989 and 2004 and followed-up until December 31, 2007. The person-year approach was used to estimate Standardized Incidence Ratios (SIRs) and Excess Absolute Risks (EARs) of metachronous SPC. Multivariate Poisson regression modules were then used to model SIRs and EARs separately by gender, adjusting for age, year of diagnosis, follow-up and first cancer site. All patients with CLL did not have HIV/AIDS-related disease. Results. Among 288,967 patients, 21,226 patients (7.5%) developed SPC. Among 4,148 CLL patients (Male: 2,336, Female: 1,812, median age: 70 years), 479 patients (11.5%) developed SPC after a median time of 54 months (2-199). EARs of SPC are different between male and female. In male, localizations of SPC are lung, bronchus and trachea, colorectum, colon, stomach and Hodgkin's disease. Their respective EARs are shown in table 1 and no excess absolute risk was observed for 24 other localizations. In female, localizations of SPC are rectum, stomach and melanoma of skin. Their respective EARs are shown in table 2 and no excess absolute risk was observed for 21 other localizations. Table 1: Excess Absolute Risks (EARs) of second primary cancer (SPC) for male Male SIR SIR IC95% EAR EAR IC95% Lung, bronchus and trachea 2.08 1.61 2.64 26.1 14.8 39.8 Colorectum 1.54 1.15 2.03 13.2 3.7 25.1 Colon 1.63 1.11 2.3 9.3 1.6 19.2 Stomach 1.91 1.07 3.15 5.4 0.4 12.7 Hodgkin's disease 8.71 2.34 22.29 2.7 0.5 7.4 Table 2: Excess Absolute Risks (EARs) of second primary cancer (SPC) for female Female SIR SIR IC95% EAR EAR IC95% Rectum 2.17 1.19 3.64 6.7 1.1 15.2 Stomach 3.04 1.45 5.58 6 1.3 13.4 Melanoma of skin 2.59 1.04 5.34 3.8 0.1 10.4 Conclusion. The risk for developing SPC after CLL is increased for male and female, especially solid cancers. Except Hodgkin's disease for male patients, there is no increase for other malignant hematological diseases, including acute leukemia and myelodysplastic syndrome. CLL survivors face a high risk of new malignancies and the excess risk of SPC increases with follow-up. As the SPC risk is closely tied to patient's characteristics, a personalized surveillance is required to allow optimal SPC prevention and early detection strategies. Disclosures No relevant conflicts of interest to declare.

Secondary Malignancies in CML Patients – Data From the German CML Study IV

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 3746-3746 ◽  
Author(s):  
Manuel Barreto Miranda ◽  
Michael Lauseker ◽  
Ulrike Proetel ◽  
Annette Schreiber ◽  
Benjamin Hanfstein ◽  
...  
Keyword(s):  
General Population ◽  
Confidence Interval ◽  
Incidence Rate ◽  
Interferon Alpha ◽  
Research Funding ◽  
Incidence Rates ◽  
Primary Cancer ◽  
Secondary Malignancies

