Rate of second primary tumors following diagnosed choriocarcinoma: a SEER analysis (1973-2010).
OBJECTIVE
Approximately 1 in 6 of new cancers has been reported to represent a second primary tumor (SPT). Choriocarcinomas (CCs) are of interest in regard to the rate of SPTs because of the potential exposure to carcinogenic therapy and reports of the benefits of its high human gonadotropin (hCG) levels on cancer incidence.


METHODS
We used the Surveillance, Epidemiology, and End Results (SEER) database to identify patients with gestational CC who subsequently developed a SPT. This is a retrospective study, following a cohort of patients during the period 1973-2010.


RESULTS
We found 818 patients with primary gestational CC. Nineteen patients had a SPT after the CC. Occurrence of several types of cancer resulted significantly higher when compared to the incidence rate in the general population. In particular the highest incidence rate ratios (IRRs) were registered for acute myeloid leukemia (AML) (6.3) and thyroid cancer (2.6). The expected rate of lung, breast, colorectal and uterine corpus cancers instead resulted lower than the rate in the general population. Regarding the IRR in the population under 50 years of age, the higher IRRs were related to AML (20) and non-Hodgkin lymphoma (NHL) (5).


CONCLUSIONS
The association of thyroid cancer and CC has not been described previously. Increases in hematological cancer following CC lend further support to the established data. The decrease in breast and colon cancers in all age groups supports past data and decreases in uterine and lung cancers are new observations meriting further study.
Department of Science for Woman and Child Health, University of Florence, Florence, Italy. Electronic address: giovanni83@email.it.
Giovanni
G
Sisti
Department of Obstetrics and Gynecology, University of Perugia, Perugia, Italy.
Tomi T
TT
Kanninen
The Icahn School of Medicine at Mount Sinai, Department of Oncological Sciences, New York, NY, United States.
Stefania
S
Asciutti
Department of Science for Woman and Child Health, University of Florence, Florence, Italy.
Flavia
F
Sorbi
Department of Science for Woman and Child Health, University of Florence, Florence, Italy.
Massimiliano
M
Fambrini
D000328:Adult; D044383:Black People / Q000706:statistics & numerical data; D002822:Choriocarcinoma / Q000453:epidemiology* / Q000208:ethnology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D016609:Neoplasms, Second Primary / Q000453:epidemiology* / Q000208:ethnology; D011247:Pregnancy; D012189:Retrospective Studies; D018426:SEER Program; D014481:United States / Q000453:epidemiology; D014594:Uterine Neoplasms / Q000453:epidemiology* / Q000208:ethnology; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult; D001741:Black or African American
Acute myeloid leukemia; Choriocarcinoma; Second primary tumors; Thyroid cancer; hCG