Second Primary Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancers after Breast Cancer Diagnosis: Korea Central Cancer Registry

하형인,이은경,임지원,정소연,장윤정,원영주,임명철 대한암학회 2021 Cancer Research and Treatment Vol.53 No.2

Purpose A prior history of breast cancer is a risk factor for the subsequent development of primary peritoneal, epithelial ovarian, and fallopian tubal (POFT) cancers. This study aimed to estimate the incidence of secondary POFT malignancy in breast cancer patients and the clinical outcomes of primary and secondary POFT cancer.Materials and Methods We searched the Korea Central Cancer Registry to find patients with primary and secondary POFT cancer who had breast cancer in 1999-2017. The incidence rate and standardized incidence ratio were calculated. Additionally, we compared the overall survival of patients with primary and secondary POFT cancer.Results Based on the age-standardized rate, the incidence of second primary POFT cancer after breast cancer was 0.0763 per 100,000 women, which increased in Korea between 1999 and 2017. Among the 30,366 POFT cancer patients, 25,721 were primary POFT cancer only, and 493 had secondary POFT cancer after a breast cancer diagnosis. Second primary POFT cancer patients were older at the time of diagnosis (55 vs. 53, p < 0.001) and had a larger proportion of serous histology (68.4% vs. 51.2%, p < 0.001) than patients with primary POFT. There were no differences between the two groups in tumor stage at diagnosis. The 5-year overall survival rates were 60.2% and 56.3% for primary and secondary POFT cancer, respectively (p=0.216).Conclusion The incidence of second primary POFT cancer after breast cancer increased in Korea between 1999 and 2017. Besides, second primary POFT cancer patients were diagnosed at older ages and had more serous histology.

Risk of Second Primary Cancer in People with Non-melanoma Skin Cancer: A Nationwide Cohort Study

Shu-Hui Wang,Ching-Chi Chi,Zi-Hao Zhao,Tao-Hsin Tung 대한암학회 2018 Cancer Research and Treatment Vol.50 No.2

Purpose Previous western studies have found Caucasians with skin cancer, either melanoma or nonmelanoma skin cancer (NMSC), have an elevated risk of second primary cancer. Our objective was to assess the risk of second primary cancer in Taiwanese with NMSC. Materials and Methods By using data from Taiwan’s National Health Insurance Research Database, we conducted a population-based cohort study to assess the risk of incident second primary cancer in Taiwanese affected by NMSC. Results We identified 505 subjects with NMSC and 2,020 matched controls. After adjustment for potential confounders including age, sex, urbanization, and Charlson Comorbidity Index, people who had NMSC had a 1.43-fold (95% confidence interval [CI], 1.05 to 1.96) risk for the development of second primary cancer as compared with control group. Men with NMSC had a 2.99-fold (95% CI, 1.00 to 9.10) risk for second primary cancer involving the lip, oral cavity, and pharynx and a 3.51-fold (95% CI, 1.21 to 10.17) risk for second primary cancer involving the genitourinary organs when compared to the control group. By contrast, women with NMSC did not have an increased risk of second primary cancer. Conclusion This study revealed Asians with NMSC have an increased risk of second primary cancer. Our findings can be a useful reference for health care for people diagnosed with NMSC.

Clinical Factors Related to Suspected Second Primary Lung Cancer Development in Patients with Head and Neck Cancer

김의배,박용,박세종,김대식,김지원,서희연,성화정,최인근,박경화,오상철,최철원,김병수,김열홍,김준석,신상원,김철용,정광윤 대한암학회 2008 Cancer Research and Treatment Vol.40 No.4

Purpose: The rate of second primary lung cancer development for patients with head and neck cancer (HNC) has been noted. The aim of our study was to evaluate the incidence and clinical features of suspected second primary lung cancer that developed in patients with primary HNC. Materials and Methods: We conducted a retrospective study of 469 patients who were newly diagnosed with HNC at the Korea University Medical Center between January 2000 and December 2006. Results: A total of 469 patients were included (389 men and 80 women). Eighteen patients (3.8%) had suspected second primary lung cancers. Statistically significant clinical variables for lung cancer development included the origin site for the primary HNC (oro-hypopharynx and larynx) (p=0.048), abnormal chest x-ray findings (p=0.027) and the histological HNC type (squamous cell carcinoma) (p=0.032). When the second primary lung cancers were combined with HNCs, the adjusted overall survival of patients with a second primary lung cancer was 16 months (p<0.001). Conclusions: Considering the relative risk factors for a second primary lung cancer developing in patients with HNC, advanced diagnostic tools, such as chest CT or PET CT scan, should be applied for the early detection of a second primary lung cancer.

