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Key Clinical Message: Epithelial‐myoepithelial carcinoma of the breast is an extremely rare biphasic tumor. This report documents the first case of epithelial‐myoepithelial carcinoma presenting in the location of a previously treated ductal carcinoma in order to increase the awareness of this entity as a potential differential for recurrent breast lesions. Epithelial‐myoepithelial carcinoma of the breast is an exceedingly rare biphasic tumor, seldom documented in medical literature. This report describes the first known case of this entity at the site of a previously treated neoplasm in a 75‐year‐old female with a history of high‐grade ductal carcinoma in situ who presented with a new breast mass. Imaging demonstrated an oval shaped mass with microlobulated borders and hypoechoic echogenicity on ultrasound. Following multidisciplinary discussion, she underwent a mastectomy, revealing epithelial‐myoepithelial carcinoma with metaplastic squamous cell carcinoma. The patient began chemotherapy but discontinued due to poor tolerance and neurological complications. Generally, prognosis for epithelial‐myoepithelial carcinoma (World Health Organization Classification of Breast Tumors 2019, 8562/3) is highly variable, with limited available data suggesting that epithelial‐myoepithelial carcinoma may follow a course similar to that of breast adenocarcinomas with both hematogenous and lymphatic spread. Treatment typically involves curative excision, though the role of axillary lymph node sampling remains under discussion. This case underscores the need for vigilance in post‐treatment surveillance for breast cancer and highlights the importance of recognizing this entity in recurrent breast pathology. [ABSTRACT FROM AUTHOR]

Developing a subsequent cancer is one of the major concerns for cancer survivors; however, whether prior cancer could affect their prognosis is unknown. We therefore aimed to analyze how prognosis varies depending on prior cancer in patients with newly developed cancer, focusing on cancer that had been "cured." We used the record‐linked database of the Osaka Cancer Registry and Vital Statistics to select 186,798 patients with stomach, colorectal, or lung cancer aged ≥40 years from 1995 to 2009 in Osaka, Japan. These cancers were defined as index cancers. We classified the patients into two groups according to whether they had a prior cancer diagnosis within 10 years before the index cancer diagnosis. The cured proportion was defined as the proportion of cancer patients with the same mortality as the general population and was estimated using the parametric mixture cure model. The cured proportion of patients with prior cancer by sex and age group was not significantly lower than those without prior cancer, except for patients with stomach cancer aged ≥65 years. According to the index cancer stage in the localized stomach or colorectal cancer, the cured proportion in patients with prior cancer was lower than in those without prior cancer. However, at any stage of lung cancer, the proportion of patients with prior cancer who had been cured was similar to patients without prior cancer, therefore prior cancer had a prognostic impact only in some patient groups based on the characteristics of their index cancer. [ABSTRACT FROM AUTHOR]

Objective: In the setting of similar outcomes, quality of life (QOL) measures can be utilized to compare treatment modalities in head and neck squamous cell carcinoma (HNSCC). We evaluate QOL and symptoms in patients treated for primary, second primary, and recurrent HNSCC. Study Design: Retrospective cohort study. Setting: Head and neck cancer survivorship clinic. Methods: We identified patients seen between 2016 and 2019. QOL and symptoms were assessed with the University of Washington Quality of Life (UW‐QOL) questionnaire, 10‐item Eating Assessment Tool, 8‐item Patient Health Questionnaire, 7‐item Generalized Anxiety Disorder, and Neck Disability Index. Regression analysis was utilized to explore associations and compare QOL outcomes. Results: Our cohort comprised 662 patients: 546 with primary HNSCC, 34 with second primary HNSCC, and 82 with recurrent HNSCC. Multimodality therapy was associated with lower UW‐QOL Physical Subscale (UW‐QOL‐PS) vs single modality: chemoradiation therapy (−12.17 [95% CI, −16.57 to −7.78]) and surgery + postadjuvant treatment (−12.11 [−16.06 to −8.16]). Multimodality therapy was also associated with lower UW‐QOL Social‐Emotional Subscale (UW‐QOL‐SS): chemoradiation therapy (−6.70 [−11.41 to −1.99]) and surgery + postadjuvant treatment (−7.41 [−11.63 to −3.19]). Recurrence (−14.42 [−18.80 to −10.04]) and second primary (−11.15 [−17.71 to −4.59]) demonstrated lower UW‐QOL‐PS vs primary. Radiation for recurrence or second primary had worse UW‐QOL‐PS (−10.43 [−19.27 to −1.59]) and UW‐QOL‐SS (−10.58 [−18.76 to −1.54]) and higher Eating Assessment Tool (6.08 [1.39‐10.77]) than surgery alone. Surgery + postadjuvant treatment showed worse UW‐QOL‐PS (−12.65 [−23.76 to −1.54]) and UW‐QOL‐SS (−12.20 [−22.38 to −2.03]). Conclusion: Multimodality therapy, particularly with recurrent and second primary HNSCC, is more likely to contribute to diminished QOL and symptoms. This important consideration should play a role in framing informed discussions with patients regarding treatment. [ABSTRACT FROM AUTHOR]

