Additional primary malignancies in patients with pancreatic cancer.

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.