Development of second primary cancer in Korean breast cancer survivors

Hong Kyu Jung,Suyeon Park,Nam Won Kim,Jong Eun Lee,Zisun Kim,Sun Wook Han,Sung Mo Hur,Sung Young Kim,Cheol Wan Lim,Min Hyuk Lee,Jihyoun Lee 대한외과학회 2017 Annals of Surgical Treatment and Research(ASRT) Vol.93 No.6

Purpose: Breast cancer survivors have slightly increased the risk of second primary cancers. Breast, colon, uterine, and ovarian cancers are common secondary cancers in breast cancer survivors. In this study, we assessed the development of second primary cancers of breast cancer survivors in Korea. Methods: Medical records of patients with breast cancer in 3 tertiary medical institutions were reviewed retrospectively. We evaluated secondary malignancy diagnosed at least 2 months after the breast cancer diagnosis. Based on the International Classification of Disease-9 codes of malignancies, secondary primary breast cancer records were evaluated with person-year adjustment. The standardized incidence ratio (SIR) was assessed using national cancer incidence. Results: A total of 3,444 treatment records were included from 3 medical centers. The cumulative incidence of overall second primary cancers was 2.8% (n = 93). The SIR was significantly higher in all sites (1.56; 95% confidence interval [CI], 1.26–1.91), endometrial cancer (5.65; 95% CI, 2.06–12.31), biliary tract cancer (3.96; 95% CI, 1.19–8.60), and thyroid cancer (2.29; 95% CI, 1.67–3.08). Conclusion: The incidence of cancer was higher in breast cancer survivors compared to general population. Surveillance of secondary cancer in this group should be recommended individually considering the benefit related to the prognosis of primary breast cancer.

두경부종양환자에서 시행한 상부위장관검사의 유용성

장지영(Ji Young Jang),조문준(Moon June Cho),김준상(Jun Sang Kim),김병국(Byoung Kook Kim),정현용(Hyun Yong Jeong),김재성(Jae Sung Kim) 대한두경부종양학회 1999 대한두경부 종양학회지 Vol.15 No.2

Background and Objectives: Multiple primary tumors of the upper aerodigestive tract are not unusual. We examined head and neck cancer patients to discover the presence of second primary cancer in their upper gastrointestinal tract, using esophagogastroscopy. Materials and Methods: Endoscopic examination of the upper gastrointestinal tract was performed on 51 patients whose head and neck cancers were treated at department of therapeutic radiology from August 1996 to April 1999. Two of all patients had been studied by barium swallowing study. In 51 patients, twenty-four had a primary tumor in the larynx, 8 in the oropharynx, 6 in the nasopharynx, 6 in the oral cavity, 6 in the hypopharynx, and 1 in the nasal cavity. Endoscopically pathologic lesions were biopsied. In control group, endoscopy was performed on 1097 patients who didn't complain any symptoms. Results: Endoscopy showed early malignant lesions in 4 cases(7.7%). Histology of esophageal cancers showed squamous cell carcinoma. Malignant lesions of stomach in 2 cases were histologically identified as adenocarcinoma. Two esophageal cancers occurred in patients whose primary lesions had oropharynx and hypopharynx. Two cases of gastric cancer were also accompanied by oropharynx and hypopharynx. The incidence of second primary cancer was 2 in oropharynx and 2 in hypopharynx. In all cases, second primary cancers were found simultaneously. In control group, 9(0.8%) of 1097 patients were confirmed as early esophageal and gastric cancers. Conclusion: The majority of esophageal and gastric cancer detected by endoscopy were early stage in both head and neck cancer and control group. The incidence of esophageal and gastric cancer of head and neck cancer patients was 10 times as high as that of control group. Although followup period was short, all second primary cancers were detected simultaneously. We would recommend that endoscopic evaluation be included in the workup and followup of all patients with newly diagnosed head and neck cancer.

