title: Increased risk of malignancies in a population-based study of 818 soft-tissue sarcoma patients.
abstract: Soft-tissue sarcomas (STS) have been associated with various rare cancer syndromes and occur at increased frequencies in survivors of childhood cancer. Also adult patients with STS have been suggested to be at an increased risk of additional malignancies. After exclusion of syndrome-associated and radiation-induced sarcomas, we studied multiple primary malignancies in a population-based cohort of 818 patients with primary STS of the extremities and the trunk wall. In total, 203 other malignancies developed in 164 (20%) patients median 10 (0-32) years before and median 4 (0-35) years after the sarcoma diagnosis. Standardised morbidity ratios (SMRs) were determined for primary malignancies following a STS. Hereby individuals who had developed a STS were identified to be at increased risk of second primary malignancies (SMR for all malignant tumours=1.3; 95% CI=1.0-1.5; P=0.02) with STS being the only specific tumour type that occurred at an increased risk (SMR=17.6; 95% CI=8.1-33.5; P<0.001). Hence, this population-based series demonstrates a high frequency of second primary tumours among STS patients and indicates a particularly increased risk of developing a new STS.
authors.affiliation: Department of Oncology, Institute of Clinical Sciences, Lund University Hospital, Lund, Sweden. Josefin.Fernebro@med.lu.se
authors.forename: J
authors.initials: J
authors.lastname: Fernebro
authors.forename: A
authors.initials: A
authors.lastname: Bladström
authors.forename: A
authors.initials: A
authors.lastname: Rydholm
authors.forename: P
authors.initials: P
authors.lastname: Gustafson
authors.forename: H
authors.initials: H
authors.lastname: Olsson
authors.forename: J
authors.initials: J
authors.lastname: Engellau
authors.forename: M
authors.initials: M
authors.lastname: Nilbert
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D016609:Neoplasms, Second Primary / Q000453:epidemiology / Q000209:etiology*; D012042:Registries / Q000706:statistics & numerical data; D012307:Risk Factors; D012509:Sarcoma / Q000150:complications* / Q000453:epidemiology; D013548:Sweden / Q000453:epidemiology