Background: There are limited studies on the risk of secondary cancers after carbon‐ion radiotherapy (CIRT). We assessed the incidence of secondary cancers in patients treated with CIRT for cervical cancer. We also evaluated the incidence of secondary cancers in patients who received standard photon radiotherapy (RT) throughout the same period. Methods: This retrospective study included patients with cervical cancer who underwent curative RT at our hospital. All cancers discovered for the first time after RT were classified as secondary cancers. To compare the risk of secondary cancers among cervical cancer survivors to the general population, standardized incidence ratios (SIRs) were calculated. Results: The analysis included a total of 197 and 417 patients in the CIRT and photon RT groups, respectively. The total person‐years during the observation period were 1052.4 in the CIRT group and 2481.5 in the photon RT group. The SIR for all secondary cancers was 1.1 (95% confidence interval [CI], 0.6–2.1) in the CIRT group and 1.4 (95% CI, 1.0–2.1) in the photon RT group. The 10‐year cumulative incidence of all secondary cancers was 9.5% (95% CI, 4.0–21.5) in the CIRT group and 9.4% (95% CI, 6.2–14.1) in the photon RT group. The CIRT and photon RT groups were not significantly different in incidence (p = 0.268). Conclusions: The incidence of secondary cancers after CIRT for cervical cancer was similar to that after photon RT. Validation of our findings after long‐term observation is warranted. [ABSTRACT FROM AUTHOR]

Background: Recovery of swallowing in patients treated with trans‐oral robotic surgery (TORS) is in general considered as favorable. However, patients afflicted with a secondary primary carcinoma of the head and neck may be more vulnerable to swallowing dysfunctions after trans‐oral surgery as a consequence of previous treatments. Methods: This is a retrospective monocentric study on patients undergoing TORS for second primary squamous cell carcinoma between 2013 and 2017 (follow‐up until June 2021). Swallowing performance was assessed via the functional outcome swallowing scale (FOSS). Also, overall survival (OS), disease‐free survival (DS) and disease‐specific survival (DSS) were evaluated. Results: Eighteen patients (median 62 years) underwent TORS with curative intent for T1‐2 oropharyngeal and supraglottic secondary primaries. The average follow‐up was of 52 months. All cases were resected R0 using TORS. 84% of patients had a post‐treatment FOSS score equal or better upon last follow‐up compared with pre‐treatment. Only one patient required a percutaneous gastrostomy long term. DSS/DFS/OS at 5 years was 94%, 60%, and 67%, respectively. The main cause of death was metachronous pulmonary neoplasia. Conclusions: Our study demonstrates encouraging results in terms of swallowing recovery in patients undergoing TORS for selected secondary primaries of the oropharynx and supraglottic larynx. Further studies into trans‐oral surgery for this condition seem therefore warranted. Level of Evidence: Case series; Level 4. [ABSTRACT FROM AUTHOR]

Background: Little data exists regarding the incidence of oropharyngeal and upper aerodigestive tract (UADT) second primary malignancies (SPM) among human papilloma virus (HPV)‐positive oropharyngeal squamous cell carcinoma (OPSCC). Here we evaluate SPM rates among patients with HPV‐related OPSCC. Methods: A retrospective cohort study of 412 patients with HPV‐related OPSCC who underwent transoral resection +/− adjuvant therapy at a single center between 1996 and 2018. Results: Twenty patients (4.9%) developed SPM of the UADT, nine (2.2%) occurring in the oropharynx. Median time to diagnosis was 59.5 months (0–173 months). Risk of SPM was lower for patients receiving adjuvant radiation (aHR: 0.25, 95%CI: 0.08–0.78). There was no difference in overall or disease‐free survival between those with and without SPM. Conclusion: The rate of SPM among patients with HPV‐positive OPSCC is lower than reported rates among HPV‐negative OPSCC. To date, this is the largest study evaluating SPM in patients with surgically treated HPV‐positive OPSCC. [ABSTRACT FROM AUTHOR]