조기 성문암의 치료 전 Fluorodeoxyglucose-Positron Emission Tomography/ Computed Tomography(FDG-PET/CT)의 역할

송찬일,한명월,이윤세,김상윤,최승호,남순열 대한이비인후과학회 2010 대한이비인후과학회지 두경부외과학 Vol.53 No.7

Background and Objectives Fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) has been widely used to detect regional and distant metastasis or second primary cancers at initial evaluation. The aim of this study was to evaluate the role of combined FDG-PET/CT in detecting early glottic cancers, which has low incidence of regional or distant metastasis. Subjects and Method We enrolled in our study 551 patients who had previously untreated glottic cancer between 2001 and 2008. Of these, 124 patients with early glottic cancer underwent FDG-PET/CT. Retrospectively, we compared the detection rates of regional, distant metastasis or second primary cancer by FDG-PET/CT with those after neck computed tomography (CT),chest X-ray, and liver sonography. Results In detecting regional metastasis, the sensitivity and specificity of FDG-PET/CT were 66.67% and 97.25%, respectively, with the positive predictive value (PPV) of 40%, the negative predictive value (NPV) of 99.16%, and the accuracy of 96.77%. The sensitivity, specificity, PPV,NPV and accuracy of neck CT were 66.67%, 96.69%, 33.33%, 99.15%, and 95.96%, respectively. The suspicious distant metastasis (n=1) and second primary cancers (n=7) were observed in FDG-PET/CT. The true second primary cancers occurred at the colon (n=1) and the prostate (n=2). The other cases were proved to be false positive. Distant metastasis and second primary cancers were not detected by the conventional work-up tests. Conclusion The regional metastasis detection rate of FDG-PET/CT was similar to those of the conventional work-up tests. However, compared to the conventional tests, FDG-PET/CT is useful for detecting distant metastasis or second primary cancers in patients with early glottic cancer. Korean J Otorhinolaryngol-Head Neck Surg 2010;53:419-24

Effect of Metformin on Progression of Head and Neck Cancers, Occurrence of Second Primary Cancers, and Cause-Specific Survival

Kwon, Minsu,Roh, Jong-Lyel,Song, Jihyun,Lee, Sang-Wook,Kim, Sung-Bae,Choi, Seung-Ho,Nam, Soon Yuhl AlphaMed Press 2015 The oncologist Vol.20 No.5

<P>This study aimed to investigate the effect of metformin on progression of head and neck cancers (HNC), occurrence of second primary cancers, and cause-specific survival. Results showed that metformin did not significantly affect the clinical course of patients with HNC but suggested that diabetes had a crucial impact on the clinical course of patients with HNC who were not overcome by metformin use.</P><P><B>Background.</B></P><P>This study aimed to investigate the effect of metformin on progression of head and neck cancers, occurrence of second primary cancers, and cause-specific survival.</P><P><B>Methods.</B></P><P>This study analyzed a retrospective cohort of 1,151 consecutive patients with head and neck squamous cell carcinoma who were treated at our hospital. Patients were divided into three groups: nondiabetic, nonmetformin, and metformin. Clinical characteristics, recurrence of index head and neck cancer, occurrence of second primary cancer, and survival were compared among the different groups.</P><P><B>Results.</B></P><P>Of 1,151 patients, 99 (8.6%) were included in the metformin group, 79 (6.8%) were in the nonmetformin group, and 973 (84.5%) were in the nondiabetic group. Diabetic status and metformin exposure had no significant impact on index head and neck cancer recurrence or second primary cancer development (<I>p</I> > .2). The nonmetformin group showed relatively lower overall (<I>p</I> = .017) and cancer-specific (<I>p</I> = .054) survival rates than the other groups in univariate analyses, but these results were not confirmed in multivariate analyses.</P><P><B>Conclusion.</B></P><P>Metformin use did not show beneficial effects on index tumor progression, second primary cancer occurrence, and cause-specific survival in patients with head and neck cancer compared with nonmetformin users and nondiabetic patients.</P>

두경부암 환자에서 발생한 이차성 원발암

최세준,최승호,김상윤,남순열 대한이비인후과학회 2006 대한이비인후과학회지 두경부외과학 Vol.49 No.2

Background and Objectives:A clinical study of second primary malignancies in patients with cancer of the head and neck was performed. Subjects and Method:Among 1741 patients with head and neck cancer, 91patients were diagnosed as second primary malignancies . We retrospectively reviewed the medical records about site, chronology, and survival. Results:There was association between the sites of index and second primary malignancy. This was explained by the concept of field cancerization. Three year-survival rate was 28.6%, and second primary malignancies in the advanced stages had poor survival. However, the chronological variable was not significant. Conclusion:The prevalence of second primary malignancies in patients with head and neck cancer was of 5.2%. Most of them were located in the upper aerodigestive tract. Frequent and regular follow-up is important for early detection of second primary malignancies. (Korean J Otolaryngol 2006;49:194-8)

