Second primary malignancy after Hodgkin's disease, ovarian cancer and cancer of the testis: A population-based cohort study

Coleman, Michel P; Bell, Chaim M.; Fraser, Patricia

doi:10.1038/bjc.1987.201

Cited by 48 publications

(26 citation statements)

References 24 publications

(21 reference statements)

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“…The overall risk in the Birmingham series for all subsequent cancers was lower but not significantly so (1.8 vs. 1.5, X(1)= 1.6), the difference being more marked in men (1.8 vs. 1.3, X()=3.92, P<0.05) but not in women (1.7 vs. 1.9, X%)=0.13). The overall relative risk was also very similar to that reported by the Thames Cancer Registry (0=58, E=41.78, RR= 1.4, P<0.05) (Coleman et al, 1987).…”

Section: Discussionsupporting

confidence: 72%

Hodgkin's disease: subsequent primary cancers in relation to treatment

Prior

Pope²

1988

Br J Cancer

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Summary A consecutive series of 2,999 patients, diagnosed with Hodgkin's disease (HD) between 1950 and 1979, was assembled from the records of the Birmingham and West Midlands Cancer Registry and followed to the end of 1984. Cohort analyses of subsequent primary cancers among 1,976 patients, surviving one or more years (mean follow-up 6.7 person-years), were carried out in relation to overall treatment by radiotherapy (RT), chemotherapy (CT) or both modalities (CT+RT). Over all sites a 50% increase in risk, relative to the West Midlands population, was found [observed (0)=65; relative risk (RR)=1.5; P<0.01]. Among patients treated by CT (with or without RT) a significant increase in acute and non-lymphocytic leukaemias was found (0=6; RR=30.0; P<0.001). The excess risk was of the order of I per 1000 patientyears and the cumulative risk was 1.2%. Among solid tumours increased risks, which might be attributable to RT, occurred in the lung (0=15; RR=1.6; P<0.05), breast (O=9; RR=2.2; P<0.05) and bone (0=2; RR=20.0; P<0.01). The excess of skin cancers (0=13; RR=2.9; P<0.01) occurred mainly within 10 years of treatment with CT. The follow-up period is still insufficient to determine the long-term effect on the incidence of solid tumours with long latent periods from multiple-agent CT which became more frequently used in the early 1970s. A sub-set of these data was analysed over all treatments and the results were contributed to an international study co-ordinated by the

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Section: Discussionsupporting

confidence: 72%

Hodgkin's disease: subsequent primary cancers in relation to treatment

Prior

Pope²

1988

Br J Cancer

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“…If a study looks only at treatment-related second cancers that occur during follow-up [e.g. studies 19,[27][28][29], then those can cers that arise simultaneously or that precede the index cancer will be missed. Using cancer registry data implies the risk of underreporting of cancers; moreover, the acurracy and quality of patient data reported to the regis try is highly dependent on the cooperation of reporting doctors.…”

Section: Prevalence O F Nontesticular Malignanciesmentioning

confidence: 99%

“…The results are not consistent, and this might be due to differ ent methodological features of the studies: some are reports from cancer registries [6,17,18,27,28], and oth ers are studies of particular subpopulations of GCT pa tients, e.g. seminoma patients only [20][21][22][23][24][25][26], or chemo therapy patients only [29], In many studies, only cancers occurring subsequently to testis cancer during follow-up are analyzed [18,19,27,28] leaving aside antecedent and simultaneously arising nontesticular malignancies (NTM). The present study analyzes the total prevalence of multiple neoplasms (i.e.…”

