Kumar Vivek, Garg Mohit, Chaudhary Neha, Soni Parita, Floudas Charalampos S, Nwanyanwu Chiemeziem, Chandra Abhinav
Maimonides Medical Center, Brooklyn, New York, NY, USA.
Yuma Regional Medical Center Cancer Center, Yuma, AZ, USA.
Cancer Causes Control. 2017 Oct;28(10):1065-1074. doi: 10.1007/s10552-017-0957-0. Epub 2017 Sep 12.
In the U.S., Kaposi sarcoma (KS) occurs mostly in HIV-infected patients, who are also at increased risk of developing secondary cancers. The trends in secondary cancer risk are unclear in the HAART era.
We extracted data from the SEER database on patients diagnosed with KS between 1981 and 2013, stratified into the pre-HAART (1981-1995) and HAART (1996-2013) eras. We compared the risk of secondary cancer in KS patients and the general population, and estimated the absolute risk.
We followed 13,535 KS patients for 49,813 person-years, during which 1,041 secondary cancers were diagnosed: 774 in the pre-HAART and 267 in the HAART era. In the pre-HAART era, non-Hodgkin's lymphoma (NHL) and anal carcinomas were the most common secondary cancers. The standard incidence ratio of secondary cancers decreased from 3.44 (pre-HAART era) to 1.94 (HAART era) in patients aged <70 years. The absolute excess risk decreased from 178 to 68 cases per 10,000 person-years. The risk of NHL decreased, while the risk of anal carcinoma did not change significantly. The risk of lung cancer was lower in KS patients than in the general population. The absolute risk of non-AIDS-defining cancers increased fourfold in the HAART era.
The absolute risk of non-AIDS-defining secondary cancers has increased in KS patients in the HAART era. However, the overall relative risk of secondary cancers has decreased, mainly due to a significant decrease in the risk of NHL.
在美国，卡波西肉瘤（KS）主要发生于感染HIV的患者，这些患者发生继发性癌症的风险也会增加。在高效抗逆转录病毒治疗（HAART）时代，继发性癌症风险的趋势尚不清楚。
我们从监测、流行病学和最终结果（SEER）数据库中提取了1981年至2013年间诊断为KS的患者的数据，并将其分为HAART治疗前（1981 - 1995年）和HAART治疗时代（1996 - 2013年）。我们比较了KS患者和普通人群中继发性癌症的风险，并估计了绝对风险。
我们对13535例KS患者进行了49813人年的随访，在此期间诊断出1041例继发性癌症：HAART治疗前为774例，HAART治疗时代为267例。在HAART治疗前时代，非霍奇金淋巴瘤（NHL）和肛管癌是最常见的继发性癌症。年龄<70岁的患者继发性癌症的标准化发病比从3.44（HAART治疗前时代）降至1.94（HAART治疗时代）。绝对超额风险从每10000人年178例降至68例。NHL的风险降低，而肛管癌的风险没有显著变化。KS患者患肺癌的风险低于普通人群。在HAART治疗时代，非艾滋病定义性癌症的绝对风险增加了四倍。
在HAART治疗时代，KS患者中非艾滋病定义性继发性癌症的绝对风险有所增加。然而，继发性癌症的总体相对风险有所降低，主要是由于NHL风险的显著下降。
