Increased risk of second primary malignancies in patients treated for thyroid cancer

2008 ◽  
Vol 4 (4) ◽  
pp. 187-188
Keyword(s):  
Thyroid Cancer ◽  
Second Primary ◽  
Increased Risk ◽  
Second Primary Malignancies

Increased risk of certain second primary malignancies in patients treated for well-differentiated thyroid cancer

2015 ◽  
Vol 21 (2) ◽  
pp. 231-239 ◽  
Author(s):  
Tommi T. Hakala ◽  
Juhani A. Sand ◽  
Arja Jukkola ◽  
Heini S. Huhtala ◽  
Saara Metso ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Second Primary ◽  
Increased Risk ◽  
Well Differentiated ◽  
Second Primary Malignancies

scholarly journals The Risk of Second Primary Malignancies up to Three Decades after the Treatment of Differentiated Thyroid Cancer

2008 ◽  
Vol 93 (2) ◽  
pp. 504-515 ◽  
Author(s):  
Aaron. P. Brown ◽  
Jergin Chen ◽  
Ying J. Hitchcock ◽  
Aniko Szabo ◽  
Dennis C. Shrieve ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
General Population ◽  
Differentiated Thyroid Cancer ◽  
Second Primary ◽  
Second Primary Cancers ◽  
Increased Risk ◽  
Absolute Excess Risk ◽  
Second Primary Malignancies ◽  
Radioisotope Therapy

Abstract Background: The 10-yr survival rate of patients with differentiated thyroid cancer exceeds 90%. These patients may be at elevated risk for secondary cancers. Methods: The risk of nonthyroid second primary malignancies after differentiated thyroid cancer was determined in 30,278 patients diagnosed between 1973 and 2002 from centers participating in the National Cancer Institute’s Surveillance, Epidemiology, and End Results program. Median follow-up was 103 months (range, 2–359 months). Risk was further assessed for the addition of radioisotope therapy, gender, latency to development of secondary cancer, and age at thyroid cancer diagnosis. Results: There were 2158 patients who developed a total of 2338 nonthyroid second primary malignancies, significantly more than that expected in the general population [observed/expected (O/E) = 1.09; 95% confidence interval (CI), 1.05–1.14; P < 0.05; absolute excess risk per 10,000 person-years (AER) = 6.39]. A significantly greater risk of second primary malignancies over that expected in the general population was for patients treated with radioisotopes (O/E = 1.20; 95% CI, 1.07–1.33; AER = 11.8) as well as for unirradiated patients (O/E = 1.05; 95% CI, 1.00–1.10; AER = 3.53). However, the increased risk was greater for the irradiated vs. the unirradiated cohort (relative risk = 1.16; 95% CI, 1.05–1.27; P < 0.05). Gender did not affect risk. The greatest risk of second primary cancers occurred within 5 yr of diagnosis and was elevated for younger patients. Conclusions: The overall risk of second primary malignancies is increased for thyroid cancer survivors and varies by radioisotope therapy, latency, and age at diagnosis.

Second Hematologic Malignancies After Radioiodine Exposure In Patients With Thyroid Cancer and The Relationship With Radioiodine Dosage: A Nationwide Population-Based Study

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 1375-1375
Author(s):  
Chia-Jen Liu ◽  
Man-Hsin Hung ◽  
Chung-Jen Teng ◽  
Yu-Wen Hu ◽  
Yi-Ping Hung ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Dose Response ◽  
Hematologic Malignancies ◽  
Population Based ◽  
Second Primary ◽  
Population Based Study ◽  
Increased Risk ◽  
Clear Dose Response ◽  
Second Primary Malignancies