Background: Endometrial cancer (EC) often occurs subsequently to a primary cancer arising from a different site. However, little is known regarding the survival experience of EC as a second primary (ECSP) malignancy, specifically in relation to the original primary site and prior treatment. Methods: Using Florida's cancer registry, all EC cases (first, second, or higher-order) diagnosed from 2005-2016 were analyzed. Kaplan-Meier methods and Cox Regression were used in a cause-specific survival analysis. Results: A total of 2879 clinically independent ECSPs and 42,714 first primary ECs were analyzed. The most common first primary sites for ECSPs were breast cancer (BC) (n = 1422) and colorectal cancer (CRC) (n = 359). Five-year cause-specific survival was 84.0% (95% CI: 83.6-84.3) for first primary ECs and 81.8% (95% CI: 80.0-83.4) for ECSPs. After adjusting for age, race/ethnicity, histology, and stage at diagnosis, ECSPs had a lower risk of EC mortality than first primary ECs (hazard ratios [HR] 0.88, 95% CI: 0.79-0.97). ECSPs with a first primary CRC had a higher risk of EC-specific death (HR 1.47, 95% CI: 1.04-2.06) compared to ECSPs that followed BC in multivariable analysis. Finally, women who had chemotherapy for ECSP and preceding BC did not have a higher risk of death (HR 0.80, 95% CI: 0.49-1.31) compared to those who only received chemotherapy for first primary EC. Conclusions: ECSPs present a complex clinical profile. ECSP survival is superior to that of first primary EC. However, ECSPs following CRC may constitute a population of interest for their worse prognosis. Chemotherapy for a previous BC does not seem to impact the effectiveness of chemotherapy for ECs. [ABSTRACT FROM AUTHOR]

Background: To assess the effect of 18‐fluorodeoxyglucose positron emission tomography (FDG‐PET) in the pretherapeutic staging of N classification, detection rate of distant metastases, and second primaries. Methods: Retrospective study on patients with head and neck carcinoma. We compared pretherapeutic N classification by ultrasound, computed tomography (CT)/magnetic resonance imaging (MRI), and FDG‐PET‐CT/MRI. Results: A change in the N classification due to FDG‐PET‐CT/MRI was observed in 116 patients (39.5%) compared to N classification by ultrasound and fine‐needle aspiration cytology. Patients with advanced nodal classification (>N2a) were more likely to be reclassified. Distant metastases were detected in 19 patients and a total of 36 second primaries were diagnosed by FDG‐PET‐CT/MRI. Detection of distant metastases was more likely in regional advanced disease (>N2a). Smokers (>10 py) had a significantly higher risk of second primary. Conclusion: FDG‐PET‐CT/MRI leads to a significant change in pretherapeutic N classification. The cumulative incidence of distant metastases and second primaries was 18.7%. [ABSTRACT FROM AUTHOR]

Background: Increased risk of a second primary malignancy (SPM) before or after diagnosis of anal squamous cell carcinoma (ASCC) has been reported in a previous single‐institution study. We hypothesize that patients diagnosed with ASCC are at increased risk for developing SPMs before or after the diagnosis of ASCC. The primary objective of this study was to identify the diagnoses of cancer most likely to occur as SPMs before or after ASCC. Methods: This work employs the Surveillance, Epidemiology, and End Results (SEER) Program registry data to conduct a US‐population‐based study of patients diagnosed with ASCC between 1975 and 2016. In patients diagnosed with ASCC, we evaluated the risk of SPMs and the risk of developing ASCC as an SPM after another cancer using standardized incidence ratios (SIR) for all SPMs by calculating the ratio of observed events in the ASCC cohort compared to expected (O/E) events in a matched reference cohort of the general population. Results: A total of 7,594 patients with primary ASCC were included. Patients with ASCC were at increased risk of the diagnosis of an SPM (SIR = 1.45), particularly cancers of the lung, vulva, oropharynx, or colon. Patients with ASCC had an increased rate of previous malignancy (SIR = 1.23), especially Kaposi sarcoma or vulvar cancer. Overall elevated incidence of SPMs was unrelated to prior radiation treatment. Radiation treatment was associated with increased risk for SPMs in the female genital system but appeared protective against prostate cancer as SPMs. Conclusions: Our findings support increased surveillance and screening for second malignancies in patients with these diagnoses, as patients with ASCC are often either survivors of a prior cancer diagnosis or are at increased risk of developing later malignancies. [ABSTRACT FROM AUTHOR]

Objectives: In contrast to secondary primary malignancies (SPM) following multiple myeloma (MM), less is known about previous malignancies. We therefore conducted a population‐based study to assess the patterns of previous malignancies in MM patients as well as the risk for SPM. Methods: Using data from the Cancer Registry of Norway, we included 9574 MM patients and 37 810 matched control subjects. The association between previous malignancies and a subsequent diagnosis of MM was analysed by a logistic regression model and the risk for SPM by a Cox model. Results: A previous diagnosis of myeloproliferative neoplasia (MPN) (OR 3.57; 95% CI:1.45‐8.80) and Hodgkin lymphoma (HL) (OR 3.66; 95% CI: 1.40‐9.55) was associated with the subsequent development of MM. For MPN, the association with MM was explained by an excess of primary myelofibrosis (PMF) in the MM group. The overall incidence of a previous malignancy was not different between MM patients and the control subjects (OR 0.93; 95% CI: 0.87‐1.00). MM patients had an increased risk for secondary acute myelogenous leukaemia/myelodysplastic syndromes (HR 6.1, 95% CI: 3.9‐9.5). Conclusions: A previous diagnosis of HL and PMF was associated with a subsequent diagnosis of MM, whereas the overall incidence of previous cancers was not increased for MM patients. [ABSTRACT FROM AUTHOR]