Screening for Lung Cancer Using Low-dose Chest Computed Tomography in Korean Long-term Colorectal Cancer Survivors

Ji Soo Park,김태일,박수정,천재희,정민규,신상준,허혁,민병소,백승혁,이강영,안중배,김남규 대한암예방학회 2019 Journal of cancer prevention Vol.24 No.1

Background: The National Lung Screening Trial (NLST) and NELSON trial showed that low-dose chest computed tomography (LDCT) screening significantly reduced the mortality form lung cancer. Although cancer survivors are known to have high risk for second malignant neoplasm (SMN), the usefulness of LDCT screening for lung cancer in cancer survivors is not clear. Methods: Between August 2016 and August 2017, 633 long-term colorectal cancer (CRC) survivors visited the survivorship clinic in Cancer Prevention Center, Yonsei Cancer Center, Seoul, Republic of Korea. We surveyed the smoking status and recommended LDCT screening to ever-smoking CRC survivors aged 55-80 years. The participants were classified into three risk groups: risk group 1 (RG1) who met the NLST criteria (Age 55-74 years, ≥ 30 pack-years of smoking, smoking cessation < 15 years); risk group 2 (RG2) who would not meet the NLST criteria but were at increased 6-year risk of lung cancer (PLCOM2012 ≥ 0.0151); risk group 3 (RG3) who did not meet any of the criteria above. Results: Among 176 ever-smoking CRC survivors, 173 (98.3%) were male, 32 (18.2%) were current-smoker, and median age was 66 years (range, 55-79 years). We found 38 positive findings (non-calcified nodule ≥ 4 mm), 8 clinically significant findings, 66 minor abnormalities, and 64 negative findings on LDCT. Positive findings were identified in 15 of 79 (19.0%) of RG1, in 9 of 36 (25%) of RG2, and in 14 of 61 (23.0%) of RG3. Second primary lung cancers were found in 2 patients of RG2, and in 1 patient of RG3. SMN was most frequently found in RG2 (11 of 36 patients, 30.6%), compared with RG1 (12.7%) or RG3 (9.8%) (P = 0.016). Conclusions: LDCT screening for lung cancer in Korean CRC survivors is feasible. Well-designed clinical trial for defining high risk patients for lung cancer among CRC survivors is needed. (J Cancer Prev 2019;24:48-53)

두경부암 환자에 병발된 위암 2예

강진형(Jin Hyoung Kang),문찬수(Chan Soo Moon),김훈교(Hoon Kyo Kim),이경식(Kyung Shik Lee),김동집(Dong Jip Kim),윤세철(Sei Chul Yoon),조승호(Seung Ho Cho),서병도(Byung Do Suh) 대한두경부종양학회 1992 대한두경부 종양학회지 Vol.8 No.1

The causes of treatment failure in head and neck cancer are locoregional recurrence, distant metastasis and second primary cancer. The favorite sites of second primary cancer are head and neck, lung and esophagus. But, the incidence of stomach cancer in Korea is the highest of all, high incidence of stomach cancer is expected in head and neck cancer patients. We experienced 2 cases of stomach cancer after successful treatment of primary head and neck cancer at Kang Nam St. Mary's hospital. The first case was a 60-year-old male with nasopharyngeal non-keratinizing carcinoma(stage III, T1N1M0). He received three cycles of induction chemotherapy including cisplatin and 5-fluorouracil followed by radiotherapy which resulted in complete response. Five months after completion of radiotherapy. stomach adenocarcinoma(stage IV, T4N2M1) was diagnosed. He received one cycle of FAM chemotherapy and died 4 months after diagnosis of stomach cancer. The second case was a 50-year-old male with pyriform sinus squamous cell carcinoma(stage II, T2N0M0). He received curative partial pharyngolaryngectomy followed by radiotherapy which result in free of disease. Four months after completion of radiotherapy. stomach adenocarcinoma(stage IV, T4N2M1) was diagnosed. Bypass gastrojejunostomy was performed. The screening test for stomach cancer including upper gastrointestinal X-xay series and/or endoscope of the stomach should be performed periodically for the patients with head and neck cancer in Korea.