Second malignant neoplasms after childhood non-central nervous system embryonal tumours in North America: A population-based study |
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| Affiliation: | 2. Eichamt Leipzig, Leipzig, Germany;3. Department for Neuropathology, University Hospital Leipzig, Leipzig, Germany;4. Clinic for Neurosurgery, University Hospital Leipzig, Leipzig, Germany;5. Clinic for Diagnostic and Interventional Radiology, University Hospital Leipzig, Leipzig, Germany;1. Department of Gynecology, Hebei Medical University Fourth Affiliated Hospital and Hebei Provincial Tumor Hospital, 12 Jiankang Road, Shijiazhuang, Hebei 050011, China;2. Cancer Institute, Hebei Medical University Fourth Affiliated Hospital and Hebei Provincial Tumor Hospital, 12 Jiankang Road, Shijiazhuang, Hebei 050011, China;3. Department of Orthopaedic Surgery, Hebei Medical University Third Affiliated Hospital, 139 Ziqiang Road, Shijiazhuang, Hebei 050051, China.;1. Epilepsy Center, Dept. Neurology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Germany;2. Dept. Neuroradiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen, Germany;3. Institute for Clinical Genetics, Faculty of Medicine Carl Gustav Carus, TU Dresden, 01307, Dresden, Germany;4. Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA;5. Institut für Humangenetik, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Germany;6. Institut für Humangenetik, Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany;7. Institute of Human Genetics, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany |
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| Abstract: | ![]()
BackgroundFew studies in North America have quantified the risks of second malignant neoplasms (SMNs) among survivors of childhood non-central nervous system (non-CNS) embryonal tumours due to their rarity. We aimed to investigate these risks by combining population-based data from the United States of America and Canada.MethodsWe evaluated patients with childhood non-CNS embryonal tumours reported to the Surveillance Epidemiology and End Results program and eight Canadian cancer registries from 1969 to 2010. Standardised incidence ratio (SIR) and cumulative incidence of SMNs were calculated. Subgroup analyses were conducted by the type of first primary cancer, age at first primary diagnosis and follow-up duration.FindingsOf the 13,107 survivors, 190 SMNs were reported over 134,548 person-years of follow-up. The SIR for all SMNs combined was 6.4 (95% confidence interval [CI]: 5.5–7.4). Most site-specific SIRs were significantly increased, ranging from 36 (95% CI: 26–49) for bone and joint cancer to 3.1 (95% CI: 1.5–5.2) for brain tumour. The risk for second malignancies declined as the time elapsed from the first primary diagnosis and was less prominent for patients first diagnosed at age 1–4 years. Notably, rhabdomyosarcoma survivors had a higher risk for SMNs than those with other first primaries. The overall cumulative incidence of SMNs was 1.0% at 10 years, increasing to 2.2% at 20 years and 4.1% at 30 years.InterpretationSurvivors with childhood non-CNS embryonal tumours faced an increased risk for SMNs compared to the general population. The risk variations observed in different patient categories may help target prevention strategies in high-risk subgroups. |
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| Keywords: | Childhood cancer non-CNS embryonal tumors Second malignant neoplasma Survival Wilms tumor Neuroblastoma Retinoblastoma Rhabdomyosarcoma Epidemiology |
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