Abstract Abstract 3746 Introduction: The increase of overall survival in chronic myeloid leukemia (CML) requires closer long-term observation in the face of a potential carcinogenicity of tyrosine kinase inhibitors (TKIs). Preclinical studies with imatinib in rats showed neoplastic changes in kidneys, urinary bladder, urethra, preputial and clitoral glands, small intestine, parathyroid glands, adrenal glands, and nonglandular stomach. Two epidemiologic studies on patients with chronic myeloproliferative neoplasms (CMPN) and CML (Frederiksen H et al., Blood 2011; Rebora P et al., Am J Epidemiol 2010) found an increased risk of secondary malignancies compared with the general population independent of treatment. In contrast, in a recent analysis of patients with CML and CMPN treated with TKI (Verma D et al., Blood 2011) a decreased risk of secondary malignancies was reported. Aims: To further elucidate the risk of TKI treated CML patients for the development of secondary malignancies we analysed data of the CML study IV, a randomized 5-arm trial (imatinib 400 mg vs. imatinib 800 mg vs. imatinib 400 mg in combination with interferon alpha vs. imatinib 400 mg in combination with AraC vs. imatinib 400 mg after interferon failure). Patients and methods: From February 2002 to April 2012, 1551 CML patients in chronic phase were randomized, 1525 were evaluable. Inclusion criteria allowed the history of primary cancer if the disease was in stable remission. Forty-nine malignancies were reported in 43 patients before the diagnosis of CML. If relapses occurred within 5 years after diagnosis of primary cancer they were not considered for further analysis. Median follow-up was 67.5 months. Age-standardized incidence rates were calculated from the age-specific rates using the European standard population (1976). Results: In total, 67 secondary malignancies in 64 patients were found in CML patients treated with TKI (n=61) and interferon alpha only (n=3). Twelve of these patients developed neoplasms after diagnosis of a primary cancer before diagnosis of CML, 5 patients with metastases or recurrence of the first malignancy (range of diagnosis 5–19 years after primary cancer). Median time to secondary malignancy was 2.5 years (range 0.1–8.3 years). The types of neoplasms were: prostate (n=9), colorectal (n=6), lung (n=6), non Hodgkin's lymphoma (NHL; n=7), malignant melanoma (n=5), skin tumors (basalioma n=4 and squamous cell carcinoma n=1), breast (n=5), pancreas (n=4), kidney (n=4), chronic lymphocytic leukemia (n=3), head and neck (n=2), biliary (n=2), sarcoma (n=2), and esophagus, stomach, liver, vulva, uterus, brain, cancer of unknown origin (each n=1). With these numbers the age-standardized incidence rates of secondary malignancies in CML patients were calculated: 534 cases per 100,000 for men (confidence interval [350;718]), and 582 for women (confidence interval [349;817]). The incidence rates of the general population in Germany were 450 and 350 cases, respectively (“Krebs in Deutschland 2007/2008”, 8th ed., Robert Koch Institute, 2012). The incidence rate of NHLs was higher for CML patients than for the general population but this is not significant. Conclusions: In our cohort, the incidence rate of secondary neoplasms in CML patients was slightly increased compared to the general population. The most common secondary malignancies in CML patients under treatment were cancers of the skin, prostate, colon, lung and NHL. Since the occurrence of secondary neoplasia increases over time, long-term follow-up of CML patients is warranted. Disclosures: Müller: Novartis, BMS: Consultancy, Honoraria, Research Funding. Hochhaus:Novartis, BMS, MSD, Ariad, Pfizer: Consultancy Other, Honoraria, Research Funding. Hehlmann:Novartis: Research Funding.

Second primary cancers and recurrence in patients after resection of colorectal cancer: An integrated analysis of trials by Japan Clinical Oncology Group: JCOG0205, JCOG0212, JCOG0404 (JCOG1702A).

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 561-561
Author(s):  
Kiyo Tanaka ◽  
Gakuto Ogawa ◽  
Junki Mizusawa ◽  
Junko Eba ◽  
Hiroshi Katayama ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Cumulative Incidence ◽  
Second Primary ◽  
Primary Cancer ◽  
Second Primary Cancer ◽  
Surveillance Strategy ◽  
Second Primary Cancers ◽  
Over Time

