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

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Mayumi Endo ◽  
Jessica B. Liu ◽  
Marcelle Dougan ◽  
Jennifer S. Lee

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.

2015 ◽  
Vol 33 (7_suppl) ◽  
pp. 446-446 ◽  
Author(s):  
Muhammad Saad Hamid ◽  
Raji Shameem ◽  
Rishi Jain ◽  
Kevin M. Sullivan

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.


2019 ◽  
Vol 39 (6) ◽  
Author(s):  
Wenming Wang

AbstractWe identified patients diagnosed with malignant astrocytoma (MA) as the first of two or more primary malignancies between 1973 and 2015 from Surveillance, Epidemiology and End Results (SEER) database. Multiple primaries-standardized incidence ratio (MP-SIR) was calculated to quantitate the risk of second primary malignancy (SPM). We further identified the risk factors of developing SPM and factors affecting overall survival (OS) in MA patients with SPM. Our results revealed that overall risk of SPM among MA patients was significantly higher than that in general population (SIR: 1.09, 95% confidence interval (CI): 1–1.18, P<0.05). Specific sites where the risk of SPM increased included salivary gland, bone and joints, soft tissue including heart, brain, cranial nerves other nervous system, thyroid, acute non-lymphocytic leukemia and acute myeloid leukemia. Overall risk of SPM in patients aged ≤29 and 30–59 years significantly increased (4.34- and 1.41-fold respectively). Whereas patients aged ≥60 years had a significantly decreased risk of SPM. Patients in the group of latency at 36–59, 60–119 and ≥120 months carried significantly increased overall risk of SPM. Multivariate analysis revealed that age, race, marital status, WHO grade, differentiated grade of cancer tissues, latency was independent predictor of OS in MA patients with SPM, which were all selected into the nomogram. The calibration curve for probability of survival showed good agreement between prediction by nomogram and actual observation. In conclusion, MA survivors should be advised of their increased risk for developing certain cancers in their lifetime. Our study had clinical implications for the surveillance of MA survivors at risk of developing SPM.


Author(s):  
K McNamara ◽  
Veronica Barry ◽  
Alexander Yao ◽  
Joanne Weekes ◽  
Thomas Saunders ◽  
...  

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


Cancer ◽  
2014 ◽  
Vol 121 (2) ◽  
pp. 166-168 ◽  
Author(s):  
Aarti Mathur ◽  
Eric B. Schneider ◽  
Martha A. Zeiger

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 8568-8568
Author(s):  
Dipesh Uprety ◽  
Lubina Arjyal ◽  
Swapna Narayana ◽  
Peter James Polewski ◽  
Amir Bista ◽  
...  

8568 Background: Thymoma is a rare neoplasm of anterior mediastinum. Patients often have an indolent disease. The prognosis of limited stage disease is excellent with a 10-year survival rate of 70 to 80%. Data regarding the risk of second primary malignancy in thymoma survivors are limited in recent years. In this study, we aimed to determine the risk of second primary malignancies (SPMs) among patients with limited stage thymoma. Methods: We utilized the Surveillance, Epidemiology and End Results (SEER)-13 registry to identify adult patients (≥ 18 years) with limited stage thymoma. We calculated the risk of SPM, developing ≥ 6 months after an index thymoma diagnosis, using Multiple Primary Standardized Incidence Ratio and an Absolute Excess Risk (AER) between 2004 and 2010. Statistical significance was defined as p < 0.05. Results: The database identified a cohort of 1,544 patients with limited stage thymoma with a median follow-up duration of 107 months (11-281 months). A total of 176 (11.39%) patients developed SPMs with a median latency of 62.5 months (range 6-272 months). Median age at diagnosis of SPM was 69 years (range 25- 96 years). Overall, SPM occurred at an observed to expected (O/E) ratio of 1.53 (95% CI 1.32-1.76), p < 0.001 with an AER of 60.52 per 10,000 patient-years at risk. A significantly increased risk was noted for cancer of lung and bronchus (O/E 1.77, 95% CI 1.21-2.52, p = 0.004; AER 12.17/10,000), skin excluding basal and squamous (O/E 2.09, 95% CI 1.04-3.75, p = 0.03; AER 5.17/10,000), urinary bladder (O/E 2.14, 95% CI 1.17-3.6, p = 0.014; AER 6.72/10,000), thyroid (O/E 3.48, 95% CI 1.4-7.17,p = 0.009; AER 4.49/10,000), and leukemia (O/E 3.26, 95% CI 1.63-5.83, p = 0.001; AER 6.86/10,000), including acute lymphocytic leukemia (O/E 16.09, CI: 1.95-58.11; AER 1.69/10,000), acute myeloid leukemia (O/E 3.83, CI: 1.04-9.8; AER 2.66/10,000) and other acute leukemia (O/E 29.45, CI: 3.57-106.39; AER 1.74/10,000). The risk was not significant for lymphoma (Hodgkin and non-Hodgkin), chronic leukemia, oropharyngeal, digestive tract and hepatobiliary cancer as SPM. Conclusions: The risk for SPMs is significantly increased in patient with thymoma compared to general population. Given the long-term risk of SPM, patient should be followed closely with judicious use of age-appropriate cancer screening.


