Correlation between second and first primary cancer: systematic review and meta-analysis of 9 million cancer patients

作者：Wang, Xinyu; Zeng, Meiyuan; Ju, Xueming; Lin, Anqi; Zhou, Chaozheng; Shen, Junyi; Liu, Zaoqu; Tang, Bufu; Cheng, Quan^*; Wang, Youyu^*; Zhang, Jian^*; Luo, Peng^*

来源：British Journal of Surgery, 2024, 111(1).

DOI：10.1093/bjs/znad377

• BREAST-CANCER
• UROTHELIAL CARCINOMA
• PRIMARY MALIGNANCY
• PRIMARY TUMORS
• SECONDARY MALIGNANCIES
• POOLED ANALYSIS
• RISK
• BLADDER
• TOBACCO
• RADIOTHERAPY

Background Many survivors of a first primary cancer (FPCs) are at risk of developing a second primary cancer (SPC), with effects on patient prognosis. Primary cancers have different frequencies of specific SPC development and the development of SPCs may be closely related to the FPC. The aim of this study was to explore possible correlations between SPCs and FPCs.Methods Relevant literature on SPCs was retrospectively searched and screened from four databases, namely, PubMed, EMBASE, Web of Science, and PMC. Data on the number of patients with SPC in 28 different organ sites were also collected from The Surveillance, Epidemiology, and End Results (SEER) 8 Registry and NHANES database.Results A total of 9 617 643 patients with an FPC and 677 430 patients with an SPC were included in the meta-analysis. Patients with a first primary gynaecological cancer and thyroid cancer frequently developed a second primary breast cancer and colorectal cancer. Moreover, those with a first primary head and neck cancer, anal cancer and oesophageal cancer developed a second primary lung cancer more frequently. A second primary lung cancer and prostate cancer was also common among patients with first primary bladder cancer and penile cancer. Patients with second primary bladder cancer accounted for 56% of first primary ureteral cancer patients with SPCs.Conclusions This study recommends close clinical follow-up, monitoring and appropriate interventions in patients with relevant FPCs for better screening and early diagnosis of SPCs. @@@ Our study is the first to use a meta-cohort of 726 019 patients with SPCs, incorporating up to 28 human organs as FPC sites to perform a systematic and pan-cancerous study of the possible correlation between SPCs and FPCs. We found multiple epidemiological clusters of organs of FPCs: FPCs of the uterus, ovary, thyroid, fallopian tube, vulva and vagina are more likely to develop into SPCs of the breast and colorectum; second primary lung cancer is more frequently developed in patients with FPCs of the head and neck, anus and oesophagus; FPCs of the bladder and penis are more likely to develop into second primary prostate cancer and lung cancer; and among patients who had an FPC in the ureter and developed an SPC, the rate of second primary bladder cancer was as high as 56%. We recommend close clinical follow-up, monitoring and appropriate interventions in patients with relevant FPCs for better screening and early diagnosis of SPCs to prolong patient survival.

• 单位
  中国医学科学院; 南方医科大学; 电子科技大学; 复旦大学