诊断为皮肤黑色素瘤后的第二原发性恶性肿瘤风险：一项基于人群的研究。

Risk of second primary malignancies following cutaneous melanoma diagnosis: a population-based study.

机构信息

Department of Dermatology, Pigmented Lesion and Melanoma Program, Stanford University Medical Center, Stanford, CA, USA.

出版信息

J Am Acad Dermatol. 2010 May;62(5):757-67. doi: 10.1016/j.jaad.2009.07.039. Epub 2010 Mar 12.

DOI:10.1016/j.jaad.2009.07.039

PMID:20223559

Abstract

BACKGROUND

Understanding risk patterns for developing a second primary malignancy (SPM) after cutaneous melanoma (CM) has implications for both research and clinical practice, including cancer screening.

OBJECTIVE

We sought to describe incidence patterns of SPMs occurring after CM.

METHODS

We calculated incidence rates and relative risks for the development of 65 different SPMs occurring in 16,591 CM survivors during 1.3 million person-years of observation in the Surveillance, Epidemiology, and End Results program data from 1973 to 2003.

RESULTS

Compared with the general population, CM survivors had a 32% higher risk of developing any SPM and demonstrated significantly elevated risks for 13 cancers: melanoma of the skin (standardized incidence ratio [SIR] 8.99), soft tissue (SIR 2.80), melanoma of the eye and orbit (SIR 2.64), nonepithelial skin (SIR 2.31), salivary gland (SIR 2.18), bone and joint (SIR 1.70), thyroid (SIR 1.90), kidney (SIR 1.29), chronic lymphocytic leukemia (SIR 1.29), brain and nervous system (SIR 1.31), non-Hodgkin lymphoma (SIR 1.25), prostate (SIR 1.13), and female breast (SIR 1.07). Risks of second primary melanoma of the skin, melanoma of the eye and orbit, and cancers of the prostate, soft tissue, salivary gland, and bone and joint were elevated throughout the study period, implying no surveillance bias.

LIMITATIONS

Possible underreporting of CM incidence in cancer registries is a limitation. In addition, the lack of individual-level data in cancer registry data precludes detailed examination of coincident risk factors.

CONCLUSION

Risks of particular SPMs after CM may be explained by surveillance bias or shared risk factors. However, these probably do not explain the increased risks observed for prostate, soft tissue, salivary gland, and bone and joint cancers years after CM diagnosis. Further investigation into genetic or environmental commonalities between CM and these cancers is warranted.

摘要

背景

了解皮肤黑色素瘤（CM）后发生第二原发恶性肿瘤（SPM）的风险模式对研究和临床实践都有意义，包括癌症筛查。

目的

我们旨在描述 CM 后 SPM 的发生模式。

方法

我们计算了 1973 年至 2003 年期间在 Surveillance, Epidemiology, and End Results 计划数据中，16591 例 CM 幸存者在 130 万人年的观察中发生的 65 种不同 SPM 的发生率和相对风险。

结果

与普通人群相比，CM 幸存者发生任何 SPM 的风险增加 32%，并显著增加了 13 种癌症的风险：皮肤黑色素瘤（标准化发病比 [SIR] 8.99）、软组织（SIR 2.80）、眼和眼眶黑色素瘤（SIR 2.64）、非上皮性皮肤（SIR 2.31）、唾液腺（SIR 2.18）、骨和关节（SIR 1.70）、甲状腺（SIR 1.90）、肾脏（SIR 1.29）、慢性淋巴细胞白血病（SIR 1.29）、脑和神经系统（SIR 1.31）、非霍奇金淋巴瘤（SIR 1.25）、前列腺（SIR 1.13）和女性乳房（SIR 1.07）。皮肤第二原发黑色素瘤、眼和眼眶黑色素瘤以及前列腺、软组织、唾液腺和骨和关节癌症的第二原发风险在整个研究期间均升高，这意味着没有监测偏倚。