Characteristics and outcomes of second cancers in patients with childhood cancer: A report from the Taiwan Pediatric Oncology Group

Wan-Ling Ho¹, Giun-Yi Hung², Hsiu-Ju Yen², Yung-Li Yang³, Hsiu-Hao Chang⁴, Meng-Yao Lu⁴, Kai-Hsin Lin⁴, Jiann-Shiuh Chen⁵, Chao-Neng Cheng⁵, Iou-Jih Hung⁶, Chao-Ping Yang⁶, Shih-Hsiang Chen⁶, Hsi-Che Liu⁷, Ting-Chi Yeh⁷, Jen-Yin Hou⁷, Chih-Cheng Hsiao⁸, Jiunn-Ming Sheen⁹, Tai-Tsung Chang¹⁰, Tai-Tong Wong¹¹, James S Miser¹², Yen-Lin Liu¹³, Rong-Long Chen¹⁴, Bow-Wen Chen¹⁴, Ching-Tien Peng¹⁵, Te-Kau Chang¹⁶, Kang-Hsi Wu¹⁷, Yu-Hsiang Chang¹⁸, Jinn-Li Wang¹⁹, Shih-Chung Wang²⁰, Ming-Tsan Lin²⁰, Fu-Chang Hu²¹, Shiann-Tarng Jou²², Dong-Tsamn Lin²³

Affiliations

¹ School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan; Department of Pediatrics, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan; Taipei Cancer Center, Taipei Medical University, Taipei, Taiwan; Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Pediatrics, Taipei Medical University Hospital, Taipei, Taiwan.
² Department of Pediatrics, Taipei Veterans General Hospital and School of Medicine, National Yang-Ming University, Taipei, Taiwan.
³ Department of Pediatrics, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan.
⁴ Department of Pediatrics, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan.
⁵ Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan.
⁶ Department of Hematology-Oncology, Chang Gung Children's Hospital-Linkou, Taoyuan, Taiwan.
⁷ Department of Pediatrics, Mackay Memorial Hospital, Mackay Medical College, Taipei, Taiwan.
⁸ Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
⁹ Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; Department of Pediatrics, Chiayi Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Chiayi, Taiwan.
¹⁰ Ditmanson Foundation Chiayi Christian Hospital, Chiayi, Taiwan; Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
¹¹ Department of Neurosurgery, Taipei Medical University Hospital, Taipei Medical University, Taiwan.
¹² Taipei Cancer Center, Taipei Medical University, Taipei, Taiwan; College of Medical Sciences and Technology, Taipei Medical University, Taipei, Taiwan.
¹³ Taipei Cancer Center, Taipei Medical University, Taipei, Taiwan; Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Pediatrics, Taipei Medical University Hospital, Taipei, Taiwan.
¹⁴ Division of Pediatric Hematology and Oncology, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan.
¹⁵ Division of Pediatric Hematology & Oncology, Children's Hospital of China Medical University, Taichung, Taiwan; Department of Biotechnology, Asia University, Wufeng, Taichung, Taiwan.
¹⁶ Division of Pediatric Hematology & Oncology, Children's Hospital of China Medical University, Taichung, Taiwan; Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan.
¹⁷ Division of Pediatric Hematology & Oncology, Children's Hospital of China Medical University, Taichung, Taiwan; Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan.
¹⁸ Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
¹⁹ Department of Pediatrics, Taipei Medical University-Wanfang Hospital, Taipei, Taiwan.
²⁰ Division of Pediatric Hematology/Oncology, Changhua Christian Children's Hospital, Taiwan.
²¹ Graduate Institute of Clinical Medicine and School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; International-Harvard Statistical Consulting Company, Taipei, Taiwan.
²² Department of Pediatrics, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan. Electronic address: stjou4@gmail.com.
²³ Department of Pediatrics, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan. Electronic address: dtlin@ntu.edu.tw.

PMID: 34154895
DOI: 10.1016/j.jfma.2021.05.012

Multicenter Study

Characteristics and outcomes of second cancers in patients with childhood cancer: A report from the Taiwan Pediatric Oncology Group

Wan-Ling Ho et al. J Formos Med Assoc. 2022 Jan.

. 2022 Jan;121(1 Pt 2):350-359.

doi: 10.1016/j.jfma.2021.05.012. Epub 2021 Jun 18.

