title: The risk of subsequent malignancies in women with uterine papillary serous or clear cell endometrial cancers.
abstract: OBJECTIVE
  Type II endometrial cancers include uterine papillary serous carcinoma (UPSC) and clear cell endometrial cancer (CC). Given their relative rarity, aggressive nature, and poor prognosis, little is known about the risk of subsequent malignancies at other sites. Our objective was to determine if women with UPSC or CC are at increased risk of subsequent malignancies.Type II endometrial cancers include uterine papillary serous carcinoma (UPSC) and clear cell endometrial cancer (CC). Given their relative rarity, aggressive nature, and poor prognosis, little is known about the risk of subsequent malignancies at other sites. Our objective was to determine if women with UPSC or CC are at increased risk of subsequent malignancies.
  
  
  METHODS
  Women diagnosed with UPSC or CC were identified from the SEER (Surveillance Epidemiology and End Results) Program from 1973 to 2005. Cases with a second gynecologic malignancy were excluded. Using SEER*Stat software, standardized incidence ratios (SIRs) of subsequent malignancies were calculated.
  
  
  RESULTS
  A total of 8045 and 1740 patients were diagnosed with UPSC and CC, respectively. Four hundred sixty-one (5.7%) of the UPSC cases were diagnosed with at least 1 additional nongynecologic malignancy. Significant associations were found with the following malignancies: the renal pelvis, soft-tissue sarcomas, acute myeloid leukemia, the bladder, and colon. Seventy-eight CC cases (4.5%) were diagnosed with at least 1 additional malignancy. In comparison with the baseline population risk, there was no statistically significant increased risk of any subsequent malignancy with a primary diagnosis of CC.
  
  
  CONCLUSIONS
  This is the first large population-based analysis of second primary malignancies after type II endometrial cancers. Uterine papillary serous carcinoma is associated with increased risks of certain subsequent malignancies, and providers should be aware of these when following up patients with this diagnosis, especially those with stage I disease. In contrast, no such associations were found with CC in this cohort.
authors.affiliation: Division of Gynecologic Oncology, Magee-Women's Hospital of UPMC, 300 Halket St., Pittsburgh, PA 15213, USA.
authors.forename: Hilary D
authors.initials: HD
authors.lastname: Hinshaw
authors.forename: Ashlee
authors.initials: A
authors.lastname: Smith
authors.forename: Bunja
authors.initials: B
authors.lastname: Rungruang
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Kelley
authors.forename: Sushil
authors.initials: S
authors.lastname: Beriwal
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Krivak
authors.forename: Paniti
authors.initials: P
authors.lastname: Sukumvanich
authors.forename: Alexander B
authors.initials: AB
authors.lastname: Olawaiye
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002291:Carcinoma, Papillary / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D018284:Cystadenocarcinoma, Serous / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D016889:Endometrial Neoplasms / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D018426:SEER Program; D014594:Uterine Neoplasms