scholarly journals Incidence, risk and survival outcomes of second primary malignancy among renal cell carcinoma survivors: A nested case-control study

2020 ◽  
Author(s):  
Zhixian Wang ◽  
Jing Wang ◽  
Yunpeng Zhu ◽  
Xing Li ◽  
Xiaoyong Zeng
Keyword(s):  
Renal Cell Carcinoma ◽  
Overall Survival ◽  
Case Control Study ◽  
Case Control ◽  
Survival Outcomes ◽  
Second Primary ◽  
Second Primary Malignancy ◽  
Primary Malignancy ◽  
Nested Case Control ◽  
Control Study

Abstract Background: Second primary malignancy (SPM) challenges survival and surveillance protocols among renal cell carcinoma (RCC) survivors. The incidence, temporal patterns, survival outcomes, and risk factors of SPM after T1-4N0-1M0 RCC diagnosis need to be investigated. Method: A nested case-control study that was designed using the Surveillance, Epidemiology, and End Results database from 2004-15; A cohort of 6204 SPM were matched with a control group of 37224 non-SPM. Results: SPM shortens the overall survival (hazard ratio [HR], 1.34; 95% confidence interval [CI]: 1.28-1.42, P< 0.001). The median time interval to SPM was 54.5 months. The adjusted standardized incidence ratio (SIR) of SPM increases by survival time (SIR12~35-month: 12.04; SIR36~59-month: 12.67; SIR60~19-month: 16.08; SIR120+-years: 25.01, all P< 0.001), and decreased with age (SIR18~44-years: 86.68; SIR45~59-years: 26.95; SIR60~74-years: 12.43; SIR75+-years: 10.66, all P< 0.001). The second primary RCC onset, especially contralateral kidney, has the highest SIR (SIR: 54.6; 95%CI: 51.0~58.4) among all sites of SPM. Prostate cancer (29.8%) in male and breast cancer (23.5%) in female were the most common SPM site. Older age, black race, male gender, higher family income statues, papillary RCC, and lower TNM stage significantly increases the risk of SPMs diagnosis. A longer time to SPM interval positively associated with a higher tumor stage of a SPM onset (P trend <0.001). The overall survival since the SPM diagnosis was associated with SPM’s stages, site, and surgical treatment, but not associated with time-to-SPM. Conclusion: Collectively, our study described the epidemiological characteristics of SPM among RCC survivors and identified the independent predictors of the SPM onset and its survival outcomes, which provides the clinicians for patients consulting and long-term individual-, tailored site-, and time-specific surveillance to improve survival outcomes.

scholarly journals Standardized Incidence Rate, Risk and Survival Outcomes of Second Primary Malignancy Among Renal Cell Carcinoma Survivors: A Nested Case-Control Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Zhixian Wang ◽  
Yisheng Yin ◽  
Jing Wang ◽  
Yunpeng Zhu ◽  
Xing Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Case Control ◽  
Survival Outcomes ◽  
Second Primary ◽  
Second Primary Malignancy ◽  
Primary Malignancy ◽  
Nested Case Control ◽  
Control Study

PurposeSecond primary malignancy (SPM) is challenging for treatment and long-term survival. We sought to investigate the standardized incidence rate (SIR), risk factors, and survival outcomes for SPM after renal cell carcinoma (RCC) treatment.MethodA nested case-control study was designed, we identified all T1-4N0-1M0 RCC patients diagnosed between 2004 and 2015 in the Surveillance, Epidemiology, and End Results database and followed them for SPM diagnosis for up to 13 years. Patients with SPM diagnosis ≥6 months after treatment of primary T1-4N0-1M0 RCC were identified as the case cohort and SPM-free patients were the control cohort. SIRs and the excess risk were calculated. A competing risks and Cox model were used to evaluate the risk factors of SPM and overall survival (OS).ResultsA cohort of 6,204 RCC patients with SPM were matched with a control group of 31,020 RCC patients without SPM. The median time-to-SPM interval was 54.5 months in RCC patients with SPM diagnosis. Besides, an SPM of T3/4 or/and M1 stage diagnosis was positively associated with a longer time-to-SPM interval. SIR of SPM increased by follow-up time and decreased with age at diagnosis (Pfor all &lt;0.001). SPM in the kidney had the highest SIR (54.6, P &lt;0.001) among all SPMs. Prostate cancer (29.8%) in males and breast cancer (23.5%) in females were the most common SPM. Older age, black ethnicity, male sex, higher family income, papillary RCC, and lower TNM stage were significant risk factors for SPM diagnosis. The proportion of deaths from SPM exceeds that of deaths from RCC 3 years after the first RCC treatment. Patients with SPM and early time-to-SPM interval shortens the OS compared with SPM-free patients. The 5-year OS was 85.9% and 58.9% from the first RCC and the SPM diagnosis, respectively. Besides, patients with low-grade/early-stage SPM could benefit from aggressive surgical treatment for solid tumors.ConclusionsCollectively, our study described the epidemiological characteristics of SPM among RCC survivors and identified the independent predictors of the SPM diagnosis and its survival outcomes. This study highlights the importance of patient education and follow-up after the surgery for RCC.

