The risk of second primary cancers in clear cell and papillary renal cancer.

446 Background: Renal cell carcinoma (RCC) survivors have an increased risk of developing second primary cancers. We sought to determine the role of RCC tumor histology for the risk of developing second primary solid tumors. Methods: The Surveillance Epidemiology and End Results (SEER) database was used to detect RCC cases diagnosed up to 12/31/2011. The Standardized Incidence Ratio (SIR) was calculated as the ratio of observed to expected cases of second primary malignancy based on incidence data in the general United States population. The two most common RCC histological subtypes were included; clear cell and papillary. The latency exclusion period from the date of diagnosis was 60 months. We investigated for the effect of latency period after initial diagnosis (5-10 years and >10 years) that may increase the risk for a second primary cancer. Results: A total of 2,669 patients with an initial diagnosis of RCC (clear cell: 2,368, papillary: 301) that developed second primary cancers were included in our analysis. There was a significantly increased risk of thyroid cancer (SIR: 2.30, p<0.05), prostate cancer (SIR: 1.12, p<0.05) and “all solid tumors” (SIR: 1.14, p<0.05) in clear cell RCC cases. Regarding latency period, thyroid cancer (SIR: 2.87, p<0.05) risk was increased in the 5-10 years latency period, but not in the >10 years latency period. Overall, in patients diagnosed with papillary RCC, tumors of the prostate (SIR: 1.30, p<0.05), lung (SIR: 1.78, p<0.05) and pancreas (SIR: 2.70, p<0.05) were increased. Exclusively in the 5-10 years latency period, the risk for developing lung cancer (SIR: 1.90, p<0.05) was significant. Conclusions: RCC histology may impact the risk for developing specific second primary solid tumors.

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Second primary cancers in young adult colorectal cancer survivors.

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.3_suppl.516 ◽

2015 ◽

Vol 33 (3_suppl) ◽

pp. 516-516 ◽

Cited By ~ 1

Author(s):

Raji Shameem ◽

Muhammad Saad Hamid ◽

James Luke Godwin ◽

Niket Sonpal ◽

Kevin M. Sullivan

Keyword(s):

Young Adult ◽

Solid Tumors ◽

Hematological Malignancies ◽

Latency Period ◽

Initial Diagnosis ◽

Second Primary ◽

Second Cancer ◽

Second Primary Cancers ◽

Increased Risk ◽

Female Genital

516 Background: Second primary cancers are a major concern for young adult colorectal cancer (CRC) survivors. The impact of treatment with radiation on the risk for second solid and hematological malignancies, as well as the typical latency period before development of a second cancer, requires elucidation. Methods: The Surveillance Epidemiology and End Results (SEER) database was used to detect CRC cases in young adults (aged 20-40 years) diagnosed up to 12/31/2011. The Standardized Incidence Ratio (SIR) was calculated as the ratio of observed to expected cases of second primary malignancy based on incidence data in the general United States population. The latency exclusion period from the date of diagnosis was 5 years. We investigated the possible effect of radiation therapy on risk for a second cancer, and established the typical latency period after initial diagnosis (5-10 years and >10 years). Results: A total of 9,537 cases of CRC in young adults were available for analysis. Radiation was administered in 1,823 (19.1%) patients. Second primary cancers occurred in 798 cases, 754 (94.5%) solid tumors and 44 (5.5%) hematological malignancies respectively. In the latency period 5-10 years after initial diagnosis, “All Solid Tumors” (SIR: 1.85, p<0.05) and female genital tumors (SIR: 3.52, p<0.05) were increased. In the latency period >10 years after initial diagnosis, an increased risk of developing pancreatic cancer (SIR: 1.90, p<0.05) and female genital tumors (SIR: 1.77, p<0.05) was observed. In patients who received radiation the only significantly increased risk was for “All Solid Tumors” (SIR: 1.42, p<0.05). No significant increase in second hematological malignancies was observed in the entire cohort, including cases that received radiation. Conclusions: An increased risk of second primary female genital tumors was seen in both the 5-10 years and >10 years latency periods. Pancreatic cancer risk was increased specifically in the >10 years latency period. Radiation treatment did not pose an increased risk for any specific second primary cancers. Interestingly, young adult CRC survivors did not have an increased risk for hematological malignancies compared to the general population.

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Risk of second malignancy in patients with ovarian clear cell carcinoma

International Journal of Gynecological Cancer ◽

10.1136/ijgc-2020-001946 ◽

2020 ◽

pp. ijgc-2020-001946

Author(s):

Julie My Van Nguyen ◽

Danielle Vicus ◽

Sharon Nofech-Mozes ◽

Lilian T Gien ◽

Marcus Q Bernardini ◽

...