Background: Most studies on sinonasal inverted papillomas (SNIPs) regarding risk factors for recurrence, recurrence rates (RRs) and malignant transformation are biased by a significant proportion of revision cases. Methods: Retrospective study on patients with consecutive, treatment‐naïve SNIPs at a tertiary referral center between 1999 and 2019. Results: Overall, RR was 9.8% (10 of 102 patients), with 2 of 10 recurrences (20%) occurring after more than 5 years. Histopathological workup revealed synchronous malignancy in 2 of 102 patients (2%). Subgroup analysis revealed a significantly higher RR for SNIPs involving the frontal sinus (26.3% vs 6.0%, P =.02). No SNIPs primarily originating from the frontal sinus were observed. Conclusion: Overall, RR of treatment‐naïve SNIPs is comparably low; however, long‐term follow‐up is mandatory due to late recurrences. Secondary involvement of the frontal sinus was identified as risk factor for recurrence. No SNIPs primarily originating from frontal sinus were observed. [ABSTRACT FROM AUTHOR]

Background: The comparative risks of a second cancer diagnosis are uncertain after primary cancer treatment with 3-dimensional conformal radiotherapy (3DCRT), intensity-modulated radiotherapy (IMRT), or proton beam radiotherapy (PBRT).Methods: Pediatric and adult patients with a first cancer diagnosis between 2004 and 2015 who received 3DCRT, IMRT, or PBRT were identified in the National Cancer Database from 9 tumor types: head and neck, gastrointestinal, gynecologic, lymphoma, lung, prostate, breast, bone/soft tissue, and brain/central nervous system. The diagnosis of second cancer was modeled using multivariable logistic regression adjusting for age, follow-up duration, radiotherapy (RT) dose, chemotherapy, sociodemographic variables, and other factors. Propensity score matching also was used to balance baseline characteristics.Results: In total, 450,373 patients were identified (33.5% received 3DCRT, 65.2% received IMRT, and 1.3% received PBRT) with median follow-up of 5.1 years after RT completion and a cumulative follow-up period of 2.54 million person-years. Overall, the incidence of second cancer diagnosis was 1.55 per 100 patient-years. In a comparison between IMRT versus 3DCRT, there was no overall difference in the risk of second cancer (adjusted odds ratio [OR], 1.00; 95% CI, 0.97-1.02; P = .75). By comparison, PBRT had an overall lower risk of second cancer versus IMRT (adjusted OR, 0.31; 95% CI, 0.26-0.36; P < .0001). Results within each tumor type generally were consistent in the pooled analyses and also were maintained in propensity score-matched analyses.Conclusions: The risk of a second cancer diagnosis was similar after IMRT versus 3DCRT, whereas PBRT was associated with a lower risk of second cancer risk. Future work is warranted to determine the cost-effectiveness of PBRT and to identify the population best suited for this treatment. [ABSTRACT FROM AUTHOR]

Aim: As the prognosis of patients who undergo resection for pancreatic cancer has improved, reports of remnant pancreatic cancer after pancreatic cancer resection have been increasing. Previous studies regarding early‐stage pancreatic cancer showed a high incidence of remnant pancreatic cancer in these patients. The aim of this study was to investigate the incidence of remnant pancreatic cancer according to the degree of progression of the initial pancreatic cancer. Methods: Patients who underwent partial pancreatic resection for primary pancreatic cancer were retrospectively reviewed and divided into an early‐stage group and an advanced‐stage group according to the stage of the initial cancer. Patient characteristics and long‐term outcomes, including development of remnant pancreatic cancer, were compared between the two groups. Results: This study included 321 patients who underwent partial pancreatectomy for pancreatic cancer; 32 patients in the early‐stage group and 289 patients in the advanced‐stage group. Remnant pancreatic cancer developed in 19 patients (5.9%); seven patients (21.9%) in the early‐stage group and 12 patients (4.5%) in the advanced‐stage group. The cumulative incidence of remnant pancreatic cancer according to the Kaplan–Meier method was comparable between the two groups (5‐year cumulative incidence: 20.6% vs 9.9%, early‐stage group vs advanced‐stage group; P =.1827). Conclusion: Our results suggested that the potential for developing remnant pancreatic cancer was comparable between the early‐stage and the advanced‐stage groups. Therefore, the incidence of remnant pancreatic cancer may increase along with improved pancreatic cancer treatment. [ABSTRACT FROM AUTHOR]