Abstract Background Second primary malignancies are one of the most important late effects after radioactive iodine (RAI) exposure, which is widely used in the diagnosis and treatment for thyroid cancers. However, dose-response correlation between RAI and second hematologic malignancies (SHM) was not established. Therefore, we conducted a nationwide population-based study to investigate the risk of SHM among thyroid cancer patients and the association between RAI dosage and development of SHM, including leukemia. Material and methods We recruited patients with newly diagnosed thyroid cancer aged 20 years or older without antecedent cancer from the Taiwan National Health Insurance database between 1997 and 2010. The standardized incidence ratios (SIR) of cancers were calculated to compare the cancer incidence of thyroid cancer patients to the general population according to gender, calendar year, and age in 5-year intervals by the corresponding stratum-specific person-time accrued in the cohort. The association of cumulative RAI dosage and development of SHM, including leukemia, was estimated using time-dependent analysis with 2-year latent period. Results After exclusion of first-year follow-up, 692 second primary malignancies developed among 20,235 patients with thyroid cancer, with a follow-up of 134,178 person-years. Fifty SHM developed with a SIR of 2.37 (95% confidence interval 1.76-3.13). The significant increased risk of SHM included: leukemia (SIR, 2.74; 95% CI, 1.65-4.28), non-Hodgkin lymphoma (SIR, 2.38; 95% CI, 1.55-3.48). As a time-dependent covariate with a 2-year latent period, RAI significantly increased the risk of leukemia with a clear dose-response correlation (age- and sex-adjusted hazard ratio per 100 mCi increase, 1.10; 95% CI, 1.01-1.19, P = 0.032). This effect was not seen in other second primary malignancies. Conclusions Our study reveals increased risk of SHM among patients with thyroid cancer. RAI increases the risk of leukemia with a clear dose-response relationship. Disclosures: No relevant conflicts of interest to declare.

Pattern of second primary malignancies in thyroid cancer patients

2013 ◽  
Vol 16 (1) ◽  
pp. 96 ◽  
Author(s):  
PCN Okere ◽  
DB Olusina ◽  
SA Shamim ◽  
V Shandra ◽  
M Tushar ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Cancer Patients ◽  
Second Primary ◽  
Second Primary Malignancies

Risk of second malignancy in patients with ovarian clear cell carcinoma

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.

scholarly journals Second primary malignancies following thyroid cancer: a population-based study in Taiwan

2013 ◽  
Vol 169 (5) ◽  
pp. 577-585 ◽  
Author(s):  
Chang-Hsien Lu ◽  
Kuan-Der Lee ◽  
Ping-Tsung Chen ◽  
Chih-Cheng Chen ◽  
Feng-Che Kuan ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Large Scale ◽  
Negative Impact ◽  
Asian Population ◽  
Population Based ◽  
Second Primary ◽  
Population Based Study ◽  
Impact On Survival ◽  
Second Primary Malignancies

ObjectiveMost studies on second primary malignancies (SPMs) after primary thyroid cancer were conducted in USA or Europe. The discrepancy between SPMs in these studies could be attributed to geographical and ethnic heterogeneity. Thus, there is a clear need for another large-scale epidemiological study, particularly in Asian countries, to define the incidence and risk of SPMs in thyroid cancer survivors.DesignA population-based study was conducted using the nation-wide database from Taiwan Cancer Registry between 1979 and 2006.MethodsWe quantified standardized incidence ratios (SIRs) and cumulative incidence of SPMs among 19 068 individuals (4205 males and 14 863 females) with primary thyroid cancer.ResultsA total of 644 cases (3.38%) developed at least a SPM during 134 678 person-years of follow-up. The risk for subsequent SPMs was significantly greater than that of the general population (SIR=1.33, 95% CI 1.23–1.44). There was a greater risk of developing major salivary glands, nasopharyngeal, lung, thymus, breast (females), bladder, and brain cancers, and leukemia and lymphoma. We observed that the risk was highest within the first 5 years of diagnosis of thyroid cancer (SIR=5.29, 1.68, and 0.68 for ≦5, 5–10, and >10 respectively) and in the younger patients (SIR=1.81 vs 1.61 for <50 and ≧50 respectively). The median overall survival for primary thyroid cancer patients was 23.28 years, but it was only 4.73 years for those who developed SPMs.ConclusionThyroid cancer is associated with a 33% risk increment of SPMs, which had a negative impact on survival. There are sites of SPMs in the Asian population that are distinctive from those in the Western population, suggesting that other genetic predisposition or environmental factors may play a role.