Keyword(s):

Radiation Therapy ◽

Cell Carcinoma ◽

Clear Cell ◽

Clear Cell Carcinoma ◽

Second Primary ◽

Ovarian Clear Cell Carcinoma ◽

Second Primary Malignancy ◽

Primary Malignancy ◽

Increased Risk ◽

Second Primary Malignancies

ObjectiveOvarian clear cell carcinoma has unique clinical and molecular features compared with other epithelial ovarian cancer histologies. Our objective was to describe the incidence of second primary malignancy in patients with ovarian clear cell carcinoma.MethodsRetrospective cohort study of patients with ovarian clear cell carcinoma at two tertiary academic centers in Toronto, Canada between May 1995 and June 2017. Demographic, histopathologic, treatment, and survival details were obtained from chart review and a provincial cancer registry. We excluded patients with histologies other than pure ovarian clear cell carcinoma (such as mixed clear cell histology), and those who did not have their post-operative follow-up at these institutions.ResultsOf 209 patients with ovarian clear cell carcinoma, 54 patients developed a second primary malignancy (25.8%), of whom six developed two second primary malignancies. Second primary malignancies included: breast (13), skin (9), gastrointestinal tract (9), other gynecologic malignancies (8), thyroid (6), lymphoma (3), head and neck (4), urologic (4), and lung (4). Eighteen second primary malignancies occurred before the index ovarian clear cell carcinoma, 35 after ovarian clear cell carcinoma, and 7 were diagnosed concurrently. Two patients with second primary malignancies were diagnosed with Lynch syndrome. Smoking and radiation therapy were associated with an increased risk of second primary malignancy on multivariable analysis (OR 3.69, 95% CI 1.54 to 9.07, p=0.004; OR 4.39, 95% CI 1.88 to 10.6, p=0.0008, respectively). However, for patients developing second primary malignancies after ovarian clear cell carcinoma, radiation therapy was not found to be a significant risk factor (p=0.17). There was no significant difference in progression-free survival (p=0.85) or overall survival (p=0.38) between those with second primary malignancy and those without.ConclusionPatients with ovarian clear cell carcinoma are at increased risk of second primary malignancies, most frequently non-Lynch related. A subset of patients with ovarian clear cell carcinoma may harbor mutations rendering them susceptible to second primary malignancies. Our results may have implications for counseling and consideration for second primary malignancy screening.

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Characteristics and survival of secondary male breast cancer: SEER database analysis.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e13690 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e13690-e13690

Author(s):

John Khoury ◽

Siddhartha Yadav ◽

Tara Rangarajan ◽

Dana Zakalik

Keyword(s):

Breast Cancer ◽

Male Breast Cancer ◽

Hormone Receptors ◽

Latency Period ◽

Male Breast ◽

Stage I ◽

Second Primary ◽

Second Primary Malignancy ◽

Primary Malignancy ◽

Increased Risk

e13690 Background: Male breast cancer (MBC) is rare accounting for less than 0.5% of all cancer diagnoses in men. We used the term secondary male breast cancer (sMBC) to refer to ipsilateral and contralateral recurrences in addition to new primary MBC. Given its low incidence, data regarding the risk of developing sMBC and its characteristics are scarce. Methods: Multiple Primary Standardized Incidence Ratios (MP-SIR) session was conducted from the SEER*Stat software. We included all patients diagnosed with stage I,II and III MBC between 1990 to 2015 from the Surveillance Epidemiology and End Results (SEER) 18 registry. The standardized incidence ratio (SIR) was calculated as an estimate of the risk of a second primary malignancy based on the incidence in the general population. Descriptive statistics and Kaplan-Meier analysis were performed using SPSS software. Results: Among all 2321 men diagnosed with a first primary MBC during the study period, 28 patients had a subsequent diagnosis of MBC. The risk of sMBC was significantly elevated with SIR of 33.12 (95% CI, 22.18 – 47.56). The median latency period between the initial and subsequent diagnoses was 5.9 years. 82.1% of the patients were White, 14.3% Black and 3.6% Asian/Pacific Islander. Majority of the cases constituting 85.7% of sMBC were diagnosed in the contralateral breast. 67.8% of the sMBC remained hormone receptors status positive similar to the initial status of the primary diagnosis. 42.9% of the sMBC patients were diagnosed with stage I, 17.9% with stage II, 3.6% with stage III, 17.9% with stage IV and 17.9% of unknown stage. The median overall survival for sMBC was 96 months (95% CI, 11.3-180.6). We also found an increased risk of developing liver cancer (SIR: 2.16), prostate cancer (SIR: 1.29), thyroid cancer (SIR: 3.08) and acute myeloid leukemia (SIR: 2.4) in individuals after a diagnosis of MBC. Conclusions: Men diagnosed with breast cancer are at increased risk of sMBC in addition to other malignancies which require careful monitoring after completing initial treatment. Contralateral mammogram screening or prophylactic contralateral mastectomy can be considered based on patient’s preferences and values.