Lung cancer as a second primary malignancy (lung‐2) is increasingly common, but its prognosis is poorly understood. This study aims to examine the overall and cancer‐specific survival of patients diagnosed with lung‐2 compared to lung‐1. Primary lung cancer patients diagnosed from 1988 to 2014 in the Surveillance, Epidemiology, and End Results (SEER) program were included. Lung‐2 was identified in patients with a previous diagnosis of nonlung primary malignancy in SEER. Hazard ratios (HRs) of overall and lung cancer‐specific mortality were estimated among patients with lung‐2 compared to lung‐1, adjusting for age and calendar period at diagnosis, sex, race, socioeconomic status, tumor stage, histology, tumor grade, and treatment. A total of 679 541 and 85 758 patients were identified as lung‐1 and lung‐2, respectively. Compared to lung‐1, patients with lung‐2 were more likely to be diagnosed at localized stage, with smaller primary tumor, and treated with surgery. Lung‐2 patients were at lower risk of lung cancer‐specific mortality in the first 5 years (HR, 0.77; 95% CI, 0.76‐0.78 at <1 year; HR, 0.87; 95% CI, 0.86‐0.89 from 1 to <5 years) but at higher risk thereafter (HR, 1.32; 95% CI, 1.27‐1.37 from 5 to 10 years), independent of tumor characteristics and cancer treatment. Similar pattern was found for overall mortality, although the survival benefit was restricted to the first year after diagnosis. Patients diagnosed with lung‐2 face a favorable lung cancer‐specific survival within the early period after diagnosis. A conservative approach to manage lung‐2 solely based on malignancy history is not supported. [ABSTRACT FROM AUTHOR]

Although personalization of cancer care is recommended, current follow‐up after the curative treatment of breast cancer is consensus‐based and not differentiated for base‐line risk. Every patient receives annual follow‐up for 5 years without taking into account the individual risk of recurrence. The aim of this study was to introduce personalized follow‐up schemes by stratifying for age. Using data from the Netherlands Cancer Registry of 37 230 patients with early breast cancer between 2003 and 2006, the risk of recurrence was determined for four age groups (<50, 50‐59, 60‐69, >70). Follow‐up was modeled with a discrete‐time partially observable Markov decision process. The decision to test for recurrences was made two times per year. Recurrences could be detected by mammography as well as by self‐detection. For all age groups, it was optimal to have more intensive follow‐up around the peak in recurrence risk in the second year after diagnosis. For the first age group (<50) with the highest risk, a slightly more intensive follow‐up with one extra visit was proposed compared to the current guideline recommendation. The other age groups were recommended less visits: four for ages 50‐59, three for 60‐69, and three for ≥70. With this model for risk‐based follow‐up, clinicians can make informed decisions and focus resources on patients with higher risk, while avoiding unnecessary and potentially harmful follow‐up visits for women with very low risks. The model can easily be extended to take into account more risk factors and provide even more personalized follow‐up schedules. This manuscript demonstrates the optimization of a risk‐based follow‐up scheme in breast cancer. [ABSTRACT FROM AUTHOR]

Abstract: Aim: To report the incidence of urological complications following curative radiation treatment for early prostate cancer, including minimally invasive urological procedures (MUIP), hospital admissions and open surgical procedures. Second malignancies following radiation are also reported and compared with patients undergoing a prostatectomy. Methods: Included were patients receiving curative intent external beam radiation treatment for early prostate cancer between January 1, 2002, and December 31, 2009. Medical records were reviewed for baseline characteristics, treatment details and outcomes. Kaplan–Meier methods were used to derive the 5‐year cumulative incidence of the urological outcomes and second malignancy. Results: There were 439 patients identified. The median follow‐up was 6.96 years. The median age was 69. A total of 56 patients developed a radiation related urological complication, 25 requiring hospital admission. The 5‐year cumulative incidence for an MIUP and admission was 3.95% (95% confidence interval (CI), 2.47–6.28) and 2.24% (95% CI, 1.17–4.27), respectively. There were no open surgical procedures. Further malignancy developed in 27 patients during the 5‐ to 9‐year posttreatment period with a cumulative incidence of 10.7% (95% CI, 7.31–15.51). Of the comparator prostatectomy group, of the 265 eligible patients analyzed, 19 patients developed a second malignancy with a cumulative incidence of 9.92% (95% CI, 6.28–15.48). On log‐rank testing, there was no difference in the cumulative incidence rates of second malignancy between 5 and 9 years, following respective treatments (P  =  0.8554). Conclusions: The incidence of MUIP, hospital admissions and open surgical procedures following radiation is reassuringly low. The second malignancy rates are also low and similar to the rates in patients treated with a prostatectomy. [ABSTRACT FROM AUTHOR]

Objective Many head and neck cancers (HNCs) have genomic features seen in breast malignancy. We sought to analyze the risk of second primary HNC following an index breast cancer. Study Design Retrospective cohort study. Setting National database from the SEER registry (Surveillance, Epidemiology, and End Results). Subjects and Methods Within the SEER database, 223,423 women diagnosed with index breast cancer from 1992 to 2002 were identified. We calculated standard incidence ratios (SIRs) for all head and neck sites with 10-year follow-up. Results Women diagnosed with an index breast cancer did not exhibit higher likelihood of developing second primary HNC (SIR = 0.99; 95% CI, 0.90-1.07). The risk was determined for each subsite of the head and neck, and salivary gland cancer presented the highest risk. Patients with index breast cancer were 83% more likely to develop salivary gland cancer than what would be expected in the general population (SIR = 1.83; 95% CI, 1.49-2.22). An overall trend of increased risk was observed for salivary gland cancers between 1992 and 2002. There was no significant higher risk observed for the other head and neck subsites. Conclusion Patients with index breast cancer did not have a higher-than-expected risk of developing HNC. We did find an increased incidence of salivary gland cancers among patients with index breast cancer. Patients were 80% more likely to develop salivary gland cancer than that expected within the population. These findings warrant further investigation on the relationship between salivary gland and breast malignancy. [ABSTRACT FROM AUTHOR]