Authors

Affiliations

¹ School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan; Department of Pediatrics, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan; Taipei Cancer Center, Taipei Medical University, Taipei, Taiwan; Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Pediatrics, Taipei Medical University Hospital, Taipei, Taiwan.
² Department of Pediatrics, Taipei Veterans General Hospital and School of Medicine, National Yang-Ming University, Taipei, Taiwan.
³ Department of Pediatrics, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan.
⁴ Department of Pediatrics, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan.
⁵ Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan.
⁶ Department of Hematology-Oncology, Chang Gung Children's Hospital-Linkou, Taoyuan, Taiwan.
⁷ Department of Pediatrics, Mackay Memorial Hospital, Mackay Medical College, Taipei, Taiwan.
⁸ Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
⁹ Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; Department of Pediatrics, Chiayi Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Chiayi, Taiwan.
¹⁰ Ditmanson Foundation Chiayi Christian Hospital, Chiayi, Taiwan; Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
¹¹ Department of Neurosurgery, Taipei Medical University Hospital, Taipei Medical University, Taiwan.
¹² Taipei Cancer Center, Taipei Medical University, Taipei, Taiwan; College of Medical Sciences and Technology, Taipei Medical University, Taipei, Taiwan.
¹³ Taipei Cancer Center, Taipei Medical University, Taipei, Taiwan; Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Pediatrics, Taipei Medical University Hospital, Taipei, Taiwan.
¹⁴ Division of Pediatric Hematology and Oncology, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan.
¹⁵ Division of Pediatric Hematology & Oncology, Children's Hospital of China Medical University, Taichung, Taiwan; Department of Biotechnology, Asia University, Wufeng, Taichung, Taiwan.
¹⁶ Division of Pediatric Hematology & Oncology, Children's Hospital of China Medical University, Taichung, Taiwan; Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan.
¹⁷ Division of Pediatric Hematology & Oncology, Children's Hospital of China Medical University, Taichung, Taiwan; Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan.
¹⁸ Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
¹⁹ Department of Pediatrics, Taipei Medical University-Wanfang Hospital, Taipei, Taiwan.
²⁰ Division of Pediatric Hematology/Oncology, Changhua Christian Children's Hospital, Taiwan.
²¹ Graduate Institute of Clinical Medicine and School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; International-Harvard Statistical Consulting Company, Taipei, Taiwan.
²² Department of Pediatrics, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan. Electronic address: stjou4@gmail.com.
²³ Department of Pediatrics, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan. Electronic address: dtlin@ntu.edu.tw.

PMID: 34154895
DOI: 10.1016/j.jfma.2021.05.012

Abstract

Background: Patients with childhood cancer are at increased risk for the development of second cancers.

Methods: A national multicenter survey of second cancers conducted by the Taiwan Pediatric Oncology Group retrieved retrospective data from the database at the Children Cancer Foundation in Taiwan beginning in 1995. The characteristics of second cancers and associations of patient demographic and clinical characteristics with time to death due to a second cancer were analyzed.

Results: We examined the records of 8782 patients with a primary cancer diagnosed between January 1, 1995 and December 31, 2013, and a total of 99 patients with a second cancer were identified. The most common type of second cancer was acute myeloid leukemia (n = 35), followed by acute lymphoblastic leukemia (n = 15), central nervous system (CNS) tumors (n = 15), and sarcomas (n = 10). Secondary hematological malignancies occurred earlier than other secondary cancers. The frequencies of second CNS tumors and second bone cancers and sarcomas were notably increased when prior radiation doses increased from zero, low dose to high dose. The overall 5-year survival of patients with a second cancer was poor (33.7%). Multivariate survival analysis revealed that the year of primary diagnosis ≤2002, secondary hematological malignancies, and age at second cancer diagnosis ≤9.3 years or >26.8 years increased the risk of death following second cancer.

Conclusion: Children who develop a second cancer have an unfavorable outcome. Early detection and improved treatment for second cancers are needed.

Keywords: Childhood; Outcome; Primary cancer; Second cancer; Survival probability.

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Conflict of interest statement

Declaration of competing interest The authors confirm that there is no conflict of interest to declare.

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Characteristics and outcomes of second cancers in patients with childhood cancer: A report from the Taiwan Pediatric Oncology Group

Affiliations

Characteristics and outcomes of second cancers in patients with childhood cancer: A report from the Taiwan Pediatric Oncology Group

Authors

Affiliations

Abstract

Conflict of interest statement

Publication types

MeSH terms