Original Article
Risks of second primary malignancies among Chinese cancer survivors at a single center during 2002–2016
Abstract
Background: The increased survival of patients after a primary cancer diagnosis has led to an increasing number of patients with second primary malignancies (SPMs). Recent studies implied the risk of SPMs among specific survivor groups. However, little is known regarding the risks of developing SPMs across the spectrum of cancer survivors. The present study was undertaken to describe the incidence, common sites, and outcomes associated with SPMs among Chinese cancer survivors at a single center.
Methods: This retrospective study evaluated patients who were ≥18 years old and diagnosed as having a malignancy during 2002–2016 at the Department of Hematology, Tongji Hospital, Tongji Medical College. Factors associated with subsequent SPMs were explored using bivariable and multivariable models.
Results: The study identified 18,257 eligible patients diagnosed with hematological malignancies, including 67 patients (0.37%) who developed SPMs, which mainly consisted of leukemia. Survivors of lymphoma had the highest risk of developing SPMs. Hematological SPMs were more common among patients who received alkylating agents, topoisomerase 2 inhibitors, or allogeneic hematopoietic stem cell transplantation (HSCT) for the first primary malignancy. Non-hematological SPMs were more common among patients who received anti-metabolites, anti-tubulin agents, or radiotherapy for the first primary malignancy. The risks of developing SPMs did not exhibit any significant differences according to age, sex, and latency interval. Hematological malignancy was a non-significant risk factor for SPM development (P>0.05).
Conclusions: Approximately 0.37% of our patients diagnosed with hematological malignancies had SPMs, mainly leukemia. Patients with lymphoma were most likely to develop SPMs. These findings may help identify patients who are at-risk of developing SPMs (e.g., based on the previous treatment and the first primary malignancy), which may help guide the treatment of cancer survivors.
Methods: This retrospective study evaluated patients who were ≥18 years old and diagnosed as having a malignancy during 2002–2016 at the Department of Hematology, Tongji Hospital, Tongji Medical College. Factors associated with subsequent SPMs were explored using bivariable and multivariable models.
Results: The study identified 18,257 eligible patients diagnosed with hematological malignancies, including 67 patients (0.37%) who developed SPMs, which mainly consisted of leukemia. Survivors of lymphoma had the highest risk of developing SPMs. Hematological SPMs were more common among patients who received alkylating agents, topoisomerase 2 inhibitors, or allogeneic hematopoietic stem cell transplantation (HSCT) for the first primary malignancy. Non-hematological SPMs were more common among patients who received anti-metabolites, anti-tubulin agents, or radiotherapy for the first primary malignancy. The risks of developing SPMs did not exhibit any significant differences according to age, sex, and latency interval. Hematological malignancy was a non-significant risk factor for SPM development (P>0.05).
Conclusions: Approximately 0.37% of our patients diagnosed with hematological malignancies had SPMs, mainly leukemia. Patients with lymphoma were most likely to develop SPMs. These findings may help identify patients who are at-risk of developing SPMs (e.g., based on the previous treatment and the first primary malignancy), which may help guide the treatment of cancer survivors.