Lenalidomide is often used in the maintenance setting for multiple myeloma and has been linked to the development of secondary primary malignancies. The mechanism of lenalidomide causing secondary malignancies has not been fully elucidated, but case reports and phase 3 trials have captured this uncommon occurrence. A case series describing development of secondary acute lymphoblastic leukemia in patients receiving lenalidomide maintenance therapy is presented. Based on data published in the literature thus far and commonalities among patients in this case series, secondary acute lymphoblastic leukemia is likely duration related rather than dose related. Increased cognizance of this secondary malignancy will allow for a more accurate characterization of its true incidence. Regimens for acute lymphoblastic leukemia can be used for management of secondary acute lymphoblastic leukemia with plan for stem cell transplantation. Further studies are needed to identify risk factors for development of secondary malignancy and the best management approach for these patients. Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objectives To determine whether the risk of second primary cancer ( SPC) among patients with bladder cancer ( BCa) has changed over past years. Materials and Methods Data from 10 French population-based cancer registries were used to establish a cohort of 10 047 patients diagnosed with a first invasive (≥T1) BCa between 1989 and 2004 and followed up until 2007. An SPC was defined as the first subsequent primary cancer occurring at least 2 months after a BCa diagnosis. Standardized incidence ratios ( SIRs) of metachronous SPC were calculated. Multivariate Poisson regression models were used to assess the direct effect of the year of BCa diagnosis on the risk of SPC. Results The risk of new malignancy among BCa survivors was 60% higher than in the general population ( SIR 1.60, 95% confidence interval [ CI] 1.51-1.68). Male patients presented a high risk of SPC of the lung ( SIR 3.12), head and neck ( SIR 2.19) and prostate ( SIR 1.54). In multivariate analyses adjusted for gender, age at diagnosis and follow-up, a significant increase in the risk of SPC of the lung was observed over the calendar year of BCa diagnosis ( P for linear trend 0.010), with an SIR increasing by 3.7% for each year (95% CI 0.9-6.6%); however, no particular trend was observed regarding the risk of SPC of the head and neck ( P = 0.596) or the prostate ( P = 0.518). Conclusions As the risk of SPC of the lung increased between 1989 and 2004, this study contributes more evidence to support the promotion of tobacco smoking cessation interventions among patients with BCa. [ABSTRACT FROM AUTHOR]

Radiation has long been associated with carcinogenesis. Nevertheless, it is an important part of multimodality therapy for many malignancies. It is critical to assess the risk of secondary malignant neoplasms (SMNs) after radiation treatment. The authors reviewed the literature with a focus on radiation and associated SMNs for primary hematologic, breast, gynecologic, and pediatric tumors. Radiation appeared to increase the risk of SMN in all of these; however, this risk was found to be associated with age, hormonal influences, chemotherapy use, environmental influences, genetic predisposition, infection, and immunosuppression. The risk also appears to be altered with modern radiotherapy techniques. Practitioners of all specialties who treat cancer survivors in follow-up should be aware of this potential risk. Cancer 2016;122:1809-21. © 2016 American Cancer Society. [ABSTRACT FROM AUTHOR]

Objective: We sought to compare clinical outcomes, pathological features, treatment patterns, and survival outcomes between radiation-induced squamous cell carcinoma (RISCC) and de novo SCC (DNSCC) of the head and neck, as well as identify prognostic factors in these patients.Study Design: Case-control study.Setting: Tertiary medical center.Subjects and Methods: Retrospective case-control analysis of 34 RISCCs and 136 DNSCCs matched by age at diagnosis, sex, smoking status, and primary tumor site.Results: Median latency of RISCC development was 13 years. Radiation-induced squamous cell carcinomas were more likely to present with node-negative disease than DNSCCs (70.6% vs 42.9%; P = .024). A greater proportion of DNSCCs was treated with curative intent (92.6% vs 79.4%; P = .048) and achieved no residual disease posttreatment (82.2% vs 41.2%; P < .001) compared with RISCCs. Patients with RISCC had poorer overall survival (OS) (median, 1.67 vs 5.03 years; P = .018) and disease-specific survival (DSS) (median, 1.67 vs 8.65 years; P = .001) than those with DNSCC. Among patients who underwent curative treatment with no residual disease after treatment, there were, however, no survival differences between RISCC and DNSCC.Conclusion: In our cohort, RISCCs have a poorer prognosis than DNSCCs. However, those able to undergo curative treatment and have no residual disease after treatment have comparable survival outcomes. Locoregional control of these tumors appears paramount in achieving the best outcomes for patients with RISCC. [ABSTRACT FROM AUTHOR]

