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05.06.2018 | Original Article

Secondary cancer after a childhood cancer diagnosis: viewpoints considering primary cancer

Zeitschrift:
International Journal of Clinical Oncology
Autoren:
Yasushi Ishida, Miho Maeda, Souichi Adachi, Hiroko Inada, Hiroshi Kawaguchi, Hiroki Hori, Atsushi Ogawa, Kazuko Kudo, Chikako Kiyotani, Hiroyuki Shichino, Takeshi Rikiishi, Ryoji Kobayashi, Maho Sato, Jun Okamura, Hiroaki Goto, Atsushi Manabe, Shinji Yoshinaga, Dongmei Qiu, Junichiro Fujimoto, Tatsuo Kuroda

Abstract

Backgrounds

Multidisciplinary therapy has increased the risk of subsequent late effects, but detailed analyses on secondary cancers in childhood cancer survivors (CCSs) are limited in Asian countries.

Methods

This was a retrospective cohort study comprising 10,069 CCSs who were diagnosed between 1980 and 2009 across 15 Japanese hospitals. We conducted secondary analyses to estimate the incidence of secondary cancer according to each primary malignancy and to elucidate the association between primary and secondary cancers. We also explored the risk factors for the development of secondary cancer in each independent primary malignancy.

Results

The cumulative incidence of secondary cancer at 20 years varied among primary cancers: hematological malignancy, 3.1% (95% CI 2.2–4.3); retinoblastoma, 6.6% (95% CI 1.5–16.8); pediatric solid tumor, 2.5% (95% CI 1.3–4.2); brain tumors, 5.2% (95% CI 1.7–11.8) bone/soft tissue sarcoma, 5.2% (95% CI 2.3–10.1); and others, 3.3% (95% CI 1.6–6.0) (p = 0.015). The cumulative incidence of secondary cancers is highest in those with osteosarcoma (13.1%) followed by those with hepatoblastoma (8.4%) and retinoblastoma (6.6%). Close association between the primary and secondary cancer diagnoses was found. The risk factors for secondary cancer development depended on the primary cancer, but autologous/allogeneic stem cell transplantation was a relatively common risk factor.

Conclusion

The cumulative incidence of secondary cancer varied among primary cancers. The primary cancer was closely associated with the secondary cancer but stem cell transplantation was a common risk factor for secondary cancers among CCSs.

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Zusatzmaterial
Supplemental Fig. 1. Cumulative incidence of secondary cancers in neuroblastoma. Cumulative incidence of secondary cancers as a function of time after the primary cancer diagnosis over a maximum follow-up of 30 years as analyzed using the Gray method: (A) age groups at primary cancer diagnosis, (B) sex, (C) chemotherapy, (D) radiotherapy, (E) surgery, and (F) autologous stem cell transplantation (SCT). (TIF 194 KB)
10147_2018_1303_MOESM1_ESM.tif
Supplemental Fig. 2 Cumulative incidence of secondary cancers in those with primary cancer of rhabdomyosarcoma and other soft tissue sarcoma. Cumulative incidence of secondary cancers as a function of time after the primary cancer diagnosis over a maximum follow-up of 30 years as analyzed using the Gray method: (A) age groups at primary cancer diagnosis, (B) sex, (C) chemotherapy, (D) radiotherapy, (E) surgery, and (F) autologous stem cell transplantation (SCT). (TIF 204 KB)
10147_2018_1303_MOESM2_ESM.tif
Literatur
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