Secondary ovarian cancer after external beam radiotherapy for nonovarian pelvic malignancy |
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| Affiliation: | 1. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA;2. Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA;3. Section of Urology, University of Chicago Medicine, Chicago, IL, USA;4. Department of Obstetrics and Gynecology, Tokai University School of Medicine, Isehara, Kanagawa, Japan;1. Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon, USA;2. Department of Pediatric Cardiology, Oregon Health & Science University, Portland, Oregon, USA;3. University Neurosurgery, LSU Health Sciences Center, Shreveport, Louisiana, USA;4. Rebound Neurosurgery, Vancouver, Washington, DC, USA;1. Interdisciplinary Arts & Sciences, University of Washington, Tacoma, WA, United States;2. Division of Zoology, National Museums of Kenya, Nairobi, Kenya;3. Center for Research in Scientific Computation, Department of Mathematics, North Carolina State University, Raleigh, NC, United States;4. Mwamba Field Study Centre, A Rocha Kenya, Watamu, Kenya;1. Department of Radiation Oncology, Leiden University Medical Center, Leiden, the Netherlands;2. Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland;3. Department of Radiotherapy, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy;4. Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands;1. Department of Colorectal Surgery, Manchester University NHS Foundation Trust, Manchester, UK;2. Abertawe Bro Morgannwg University Health Board, UK;3. Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK;4. Department of Digestive Surgery, Colorectal Unit, Haut-Lévêque Hospital, Bordeaux University Hospital, Pessac, France;5. Department of Colorectal Surgery, Cambridge University Hospitals, Cambridge, UK;6. Department of Surgery, St Mark''s Hospital, Watford Road, Harrow, UK |
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| Abstract: | ![]()
ObjectiveTo examine characteristics and survival of patients who developed secondary ovarian cancer after external beam radiotherapy (EBRT) for a prior nonovarian pelvic malignancy.MethodsThis is a population-based retrospective cohort study, querying the Surveillance, Epidemiology, and End Result program from 1975 to 2016. 167,269 women who received EBRT for 7 malignancies (anus, rectum, bladder, cervix, uterus, vulva, or vagina) were examined to identify subsequent secondary ovarian cancer diagnosis after EBRT. Then, within the ovarian cancer cohort (n = 147,618), characteristics and survival of patients with secondary ovarian cancer after EBRT were compared to those with ovarian cancer who did not receive prior EBRT.ResultsFollowing EBRT for a pelvic malignancy, 215 (1.3 per 1000) patients developed secondary ovarian cancer. Among those, the most frequent prior malignancy was cervical cancer (45.6%), followed by rectal cancer (20.9%). The median time from prior EBRT to secondary ovarian cancer was 8.8 years (interquartile range, 2.8–14.5). In multivariable analysis, patients with secondary ovarian cancer after EBRT were more likely to be older, and have a recent year of diagnosis, but less likely to have early-disease compared to ovarian cancer patients without prior EBRT (all, P < 0.05). In weighted model, patients with secondary ovarian cancer after EBRT had decreased overall survival compared to those with ovarian cancer without prior EBRT (5-year rates, 19.6% versus 39.9%, hazard ratio 1.62, 95% confidence interval 1.43–1.85). Similar association was observed in ages <70, ≥70, White, non-White, early-disease, and advanced-disease in sensitivity analyses.ConclusionRadiotherapy-related secondary ovarian cancer may be associated with decreased overall survival. |
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| Keywords: | Secondary primary ovarian cancer Prior pelvic radiotherapy External beam radiotherapy Characteristics Survival |
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