Background The purpose of this study was to investigate the rate of simultaneous second primary tumor (SPT) in patients with oral squamous cell carcinoma. The survival of patients with simultaneous SPT was also compared with patients without. Methods The presence of SPT was documented along with the patients' demographic data, tumor-related features, and survival status. Kaplan-Meier method was used for survival analysis. Relevant factors influencing the survival were examined by the Cox proportional hazard model. Results A total of 897 patients' medical records were obtained. Among them, 43 patients (4.8%) had simultaneous SPT and their prognosis was poorer than that of patients without. The Cox proportional hazard model revealed that patients with simultaneous SPT tended to have a higher probability of death (relative risk [RR], 1.694; p = .015). Conclusions Simultaneous SPT is an independent prognostic factor for patients with oral squamous cell carcinoma. Those with simultaneous SPT have poorer survival when compared to those without. © 2012 Wiley Periodicals, Inc. Head Neck 35: 1801-1807, 2013 [ABSTRACT FROM AUTHOR]

Background Among patients with index oropharyngeal cancer, second primary malignancies (SPMs) may be less common in cases of human papillomavirus (HPV)-associated tumors than HPV-negative tumors. Further modification of these SPM risks by smoking has not been reported. Methods SPM outcomes of 356 patients with incident oropharyngeal cancer were analyzed using Cox proportional hazards and Kaplan-Meier models. SPM risk and SPM-free survival were compared in HPV-seronegative patients, HPV-seropositive never smokers, and HPV-seropositive ever smokers. Results HPV-seropositive patients had a lower 5-year SPM rate than HPV-seronegative patients (5.6% vs 14.6%; p = .051). Compared to HPV-seronegative patients, HPV-seropositive never smokers had a 73% reduced SPM risk, and HPV-seropositive ever smokers had a 27% reduced SPM risk (trend p = .028). Although HPV-seronegative patients had SPMs in traditional locations, 70% of SPMs among HPV-seropositive patients were outside typical tobacco-related sites. Conclusion HPV serologic status and smoking may stratify patients with index oropharyngeal cancers in terms of risk and location of SPMs. © 2012 Wiley Periodicals, Inc. Head Neck, 2012 [ABSTRACT FROM AUTHOR]

BACKGROUND: This study sought to estimate the risk of breast cancer (BC) after a diagnosis of ovarian cancer (OC) associated with mutation of the BRCA1/2 (breast cancer, early onset) genes ( BRCA-OC). METHODS: The Memorial Sloan-Kettering Cancer Center and the University of Pennsylvania, clinical genetics databases were searched to identify women with BRCA-OC who participated in genetic testing and follow-up studies from 1995 to 2009. The primary objective was to determine the risk of developing BC after BRCA-OC. Overall survival (OS) and BC-free survival (BCFS) were determined by the Kaplan-Meier method; patients were censored at the time of last follow-up. RESULTS: A total of 164 patients had BRCA-OC (115 with BRCA1; 49 with BRCA2). Of these 164 patients, 152 developed OC prior to BRCA testing (median time to testing, 2.4 years [0.01-55 years]). Median follow-up from OC for those not developing BC was 5.8 years (0.25-55.6 years). There were 46 deaths, but none were due to BC. The 5- and 10-year OS were 85% (95% confidence interval [CI] = 0.78, 0.90) and 68% (95% CI = 0.59, 0.76), respectively. There were 18 metachronous BC diagnoses. The 5- and 10-year BCFS were 97% (95% CI = 0.92, 0.99) and 91% (95% CI = 0.82, 0.95), respectively. A subset of 64 women were tested either before or within 12 months of BRCA-OC. In this pseudo-incident subset, 5- and 10- year OS was 71% (95% CI = 0.53, 0.83) and 62% (95% CI = 0.44, 0.75), respectively, and 5- and 10-year BCFS were 100% and 87% (95% CI = 0.56, 0.96), respectively. CONCLUSIONS: OS was dominated by OC deaths. Metachronous BC risk was lower than reported for unaffected BRCA mutation carriers. These results support nonsurgical management of BC risk in women with BRCA-OC. Cancer 2013. © 2012 American Cancer Society. [ABSTRACT FROM AUTHOR]

