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Secondary bone/soft tissue sarcoma in childhood cancer survivors: a nationwide hospital-based case-series study in Japan.
- Source :
-
Japanese journal of clinical oncology [Jpn J Clin Oncol] 2018 Sep 01; Vol. 48 (9), pp. 806-814. - Publication Year :
- 2018
-
Abstract
- Background: Secondary cancer is the most life-threatening late effect of childhood cancer. We investigated the clinical features of secondary bone/soft tissue sarcoma among childhood cancer survivors (CCSs).<br />Methods: We conducted a retrospective case-series study of 10 069 CCSs newly diagnosed with cancer between 1980 and 2009 across 15 Japanese hospitals. Twenty-one cases of pathologically diagnosed secondary bone/soft tissue sarcoma were selected, and the respective clinical courses were determined using additional questionnaires.<br />Results: The primary cancers included retinoblastoma (n = 7), acute lymphoblastic leukemia (n = 5), lymphoma (n = 5), osteosarcoma (n = 1), rhabdomyosarcoma (n = 1), brain tumor (n = 1) and Langerhans cell histiocytosis (n = 1). The median age at the primary cancer diagnosis was 2.9 years, and the male-to-female ratio was 16:5. The histological classifications of the secondary sarcoma included osteosarcoma (n = 10), malignant peripheral nerve sheath tumor (n = 4), rhabdomyosarcoma (n = 3), Ewing's sarcoma (n = 3) and primitive neuroectodermal tumor (n = 1). The median latency period to the secondary sarcoma was 10.2 years. Significant risk factors for secondary sarcoma in the multivariate Cox regression model included a history of retinoblastoma as the primary cancer (hazard ratio [HR], 20.9; 95% confidence interval [CI], 5.70-76.5) and autologous stem cell transplantation (SCT) (HR, 2.56; 95% CI, 1.08-6.03). Seventeen CCSs with secondary sarcoma underwent radiation, and nine, hematopoietic SCT. Twelve CCSs with secondary sarcoma achieved disease-free survival, while CCSs with hematological cancer or relapsed primary cancer who developed secondary sarcoma had the worst prognoses.<br />Conclusion: The prognoses of CCSs with secondary sarcoma may depend on the primary cancer or prior relapse of primary cancer.
- Subjects :
- Adolescent
Adult
Child
Child, Preschool
Disease-Free Survival
Female
Humans
Incidence
Infant
Japan epidemiology
Male
Multivariate Analysis
Neoplasms, Second Primary pathology
Proportional Hazards Models
Retrospective Studies
Risk Factors
Sarcoma pathology
Cancer Survivors statistics & numerical data
Hospitals
Neoplasms, Second Primary epidemiology
Sarcoma epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1465-3621
- Volume :
- 48
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Japanese journal of clinical oncology
- Publication Type :
- Academic Journal
- Accession number :
- 30053029
- Full Text :
- https://doi.org/10.1093/jjco/hyy102