DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida 33136, USA.
J Surg Res. 2010 May 15;160(2):184-9. doi: 10.1016/j.jss.2009.05.030. Epub 2009 Jun 21.
To examine the incidence, characteristics, and outcomes for second malignancies following the diagnosis of a primary solid tumor in pediatric patients.
The Surveillance, Epidemiology, and End Results (SEER) database was queried from 1973 to 2005, excluding recurrences, in patients <20 y.
A total of 31,685 cases of pediatric solid malignancies were identified. Overall, 177 patients were diagnosed with a unique second malignancy before the age 20 (0.56%) The mean follow-up was for 8.5 y (2 mo-30.8 y). Mean age at diagnosis of the primary tumor was 7.7 y. The most common primary malignancies were CNS tumors (22.5%), followed by soft tissue sarcoma (15.8%), retinoblastoma (14.1%), and bone tumors (13%). Hematologic malignancies (35.5%) were the most common second malignancies noted in the cohort, followed by bone tumors (18%) and soft tissue sarcomas (15%). Hematologic malignancies had a shorter latency (3.1 y) compared with solid second tumors (11.6 y). The overall 10-y survival for the entire cohort was 41.5%. For most tumor categories, development of a secondary malignancy was associated with lower 5- and 10-y survival than expected.
CNS tumors, retinoblastoma, and soft tissue sarcomas in children are the most common solid primary tumors, with an increased risk of a second malignancy. Leukemia is the most common second malignancy seen in pediatric solid tumors. Second malignancies are associated with significantly reduced survival rates compared with the general childhood cancer population.
研究儿科患者原发性实体瘤诊断后的第二恶性肿瘤的发生率、特征和结果。
从 1973 年至 2005 年，通过监测、流行病学和最终结果（SEER）数据库进行检索，排除了复发患者，患者年龄均小于 20 岁。
共发现 31685 例儿科实体恶性肿瘤病例。总的来说，177 例患者在 20 岁之前被诊断为单一第二恶性肿瘤（0.56%）。平均随访时间为 8.5 年（2 个月至 30.8 年）。原发性肿瘤的平均诊断年龄为 7.7 岁。最常见的原发性恶性肿瘤是中枢神经系统肿瘤（22.5%），其次是软组织肉瘤（15.8%）、视网膜母细胞瘤（14.1%）和骨肿瘤（13%）。血液恶性肿瘤（35.5%）是该队列中最常见的第二恶性肿瘤，其次是骨肿瘤（18%）和软组织肉瘤（15%）。血液恶性肿瘤的潜伏期（3.1 年）比实体第二肿瘤（11.6 年）短。整个队列的 10 年总生存率为 41.5%。对于大多数肿瘤类别，继发性恶性肿瘤的发生与预期相比，5 年和 10 年生存率较低。
儿童中枢神经系统肿瘤、视网膜母细胞瘤和软组织肉瘤是最常见的实体原发性肿瘤，发生第二恶性肿瘤的风险增加。白血病是儿科实体肿瘤中最常见的第二恶性肿瘤。与一般儿童癌症人群相比，第二恶性肿瘤的生存率显著降低。
