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Characteristics and Outcomes of Second Malignant Neoplasms after Childhood Cancer Treatment: Multi-Center Retrospective Survey

Authors
Koh, Kyung-NamYoo, Keon HeeIm, Ho JoonSung, Ki WoongKoo, Hong HoeKim, Hyo SunHan, Jung WooYoon, Jong HyungPark, Hyeon JinPark, Byung-KiuBaek, Hee JoKook, HoonLee, Jun AhLee, Jae MinLee, Kwang ChulKim, Soon KiPark, MeerimLee, Young-HoLyu, Chuhl JooSeo, Jong Jin
Issue Date
8월-2016
Publisher
KOREAN ACAD MEDICAL SCIENCES
Keywords
Childhood; Cancer; Survivors; Second Neoplasm
Citation
JOURNAL OF KOREAN MEDICAL SCIENCE, v.31, no.8, pp.1254 - 1261
Indexed
SCIE
SCOPUS
KCI
Journal Title
JOURNAL OF KOREAN MEDICAL SCIENCE
Volume
31
Number
8
Start Page
1254
End Page
1261
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/87925
DOI
10.3346/jkms.2016.31.8.1254
ISSN
1011-8934
Abstract
This retrospective study investigated the clinical characteristics and outcomes of second malignant neoplasms (SMNs) in survivors of childhood cancer from multiple institutions in Korea. A total of 102 patients from 11 institutions who developed SMN after childhood cancer treatment between 1998 and 2011 were retrospectively enrolled. The most common primary malignant neoplasms (PMNs) were central nervous system (CNS) tumors (n = 17), followed by acute lymphoblastic leukemia (n = 16), non-Hodgkin lymphoma (n = 13), and osteosarcoma (n = 12). The most common SMNs were therapy-related myeloid neoplasms (t-MNs; acute myeloid leukemia [AML], 29 cases; myelodysplastic syndrome [MDS], 12 cases), followed by thyroid carcinomas (n = 15) and CNS tumors (n = 10). The median latency period was 4.9 years (range, 0.5-18.5 years). Among 45 patients with solid tumors defined as an SMN, 15 (33%) developed the lesion in a field previously subjected to radiation. The 5-year overall survival (OS) rate of patients with an SMN was 45% with a median follow-up time of 8.6 years. Patients with AML, MDS, and CNS tumors exhibited the poorest outcomes with 5-year OS rates of 18%, 33%, and 32%, respectively, whereas those with second osteosarcoma showed comparable outcomes (64%) to patients with primary counterpart and those with second thyroid carcinoma had a 100% OS rate. Further therapeutic efforts are recommended to improve the survival outcomes in patients with SMNs, especially in cases with t-MNs and CNS tumors.
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