title: Occurrence of second primary malignancies in patients with neuroendocrine tumors of the digestive tract and pancreas.
abstract: An increased association between neuroendocrine tumors of the gastrointestinal tract and pancreas (GEP-NET) and other second primary malignancies has been suggested. We determined whether there is indeed an increased risk for second primary malignancies in GEP-NET patients compared with an age- and sex-matched control group of patients with identical malignancies. The series comprised 243 men and 216 women, diagnosed with a GEP-NET between 2000 and 2009 in a tertiary referral center. The timeline, before-at-after diagnosis, and the type of other malignancies were studied using person-year methodology. Poisson distributions were used for testing statistical significance. All data were cross-checked with the Dutch National Cancer Registry. Out of 459 patients with GEP-NET, 67 (13.7%) had a second primary cancer diagnosis: 25 previous cancers (5.4%), 13 synchronous cancers (2.8%), and 29 metachronous cancers (6.3%). The most common types of second primary cancer were breast cancer (n=10), colorectal cancer (n=8), melanoma (n=6), and prostate cancer (n=5). The number of patients with a cancer history was lower than expected, although not significant (n=25 vs n=34.5). The diagnosis of synchronous cancers, mainly colorectal tumors, was higher than expected (n=13 vs n=6.1, P<0.05). Metachronous tumors occurred as frequent as expected (n=29 vs n=25.2, NS). In conclusion, our results are in contrast to previous studies and demonstrate that only the occurrence of synchronous second primary malignancies, mainly colorectal cancers, is increased in GEP-NET patients compared with the general population.
authors.affiliation: Department of Internal Medicine, Sector of Endocrinology, Erasmus MC, S-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Kamp
authors.forename: Ronald A M
authors.initials: RA
authors.lastname: Damhuis
authors.forename: Richard A
authors.initials: RA
authors.lastname: Feelders
authors.forename: Wouter W
authors.initials: WW
authors.lastname: de Herder
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D004067:Digestive System Neoplasms / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D009426:Netherlands / Q000453:epidemiology; D018358:Neuroendocrine Tumors / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D011379:Prognosis; D055815:Young Adult