scholarly journals Risk of Second Primary Malignancy in Breast Cancer Survivors: A Nested Population-Based Case-Control Study

2015 ◽  
Vol 18 (4) ◽  
pp. 378 ◽  
Author(s):  
Raffaella Marcheselli ◽  
Luigi Marcheselli ◽  
Laura Cortesi ◽  
Alessia Bari ◽  
Claudia Cirilli ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Case Control Study ◽  
Population Based ◽  
Case Control ◽  
Second Primary ◽  
Second Primary Malignancy ◽  
Primary Malignancy ◽  
Control Study

scholarly journals Obesity and renal cell carcinoma risk by histologic subtype: A nested case-control study and meta-analysis

2018 ◽  
Vol 56 ◽  
pp. 31-37 ◽  
Author(s):  
Catherine L. Callahan ◽  
Jonathan N. Hofmann ◽  
Douglas A. Corley ◽  
Wei K. Zhao ◽  
Brian Shuch ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Renal Cell ◽  
Case Control Study ◽  
Meta Analysis ◽  
Case Control ◽  
Histologic Subtype ◽  
Subtype A ◽  
Nested Case Control ◽  
Carcinoma Risk ◽  
Control Study

Identification of genetic predispositions related to ionizing radiation in primary human skin fibroblasts from survivors of childhood and second primary cancer as well as cancer-free controls: Protocol for the nested case-control study KiKme. (Preprint)

2021 ◽  
Author(s):  
Manuela Marron ◽  
Lara Kim Brackmann ◽  
Heike Schwarz ◽  
Willempje Hummel-Bartenschlager ◽  
Sebastian Zahnreich ◽  
...  
Keyword(s):  
Ionizing Radiation ◽  
Childhood Cancer ◽  
Case Control Study ◽  
Population Based ◽  
Case Control ◽  
Second Primary ◽  
Human Skin Fibroblasts ◽  
Skin Biopsies ◽  
Nested Case Control ◽  
Control Study

BACKGROUND Therapy of a first primary neoplasm (FPN) in childhood with high doses of ionizing radiation is an established risk factor for second primary neoplasms (SPN). An association between exposure to low doses and childhood cancer is also suggested, however, results are inconsistent. As only subgroups of children with FPNs develop SPNs, an interaction between radiation, genetic, and other risk factors is presumed to influence cancer development. OBJECTIVE Therefore, the population-based nested case-control study KiKme aims to identify differences in genetic predispositions and radiation-response between childhood cancer survivors with and without SPNs as well as cancer-free controls. METHODS We conducted a population-based nested case-control study KiKme. Besides questionnaire information, skin biopsies and saliva samples are available. By measuring individual reactions to different exposures of radiation (e.g., 0.05 and 2 Gray) in normal somatic cells of the same person, our design enables us to create several exposure scenarios for the same person simultaneously and measure several different molecular markers (e.g., deoxyribonucleic acid (DNA), messenger RNA, long non-coding RNA, copy number variation). RESULTS Since 2013, 101 out of 247 invited SPN patients, 340 out of 1,729 invited FPN patients, and 150 out of 246 invited cancer-free controls were recruited and matched by age and sex. Childhood cancer patients were additionally matched by tumor morphology, year of, and age at diagnosis. Participants reported on lifestyle, socio-economical and anthropometric factors, as well as on medical radiation history, health, and family history of diseases (N = 556). Primary human fibroblasts from skin biopsies of the participants were cultivated (N = 499) and cryopreserved (N = 3,886). DNA was extracted from fibroblasts (N = 488) and saliva (N = 510). CONCLUSIONS This molecular-epidemiological study is the first to combine observational epidemiological research with standardized experimental components in primary human skin fibroblasts to identify genetic predispositions related to ionizing radiation in childhood and SPNs. In the future, fibroblasts of the participants will be used for standardized irradiation experiments, which will inform analysis of the case-control study and vice versa. Differences between participants will be identified using several molecular markers. With its innovative combination of experimental and observational components, this new study will provide valuable data to forward research on radiation-related risk factors in childhood cancer and SPNs.

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