BACKGROUND: In patients with multiple primary melanomas (MPM), mean tumor thickness tends to decrease from the first melanoma to the second melanoma, and prognosis may be improved compared with the prognosis for patients who have a single primary melanoma (SPM). In this study, the authors compared the clinicopathologic features of patients with MPM and SPM to better characterize the differences between these 2 groups and to determine whether or not there is an inherent difference in tumor aggression. METHODS: In total, 788 patients with melanoma who were enrolled prospectively in the Interdisciplinary Melanoma Cooperative Group database from 2002 to 2008 were studied. Patients with SPM and with MPM were compared with regard to clinical and primary melanoma characteristics. RESULTS: Of 788 patients with melanoma, 61 patients (7.7%) had 2 or more primary melanomas. The incidence of developing a second primary melanoma 1 year and 5 years after initial melanoma diagnosis was 4.1% and 8.7%, respectively, and most of the risk accumulated within the first year. The incidence of MPM was greater in patients aged ≥60 years than in those aged ≤60 years. The absence or presence of mitosis and other tumor characteristics did not differ significantly between patients with SPM and patients with MPM ( P = .61). CONCLUSIONS: No difference was observed in the presence or absence of mitoses, a marker of tumor proliferation, in SPM and MPM. Because it has been demonstrated that the presence of mitosis is a powerful prognostic marker, the current findings suggested that the tumors behave similarly in patients with SPM and patients with MPM. The authors concluded that differences in tumor thickness and prognosis between SPM and MPM more likely are caused by factors other than tumor biology, such as increased surveillance. Cancer 2012. © 2012 American Cancer Society. [ABSTRACT FROM AUTHOR]

The article reports on a study analyzing incidence data on all malignant cancers diagnosed between 1989 and 2006 in the Netherlands. The data was retrieved from the population-based Netherlands Cancer Registry. The study found that the most common cancers which prevailed in a combination include squamous cell skin cancer, colorectal cancer, and breast cancer. Multiple malignancies (MMs) are becoming more important in the field of cancer surveillance as the number of survivors is increasing.

The article reports on a study reviewing outcomes after stereotactic radiation therapy (SRT) for patients who developed a new clinical stage I lung cancer at a median of 8, 9 years postpneumonectomy. As reported, SRT was undergone by 15 such patients, half of whom had severe chronic obstructive pulmonary disorder (COPD). One of the findings of the study was that SRT was tolerated well, and was a safe and effective treatment for stage I lung tumors that arose after prior pneumonectomy.

Objectives: To report the oncologic and functional outcomes of transoral laser microsurgery (TLM) in the treatment of persistent, recurrent, and second primary squamous cell carcinoma of the tongue base. Study Design: A two-center prospective case series analysis. Methods: Twenty-five patients with persistent, recurrent, or second primary squamous cell carcinoma of the tongue base were treated with TLM between 1997 and 2005. Four (16%) patients with persistent disease at the primary site were considered TX. Eleven (44%) patients with recurrent disease were pathologically staged rT1 3/11, rT2 2/11, rT3 4/11, T4 1/11, and TX 1/11. Ten (40%) patients with second primary tumors were staged pT1, 4/10; pT2, 3/10; pT3, 2/10; and pT4, 1/10. Eight (32%) patients underwent neck dissection. Three (12%) patients received adjuvant radiotherapy. Pre- and post-treatment organ function was assessed using a clinical Functional Outcome Swallowing Scale (FOSS) and Communication Scale. Results: The mean follow-up period was 26 months. The 2-year Kaplan-Meier local control and locoregional control estimate was 69%. For those patients presenting with persistent/recurrent or second primary disease, the 2 year local control estimates were 75% and 68%, respectively. For all patients, the respective 2 and 5 year overall survival estimates were 54% and 26%. Two (8%) patients suffered postoperative hemorrhage. The average duration of hospitalization was 3.6 days. The median pretreatment and posttreatment FOSS stage was stage 2 and stage 3, respectively. Conclusions: Transoral laser surgery is a rational and effective treatment in appropriately selected patients with persistent, recurrent, or second primary tongue base cancer. The low morbidity and mortality and shortened duration of hospitalization associated with TLM make it an attractive therapeutic alternative. [ABSTRACT FROM AUTHOR]

Objectives: To better define the characteristics of second primary malignancies appearing in patients suffering from head and neck cancers, and more specifically laryngeal carcinoma, and to elicit those parameters that may be of assistance in better diagnosing, treating, and predicting outcome in such patients. Study Design: Retrospective review of a group of 514 compliant subjects, examined and treated during an 8-year period until 1996. After initial diagnosis and subsequent treatment, rigorous follow-up ensured systematic screening of the subjects, who underwent standard examinations in outpatient clinics for periods of up to 56 months. Results: Of 514 cases followed, presence of second primary neoplasms was established in 42 or 8.17%, 8 being synchronous and 34 metachronous of the original primary lesion. Conclusions: Respiratory and upper gastrointestinal localizations were primarily affected, incidence was highest in septuagenarians, and staging of the primary was found to be irrelevant to the incidence rates of second primaries. No statistical significance was attached to the fact that supraglottic primary tumors showed slightly higher second primary rates; the same applying for well-differentiated primary tumors compared with poorly differentiated ones. Modality of treatment-surgery, and radiotherapy being the options in question-did not in the long run statistically influence incidence rates. Throughout, reference to current literature and this study's relevance in light of similar efforts were taken into account. [ABSTRACT FROM AUTHOR]