Section: Introductionmentioning

confidence: 99%

Multiple Primary Neoplasms in Patients with Testicular Germ Cell Tumor

Dieckmann

Wegner

Krain³

1994

Oncology

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The study of multiple primary neoplasms may provide more insight into the pathogenesis of specific cancers and, secondly, it addresses the issue of treatment-related induction of second tumors. 584 consecutive patients with testicular germ cell tumors treated during 1969-1992 in Berlin were retrospectively analyzed for the prevalence of multiple primary neoplasms. 23 patients (16 pure seminoma, 7 nonseminoma) developing nontesticular malignancies in addition to testis cancer were identified (3.9%, 95 confidence intervals ± 1.6%). The mean age at the time of the testis cancer was 42.8 years, and mean age at the time of nontesticular malignancy was 50.2 years. In 4 cases, the nontesticular malignancy preceded testis cancer, in 3 patients both neoplasms occurred simultaneously, and in 16, nontesticular malignancies developed subsequently to testis cancer. In 4 patients, triple malignancies were observed. Bladder carcinoma and bronchogenic cancer with each 3 cases were the most frequent second neoplasms seen in these patients. 9 consecutive cancers developed within radiation fields, the median latency period in these cases was 12 years. None of the subsequent cancers developed after chemotherapy. It is concluded that genetic predisposition and radiation effects are the most important factors contributing to the occurrence of multiple primary neoplasms in patients with testicular germ cell cancer. The high rate of multiple primary neoplasms in these patients lends further evidence to the theory of genetic anticipation of germ cell cancer.

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“…Leukemia has also been found to occur more frequently than expected in patients with testicular cancer [5, 36, 48, 58, 60]. Treatment with ionizing radiation or cytotoxic chemotherapy are most probably etiologic in most of these cases [5]although cases with simultaneous presentation of leukemia and testicular cancer [61]as well as leukemia preceding seminoma [62, 63]have been reported as well.…”

Section: Discussionmentioning

confidence: 99%

Second Malignancies following Pure Seminoma

Rüther

Dieckmann²,

Bussar-Maatz

et al. 2000

Oncology

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Purpose: Second malignancies in patients with pure testicular seminoma were studied in order to look for adverse late effects of treatment and to study the significance of second malignancies during follow-up. Patients, Methods: In a multicentric investigation, 839 consecutive patients with pure testicular seminoma were observed for a median follow-up of 3.9 years. Thirty-seven patients had been excluded from the study because they already had had either a contralateral testicular germ cell tumor or another malignancy. 758 patients received radiotherapy, 76 underwent chemotherapy, 5 had surveillance only. The expected rate of second cancers was calculated according to the data of the cancer registry of Saarland, Germany. Results: Twenty-two second cancers (13 contralateral testicular tumors, 9 extratesticular malignancies) were recorded. The overall risk of having a second cancer was RR = 4.8 (95% CI 3.0–7.3). The risk of having a subsequent testicular tumor is RR = 44.8 (95% Cl 23.9–76.7). 1.1% of the patients developed a nontesticular second tumor. The risk of having a nontesticular second cancer is RR = 2.1 (95% CI 1.0–4.0). A significantly increased risk was observed for renal cell cancer as well (RR = 12.5; 95% Cl: 1.5–45.1). Increased RR without reaching statistical significance were found for rectal cancer (RR = 5.0; 95% Cl: 0.1–27.9) and non-Hodgkin lymphoma (RR = 6.7; 95% CI 0.2–37.1). None of the second cancers were directly located within the radiation field; 5 neoplasms arose at the border of the radiation field. Conclusions: This study confirmed the increased risk of having a second testicular germ cell cancer. There is also a small but definitely increased overall risk of having a nontesticular second cancer. Treatment-unrelated factors – possibly genetic predisposition – must be considered for a substantial number of these second tumors, since in the present study the follow-up was rather short and most of the second cancers were located outside of the radiation fields. In particular, the association of renal cancer with testicular cancer appears to be a more than chance occurrence. Second cancer is a real hazard following treatment of testicular cancers and should always be considered during follow-up.

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Second primary malignancy after Hodgkin's disease, ovarian cancer and cancer of the testis: A population-based cohort study

Cited by 48 publications

References 24 publications

Hodgkin's disease: subsequent primary cancers in relation to treatment

Hodgkin's disease: subsequent primary cancers in relation to treatment

Multiple Primary Neoplasms in Patients with Testicular Germ Cell Tumor

Second Malignancies following Pure Seminoma

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