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Incidence of Second Malignancy in Patients with Papillary Thyroid Cancer from Surveillance, Epidemiology, and End Results 13 Dataset

Journal of Thyroid Research ◽

10.1155/2018/8765369 ◽

2018 ◽

Vol 2018 ◽

pp. 1-11 ◽

Cited By ~ 6

Author(s):

Mayumi Endo ◽

Jessica B. Liu ◽

Marcelle Dougan ◽

Jennifer S. Lee

Keyword(s):

Thyroid Cancer ◽

Papillary Thyroid Cancer ◽

Incidence Rates ◽

Lymphocytic Leukemia ◽

Second Primary ◽

Papillary Thyroid ◽

Second Primary Malignancy ◽

Primary Malignancy ◽

Increased Risk ◽

End Results

Increased risk of second primary malignancy (SPM) in papillary thyroid cancer (PTC) has been reported. Here, we present the most updated incidence rates of second primary malignancy from original diagnosis of PTC by using the data from the Surveillance, Epidemiology, and End Results. In this cohort, 3,200 patients developed SPM, a substantially higher number than in the reference population of 2,749 with observed to expected ratio (O/E) of 1.16 (95% CI; 1.12–1.21). Bone and joint cancer had the highest O/E ratio of 4.26 (95% confidence interval [CI] 2.33–7.15) followed by salivary gland (O/E 4.15; 95% CI 2.76–6.0) and acute lymphocytic leukemia (O/E 3.98; 95% CI 2.12–6.8). Mean age at the diagnosis of SPM was 64.4 years old. Interestingly, incidence of colorectal cancer was lower in thyroid cancer survivors compared to general population (large intestine O/E 0.3; 95% CI 0.06–0.88, rectum O/E 0.6; 95% CI 0.41–0.85); however, this was not observed in patients who underwent radiation therapy. The incidence of SPM at all sites was higher during 2000–2012 compared to 1992–1999 (O/E 1.24 versus 1.10). Surprisingly, patients with micropapillary cancer had higher incidence of SPM than counterparts with a larger tumor in radiation group (O/E of 1.40 versus 1.15). O/E of all cancers were higher in males compared to females with O/E of 1.41 versus 1.17 during the period of 2000–2012. Diagnosis of PTC before age 50, especially at age 30–34, was associated with higher incidence of overall SPM (age 30–34; O/E 1.43; 95% CI; 1.19–1.71). Efficient monitoring strategies that include age at the time of thyroid cancer diagnosis, exposure to radiation, gender, and genetic susceptibility may successfully detect SPM earlier in the disease course. This is especially important given the excellent prognosis of the initial thyroid cancer itself.

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Risk of Second Primary Malignancy in Patients Treated with Radioactive Iodine for Thyroid Cancer

10.22541/au.161271334.44432383/v1 ◽

2021 ◽

Author(s):

K McNamara ◽

Veronica Barry ◽

Alexander Yao ◽

Joanne Weekes ◽

Thomas Saunders ◽

...

Keyword(s):

Thyroid Cancer ◽

Total Thyroidectomy ◽

Neck Dissection ◽

Differentiated Thyroid Cancer ◽

Radioactive Iodine ◽

Second Primary ◽

Second Primary Malignancy ◽

Recurrence Rates ◽

Primary Malignancy ◽

Increased Risk

ABSTRACT Introduction Radioactive iodine (RAI) is widely used as a treatment for differentiated thyroid cancer following total thyroidectomy. There is a risk of second primary malignancy (SPM) in these patients which is estimated between 0-5% although research to support this is limited. The primary aim of this study was to ascertain the rate of SPM in patients who have undergone RAIT for thyroid cancer. The secondary objectives were to assess whether the risk is dose dependant and examine the overall survival and recurrence rates. Methods A retrospective review of all patients treated with radioactive iodine for thyroid cancer between 2002 and 2014. Patient information was collected from a structured database. Data regarding second cancers and recurrence rates was obtained from an online clinical portal. Follow up was 5 years minimum. Results 199 patients underwent RAI treatment. Median age was 53. 71.4% patients were female and 28.6% were male. All patients underwent total thyroidectomy. 13.6% underwent total thyroid and central neck dissection. 11% underwent total thyroidectomy and lateral neck dissection. 5.5% required post-operative radiotherapy. 12% patients developed recurrent thyroid cancer. 8% developed a SPM of which prostate, skin, head and neck SCC were the most common. A dose ≥3.7 (Gigabecquerel) GBq was statistically significantly more likely to lead to a SPM with a P value of 0.041 (95% CI -0.52 – 0.01318). Conclusions Increased risk of developing a second primary malignancy should be taken into account, especially in younger patients with low risk disease, when deciding on RAIT. Key words Radioactive iodine, Differentiated thyroid cancer, Second primary malignancy, Radioiodine, Thyroid cancer

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