Characteristics and outcomes of second cancers in patients with childhood cancer: A report from the Taiwan Pediatric Oncology Group

Wan Ling Ho, Giun Yi Hung, Hsiu Ju Yen, Yung Li Yang, Hsiu Hao Chang, Meng Yao Lu, Kai Hsin Lin, Jiann Shiuh Chen, Chao Neng Cheng, Iou Jih Hung, Chao Ping Yang, Shih Hsiang Chen, Hsi Che Liu, Ting Chi Yeh, Jen Yin Hou, Chih Cheng Hsiao, Jiunn Ming Sheen, Tai Tsung Chang, Tai Tong Wong, James S. MiserYen Lin Liu, Rong Long Chen, Bow Wen Chen, Ching Tien Peng, Te Kau Chang, Kang Hsi Wu, Yu Hsiang Chang, Jinn Li Wang, Shih Chung Wang, Ming Tsan Lin, Fu Chang Hu, Shiann Tarng Jou, Dong Tsamn Lin

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Patients with childhood cancer are at increased risk for the development of second cancers. Methods: A national multicenter survey of second cancers conducted by the Taiwan Pediatric Oncology Group retrieved retrospective data from the database at the Children Cancer Foundation in Taiwan beginning in 1995. The characteristics of second cancers and associations of patient demographic and clinical characteristics with time to death due to a second cancer were analyzed. Results: We examined the records of 8782 patients with a primary cancer diagnosed between January 1, 1995 and December 31, 2013, and a total of 99 patients with a second cancer were identified. The most common type of second cancer was acute myeloid leukemia (n = 35), followed by acute lymphoblastic leukemia (n = 15), central nervous system (CNS) tumors (n = 15), and sarcomas (n = 10). Secondary hematological malignancies occurred earlier than other secondary cancers. The frequencies of second CNS tumors and second bone cancers and sarcomas were notably increased when prior radiation doses increased from zero, low dose to high dose. The overall 5-year survival of patients with a second cancer was poor (33.7%). Multivariate survival analysis revealed that the year of primary diagnosis ≤2002, secondary hematological malignancies, and age at second cancer diagnosis ≤9.3 years or >26.8 years increased the risk of death following second cancer. Conclusion: Children who develop a second cancer have an unfavorable outcome. Early detection and improved treatment for second cancers are needed.

Original languageEnglish
JournalJournal of the Formosan Medical Association
DOIs
Publication statusAccepted/In press - Jun 18 2021

Keywords

  • Childhood
  • Outcome
  • Primary cancer
  • Second cancer
  • Survival probability

ASJC Scopus subject areas

  • Medicine(all)

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