Risk of new primary nonbreast cancers after breast cancer treatment: A Dutch population-based study
Risk of new primary nonbreast cancers after breast cancer treatment: A Dutch population-based study
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DOI：
10.1200/jco.2007.11.9081
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发表时间：
2008-03-10
影响因子：
45.3
通讯作者：
van Leeuwen, Flora E.
中科院分区：
文献类型：
--
作者：
Schaapveld, Michael;Visser, Otto;van Leeuwen, Flora E.
PurposeTo评估继发性非乳腺癌（SNBC）的风险，在最近治疗的人群为基础的队列的乳腺癌患者集中在与治疗和预后的implications.Patients和MethodsIn 58,068荷兰患者诊断为浸润性乳腺癌之间的1989年和2003年，SNBC的风险进行了量化使用标准化发病率比（SIR），累积发病率，和考克斯回归分析，调整竞争risk.ResultsAfter一个中位数为5.4年的随访，2,578 SNBC发生。与整个荷兰女性人群相比，在该队列中，SNBC的SIR增加（SIR，1.22; 95% CI，1.17至1.27）。绝对超额风险为13.6（95% CI，9.7 - 17.6）/10，000人-年。食管癌、胃癌、结肠癌、直肠癌、肺癌、子宫癌、卵巢癌、肾癌和膀胱癌以及软组织肉瘤（STS）、黑色素瘤、非霍奇金淋巴瘤和急性髓性白血病（AML）的SIR升高。SNBC的10年累积发生率为5.4%（95% CI，5.1%-5.7%）。在年龄小于50岁的患者中，放疗与肺癌风险增加相关（风险比[HR] = 2.31; 95% CI，1.15 - 4.60），化疗与所有SNBC风险降低相关（HR = 0.78; 95% CI，0.63 - 0.98）以及结肠癌和肺癌风险降低相关。在50岁及以上的患者中，放疗与STS风险增加相关（HR = 3.43; 95% CI，1.46 - 8.04）;化疗增加了黑色素瘤、子宫癌和AML的风险;激素治疗联合所有SNBC（HR = 1.10; 95% CI，1.01至1.21）和子宫癌（HR = 1.78; 95% CI，1.40至2.27）。SNBC恶化生存率（HR = 3.98; 95%CI 3.77至4.20）。ConclusionBreast cancer patients diagnosed in the 1990 s experienced a small but significant excess risk of developing a SNBC.
PurposeTo assess the risk of secondary nonbreast cancers (SNBCs) in a recently treated population-based cohort of breast cancer patients focused on the association with treatment and prognostic implications.Patients and MethodsIn 58,068 Dutch patients diagnosed with invasive breast cancer between 1989 and 2003, SNBC risk was quantified using standardized incidence ratios (SIRs), cumulative incidence, and Cox regression analysis, adjusted for competing risks.ResultsAfter a median follow-up of 5.4 years, 2,578 SNBCs had occurred. Compared with the Dutch female population at large, in this cohort, the SIR of SNBCs was increased (SIR, 1.22; 95% CI, 1.17 to 1.27). The absolute excess risk was 13.6 (95% CI, 9.7 to 17.6) per 10,000 person-years. SIRs were elevated for cancers of the esophagus, stomach, colon, rectum, lung, uterus, ovary, kidney, and bladder cancers, and for soft tissue sarcomas (STS), melanoma, non-Hodgkin's lymphoma, and acute myeloid leukemia (AML). The 10-year cumulative incidence of SNBCs was 5.4% (95% CI, 5.1% to 5.7%). Among patients younger than 50 years, radiotherapy was associated with an increased lung cancer risk (hazard ratio [HR] = 2.31; 95% CI, 1.15 to 4.60) and chemotherapy with decreased risk for all SNBCs (HR = 0.78; 95% CI, 0.63 to 0.98) and for colon and lung cancer. Among patients age 50 years and older, radiotherapy was associated with raised STS risk (HR = 3.43; 95% CI, 1.46 to 8.04); chemotherapy with increased risks of melanoma, uterine cancer, and AML; and hormonal therapy with all SNBCs combined (HR = 1.10; 95% CI, 1.01 to 1.21) and uterine cancer (HR = 1.78; 95% CI, 1.40 to 2.27). An SNBC worsened survival (HR = 3.98; 95% CI 3.77 to 4.20).ConclusionBreast cancer patients diagnosed in the 1990s experienced a small but significant excess risk of developing an SNBC.