2019 ◽  
Author(s):  
George Simeakis ◽  
Katerina Saltiki ◽  
Evangelia Zapanti ◽  
Evanthia Kassis ◽  
Maria Alevizaki

2021 ◽  
Author(s):  
Hu Hei ◽  
Bin Zhou ◽  
Wenbo Gong ◽  
Chen Zheng ◽  
Jianwu Qin

Abstract Purpose: There is a sex disparity in papillary thyroid cancer (PTC). Male sex is associated with a higher likelihood of advanced stage disease. This study aimed to examine the significance of sex for extranodal extension (ENE) in PTC. Patients and Methods: We reviewed the data of PTC patients who had undergone initial surgical resection from July 2012 to December 2014 (N = 1531). The effects of sex and other clinicopathological factors on ENE were investigated.Results: Of 1531 patients identified, 377 (24.6%) were male, 816 (53.3%) had positive nodes, and 256 (16.7%) had ENE. Compared with female patients, male patients had a higher risk of ENE (P < 0.001). Multivariable analysis of clinicopathological factors revealed that male sex (odds ratio [OR], 1.98; 95% confidence interval [CI], 1.37 - 2.87; P < 0.001), age older than 60 years (OR, 1.93; 95% CI, 1.08 - 3.35; P = 0.023), extrathyroidal extension (OR, 3.52; 95% CI, 2.42 - 5.14; P < 0.001), bilateral multifocality (OR, 2.18; 95% CI, 1.53 - 3.13; P < 0.001), and more positive nodes were significantly associated with increased risk of ENE. Patients with 6-10 positive nodes were 16.45-fold higher to have ENE than patients with 5 positive nodes or less (95% CI, 11.07 - 24.68; P < 0.001).Conclusion: Male PTC patients had a higher risk of ENE than female. Sex was an independent predictor of ENE. The underlying mechanism needs to be investigated further.


2020 ◽  
Vol 9 (8) ◽  
pp. 2481
Author(s):  
Kirk Jensen ◽  
Shilpa Thakur ◽  
Aneeta Patel ◽  
Maria Cecilia Mendonca-Torres ◽  
John Costello ◽  
...  

The detection of rare mutational targets in plasma (liquid biopsy) has emerged as a promising tool for the assessment of patients with cancer. We determined the presence of cell-free DNA containing the BRAFV600E mutations (cfBRAFV600E) in plasma samples from 57 patients with papillary thyroid cancer (PTC) with somatic BRAFV600E mutation-positive primary tumors using microfluidic digital PCR, and co-amplification at lower denaturation temperature (COLD) PCR. Mutant cfBRAFV600E alleles were detected in 24/57 (42.1%) of the examined patients. The presence of cfBRAFV600E was significantly associated with tumor size (p = 0.03), multifocal patterns of growth (p = 0.03), the presence of extrathyroidal gross extension (p = 0.02) and the presence of pulmonary micrometastases (p = 0.04). In patients with low-, intermediate- and high-risk PTCs, cfBRAFV600E was detected in 4/19 (21.0%), 8/22 (36.3%) and 12/16 (75.0%) of cases, respectively. Patients with detectable cfBRAFV600E were characterized by a 4.68 times higher likelihood of non-excellent response to therapy, as compared to patients without detectable cfBRAFV600E (OR (odds ratios), 4.68; 95% CI (confidence intervals)) 1.26–17.32; p = 0.02). In summary, the combination of digital polymerase chain reaction (dPCR) with COLD-PCR enables the detection of BRAFV600E in the liquid biopsy from patients with PTCs and could prove useful for the identification of patients with PTC at an increased risk for a structurally or biochemically incomplete or indeterminate response to treatment.


Cancer ◽  
2011 ◽  
Vol 118 (1) ◽  
pp. 216-222 ◽  
Author(s):  
Pamela L. Horn-Ross ◽  
Ellen T. Chang ◽  
Christina A. Clarke ◽  
Theresa H. M. Keegan ◽  
Rudolph P. Rull ◽  
...  

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