561 Background: Improvements in early detection and treatment have resulted in an increasing number of long-term survivors of colorectal cancer (CRC). For the survivors, Second primary cancers and recurrence are important issues, but the evidence for appropriate surveillance strategy is limited. The aim of this study was to investigate the frequency and the timing of second primary cancers and recurrence in patients (pts) after surgery using 3 randomized trials (J0205, J0212 and J0404) conducted by Colorectal Cancer Study Group of JCOG. Methods: Eligibility criteria included histologically proven CRC and having received surgery. The timing, site and frequency of second primary cancer and recurrence were investigated. Risk factors associated with the events were explored. Standardized incidence ratio (SIR) about second primary cancer compared with national database of Japan Cancer Registry was estimated. Results: A total of 2,824 pts with a median follow-up time of 6 years were included. Median age was 62 years old (23-75), male/female was 58%/42%, and stage 0/I/II/III/IV was 0.2%/8.7%/25.4%/64.8%/0.9%. Pts with 5-FU based adjuvant chemotherapy were 63%. Cumulative incidence of second primary cancer increased constantly over time (Table). Among 240 pts, the most common site was lung (37), stomach (35) and colon (32). In multivariable analysis, age (over 64 years old) and sex (male) were risk factors (age HR: 1.60 (95% CI: 1.24-2.07), sex HR: 1.36 (95% CI: 1.04-1.78)). The SIR of any second primary cancers was 1.07 (95% CI: 0.94-1.21). The SIR for second primary cancers of colon was 1.09 (95% CI: 0.79-1.47). On the other hand, cumulative incidence of recurrence almost reached at 3 years. Conclusions: Common surveillance strategy can be applied even for curatively resected CRC pts after 3 years from surgery, because the risk of second primary cancer was almost same as general population over time. The necessity of intensive follow-up to detect recurrence decreases after 3 years. [Table: see text]

scholarly journals The association between histological subtype of a first primary endometrial cancer and second cancer risk

2018 ◽  
Vol 29 (2) ◽  
pp. 290-298
Author(s):  
Jennifer Rhoades ◽  
Monica Hagan Vetter ◽  
James L Fisher ◽  
David E Cohn ◽  
Ritu Salani ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
General Population ◽  
Cancer Risk ◽  
Second Primary ◽  
Low Grade ◽  
Primary Cancer ◽  
Histological Subtype ◽  
Second Primary Cancer ◽  
Histological Subtypes ◽  
Cancer Risks

ObjectiveTo evaluate the risk of a second primary cancer after endometrial cancer according to histological subtype.MethodsUsing data from the 13 National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) registries we identified women diagnosed with a primary endometrial cancer between 1992 and 2014. We calculated standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) for second primary cancer risk (all anatomical sites combined and for individual anatomical sites) among patients with endometrial cancer compared with the general population, in the overall study population and according to histological subtype.ResultsAmong 96 256 women diagnosed with endometrial cancer, 8.4% (n=8083) developed a second primary cancer. The risk of second primary cancer was higher among patients with endometrial cancer than in the general population (SIR=1.05, 95% CI 1.03 to 1.07). We observed significantly higher second primary cancer risk among women with high grade endometrioid (SIR=1.12, 95% CI 1.05 to 1.19), serous (SIR=1.24, 95% CI 1.11 to 1.38), carcinosarcoma (SIR=1.18, 95% CI 1.02 to 1.35), mixed epithelial (SIR=1.22, 95% CI 1.06 to 1.40), and sarcoma (SIR=1.28, 95% CI 1.12 to 1.45) compared with the general population, but not for women with low grade endometrioid (SIR=1.01, 95% CI 0.98 to 1.03) or clear cell (SIR=1.09, 95% CI 0.88 to 1.33) endometrial cancer. Women with low grade endometrioid endometrial cancer had significantly lower second primary cancer risks in the gum and other mouth (SIR=0.57, 95% CI 0.30 to 0.97), lung and bronchus (SIR=0.72, 95% CI 0.66 to 0.77), and lymphocytic leukemia (SIR=0.71, 95% CI 0.54 to 0.93) while women with high risk endometrial cancer histological subtypes experienced significantly higher second primary cancer risk at several anatomical sites.ConclusionsRisk of developing second primary cancersat all anatomic sites combined and at individual anatomical sites varied according to histological subtype. Clinicians should be aware that women with different histological subtypes carry different second primary cancer risks .

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