title: Assessment of the frequency of additional cancers in patients with splenic marginal zone lymphoma.
abstract: OBJECTIVE
  Solid second primary cancers (SPC) have become an issue of extensive research. The purpose of the present study was to estimate the standardised incidence ratio (SIR) and the absolute excess risk (AER) of SPC in patients with splenic marginal zone lymphoma (SMZL).
  
  
  METHODS
  We investigated the incidence of additional cancers in 129 patients consecutively diagnosed with SMZL in three Italian haematological centres, asking the cooperating doctors for additional information on initial and subsequent therapies and on the onset and type of second cancers.
  
  
  RESULTS
  Twelve SPC were recorded (9.3%); the 3- and 5-yr cumulative incidence rates were 5.5% and 18.3% respectively, with an SIR of 2.03 [95% confidence interval (CI): 1.05-3.56; P < 0.05; AER = 145.81]. Of 12 SPC observed, four were urinary tract neoplasms (SIR, 3.70; 95% CI: 1.01-9.48; P < 0.05; AER = 70.06), four were lung cancers (SIR, 9.16; 95% CI: 1.41-13.25; P < 0.05; AER = 85.50) and the other four were hepatic carcinoma, endometrial cancer, breast cancer and colorectal cancer.
  
  
  CONCLUSIONS
  Our findings evidence a high frequency of additional cancers in patients with SMZL and suggest that the incidence rate of SPC is significantly different from that expected in the general population. The frequency of cases with urinary tract and lung malignancies in our series is higher than expected. Although confirmatory data are needed, it is our opinion that SMZL patients are at risk of second cancer and should be carefully investigated on diagnosis and monitored during the follow-up.
authors.affiliation: Hematology and BMT Unit, Department of Oncology, University of Palermo, Palermo, Italy. eiannitto@tin.it
authors.forename: Emilio
authors.initials: E
authors.lastname: Iannitto
authors.forename: Viviana
authors.initials: V
authors.lastname: Minardi
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Callea
authors.forename: Caterina
authors.initials: C
authors.lastname: Stelitano
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Calvaruso
authors.forename: Claudio
authors.initials: C
authors.lastname: Tripodo
authors.forename: Gerlando
authors.initials: G
authors.lastname: Quintini
authors.forename: Stefano
authors.initials: S
authors.lastname: De Cantis
authors.forename: Achille
authors.initials: A
authors.lastname: Ambrosetti
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pizzolo
authors.forename: Vito
authors.initials: V
authors.lastname: Franco
authors.forename: Ada M
authors.initials: AM
authors.lastname: Florena
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Abbadessa
mesh_terms: D000368:Aged; D006801:Humans; D015994:Incidence; D008223:Lymphoma / Q000150:complications*; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000145:classification / Q000150:complications*; D013160:Splenic Neoplasms / Q000150:complications*