Second primary malignancies in patients with neuroendocrine tumors.
OBJECTIVE
An association between neuroendocrine tumors (NETs) and second primary malignancies (SPMs) has been reported. We have examined the incidence and etiology of SPMs in patients with NETs included in the Neuroendocrine Tumor Association of Andalusia (ATNEA) Registry.


METHODS
Data on 111 patients were collected. Sex, age, NET site, chromogranin A levels, neuropeptide secretion and disease stage were compared between NETs with and without SPMs.


RESULTS
SPMs were present in 21 patients (18.9 %): five colorectal tumors, four non-small-cell lung cancers, three gastric cancers, two tumors in the small intestine, one hepatocarcinoma, two ovarian tumors, one breast adenocarcinoma, one hypernephroma, one bladder cancer, and one neuroblastoma. SPMs were present in 18 % of patients with a gastrointestinal NET and 22 % of those with a non-gastrointestinal NET. SPMs were found in 23 % of patients with elevated levels of serum chromogranin A, compared to 17 % of patients with normal levels, and in 22 % of patients with functional tumors, compared to 11 % of those with non-functional tumors. Finally, SPMs were observed in 24 % of patients with a local or locoregional tumor but in only 13 % of those with a metastatic tumor. No other differences between patients with and without SPMs were observed.


CONCLUSIONS
The percentage of patients with SPMs in the ATNEA Registry is similar to those reported in other series. In our registry, patients with functional NETs and local/locoregional tumors have higher probability of SPMs. The low number of patients, selection bias and other etiologic factors of SPMs may have influenced our results.
Servicio de Oncología Médica, Hospital Virgen Macarena, Avda Dr Fedriani 3, 41009, Sevilla, Spain, juanjoreinaz@yahoo.es.
J J
JJ
Reina
R
R
Serrano
M
M
Codes
E
E
Jiménez
M
M
Bolaños
E
E
Gonzalez
I
I
Sevilla
D000293:Adolescent; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000453:epidemiology; D018270:Carcinoma, Ductal, Breast / Q000453:epidemiology; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology; D002289:Carcinoma, Non-Small-Cell Lung / Q000453:epidemiology; D002292:Carcinoma, Renal Cell / Q000453:epidemiology; D053379:Chromogranin A / Q000097:blood*; D015179:Colorectal Neoplasms / Q000453:epidemiology; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000097:blood / Q000453:epidemiology*; D006801:Humans; D007680:Kidney Neoplasms / Q000453:epidemiology; D008113:Liver Neoplasms / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000453:epidemiology*; D009447:Neuroblastoma / Q000453:epidemiology; D018358:Neuroendocrine Tumors / Q000097:blood / Q000453:epidemiology*; D010051:Ovarian Neoplasms / Q000453:epidemiology; D012042:Registries; D013030:Spain; D013274:Stomach Neoplasms / Q000453:epidemiology; D055815:Young Adult
D053379:Chromogranin A