Second primary malignancies in gastric cancer: A U.S. population-based study.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 191-191
Author(s):  
Binay Kumar Shah ◽  
Amit Khanal
Keyword(s):  
Breast Cancer ◽  
Prostate Cancer ◽  
Gastric Cancer ◽  
Thyroid Cancer ◽  
Myeloid Leukemia ◽  
Population Based ◽  
Second Primary ◽  
Population Based Study ◽  
Gastrointestinal Malignancies ◽  
Second Primary Malignancies

191 Background: Risk of second primary malignancies (SPM) is not known in gastric cancer. In this population based study, we analyzed rates of SPM in gastric cancer. Methods: We selected adult (≥18 years) patients with gastric cancer as first primary malignancy diagnosed from January 1992 to December 2011 from Surveillance, Epidemiology and End Result 13 database. We used SEER*stat’s multiple primary standardized incidence ratio (MP-SIR) session to calculate the risk of SPM diagnosed 6 months after the diagnosis of index gastric cancer. Results: Among 31,818 patients with first primary gastric cancer, 1674 (5.26%) developed 1,839 SPM with observed/expected (O/E) ratio of 1.09 (95% CI = 1.05-1.15, p<0.0001) and excess risk of 16.15 per 10,000 population. The median time to first SPM from the time of diagnosis of stomach cancer was 49 months (range 6 months to 19.08 years). There was significantly increased risk of gastrointestinal malignancies [O/E ratio 1.65 (CI=1.53-1.79, p<0.001)], thyroid cancer [O/E ratio 1.98 (CI=1.32-2.84, p<0.01)] and myeloid leukemia [O/E ratio 1.47(CI=1-2.09, p<0.05)]. Interestingly, there was significantly decreased risk of melanoma, breast cancer and prostate cancer. Conclusions: Our study showed that patients with gastric cancer are at higher risk of gastrointestinal malignancies, thyroid cancer and myeloid leukemia. Similarly, risk of melanoma, breast cancer and prostate cancer in patients with gastric cancer is lower than general population.

scholarly journals Safety and Efficacy of Lenalidomide in Relapsed or Refractory Multiple Myeloma

2011 ◽  
Vol 6 ◽  
pp. CMO.S7275 ◽  
Author(s):  
Adrian Alegre ◽  
Isabel Vicuña ◽  
Beatriz Aguado
Keyword(s):  
Multiple Myeloma ◽  
Venous Thromboembolism ◽  
Survival Outcomes ◽  
Second Primary ◽  
Safety And Efficacy ◽  
Depth Of Response ◽  
Increased Risk ◽  
First Relapse ◽  
Immunomodulatory Drug ◽  
Second Primary Malignancies

Lenalidomide is an oral immunomodulatory drug that has helped improve outcomes in multiple myeloma (MM) patients. Combination lenalidomide and dexamethasone (Len+Dex) has been shown to increase response rates and prolong survival compared with dexamethasone alone in patients with relapsed or refractory MM (RRMM). Clinical benefit may be greatest when Len+Dex is given at first relapse, and continued treatment appears to provide greater depth of response and improved survival outcomes. The most common adverse events associated with Len+Dex are cytopenias, which are predictable and manageable. Len+Dex is associated with an increased risk of venous thromboembolism, which necessitates adequate prophylaxis. The risk of second primary malignancies does not appear to be increased in patients with RRMM treated with lenalidomide-based therapy. Here we review the safety and efficacy of Len+Dex in RRMM, and provide an overview of data from Spain on the use of Len+Dex in RRMM.

Complications of Radioactive Iodine Treatment of Thyroid Carcinoma

2010 ◽  
Vol 8 (11) ◽  
pp. 1277-1287 ◽  
Author(s):  
Stephanie L. Lee
Keyword(s):  
Thyroid Cancer ◽  
Radioactive Iodine ◽  
Second Primary ◽  
Cancer Metastases ◽  
Risk Patients ◽  
Iodine Treatment ◽  
The Common ◽  
Second Primary Malignancies ◽  
Thyroid Cancer Metastases

Radioactive iodine (RAI) in the form of 131I has been used to treat thyroid cancer since 1946. RAI is used after thyroidectomy to ablate the residual normal thyroid remnant, as adjuvant therapy, and to treat thyroid cancer metastases. Although the benefits of using RAI in low-risk patients with thyroid cancer are debated, it is frequently used in most patients with thyroid cancer and is clearly associated with acute and long-term risks and side effects. Acute risks associated with RAI therapy include nausea and vomiting, ageusia (loss of taste), salivary gland swelling, and pain. Longer-term complications include recurrent sialoadenitis associated with xerostomia, mouth pain, dental caries, pulmonary fibrosis, nasolacrimal outflow obstruction, and second primary malignancies. This article summarizes the common complications of RAI and methods to prevent and manage these complications.

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