The Incidence of Other Primary Cancers in Patients with Cutaneous Lymphoma

Abstract

BackgroundSkin cancer is the most common other primary cancer in patients with lymphoma. However, an intriguing association between cutaneous lymphoma and other primary cancers has been suggested in a few studies.ObjectiveThis study investigated other primary cancers in patients with cutaneous lymphoma to evaluate the risk for occurrence of each type of cancer.MethodsWe screened for other primary cancers in 428 patients with cutaneous lymphoma. Clinical features were analyzed according to the lineage and origin of the lymphomas. We calculated the standardized incidence ratio with statistical analysis for each group according to age.ResultsAmong 330 patients with cutaneous T cell lymphoma and 98 with cutaneous B cell lymphoma, a total of 43 cancers in 38 patients were finally included. Other primary cancers were prevalent in patients with cutaneous B cell lymphoma and patients with secondary cutaneous lymphoma. However, those differences were not significant when the age was calibrated by multiple logistic regression. Metachronously higher standardized incidence ratios were observed for primary lung (standardized incidence ratio [SIR], 14.81; 95% confidence interval [CI], 3.05~39.54), skin (SIR, 68.05; 95% CI, 14.03~181.62), and breast (SIR, 12.91; 95% CI, 1.56~41.41) cancers with statistical significance.ConclusionOther primary cancers more preferentially occurred in patients with cutaneous lymphoma. Clinicians should carefully examine patients with cutaneous lymphoma for other cancers, especially lung, skin, and breast cancers.

Importance of diagnostics and risk of secondary malignancies in primary cutaneous lymphomas

“…In some studies an increased risk of secondary cutaneous malignancies, urogenital cancer, leukemia, biliary cancer, colon and lung cancer were demonstrated. However, there are inconsistencies in the type of associated malignancies and the magnitude of the reported risk increase [38–41]. In our study, 72 patients with MF developed 16 malignant comorbidities (9 malignant skin tumors, 5 solid tumors, 2 hematological malignancies) in a median observation period of 6.3 years.…”

“…prostate cancer), extended staging procedures can lead to a higher incidence rate of otherwise incipient carcinomas [43]. Another reason for the higher incidence rate can be a dysfunctional immune surveillance favoring cancer development [39, 40]. However, in our study the case number was too low to evaluate the rate of solid tumors in CTCL patients.…”

Twenty‐eight‐year incidence and characteristics of post‐transplant skin cancers: Comparative analysis of past and recent 10‐year experience

“…Multiple variables were compared by the Kruskal–Wallis test and post‐hoc by Bonferroni’s method. The relative risk of developing a skin cancer was evaluated by calculating standardized incidence ratios (SIR), defined as the ratio of the observed number of cancers divided by the expected number of cancers 1,12 . The expected number of each cancer was calculated by multiplying person‐years by the age‐ and sex‐specific incidence rates of each cancer.…”

Stellenwert diagnostischer Verfahren und Risiko von Zweittumoren bei primär kutanen Lymphomen

“…In einigen Studien wurde ein erhöhtes Risiko für sekundäre kutane Malignome, Urogenitalkarzinome, Leukämie, Gallengangskarzinome, Dickdarm‐ und Lungenkarzinome nachgewiesen. Es bestehen jedoch Unstimmigkeiten hinsichtlich der Art der assoziierten bösartigen Erkrankungen und dem Ausmaß der berichteten Risikoerhöhung [38–41]. In unserer Studie entwickelten 72 Patienten mit MF in einem medianen Beobachtungszeitraum von 6,3 Jahren 16 maligne Komorbiditäten (9 bösartige Hauttumoren, 5 solide Tumoren, 2 hämatologische Malignome).…”