title: Risk of Second Primary Tumors After Childhood and Adolescent Ovarian Malignancies: A SEER Analysis (1973-2011).
abstract: OBJECTIVE
  To calculate the incidence of second primary tumors (SPTs) in patients previously diagnosed with malignant ovarian tumors in childhood and adolescence. This is an area of interest given the high survival rate and, thus, the long disease-free period that these patients face.
  
  
  METHODS
  We conducted a retrospective study following a cohort of patients between 1973 and 2011. Using the National Cancer Institute's Surveillance, Epidemiology and End-Result (SEER) database, we identified patients with an ovarian malignant tumor diagnosed at 19 years of age or younger.
  
  
  RESULTS
  Of the 806 patients included in our study, 28 patients developed an SPT after the diagnosis of malignant ovarian tumor. This cohort had higher risk of solid tumors (standardized incidence ratio [SIR] 1.85, 95% CI 1.15 to 2.83) and lymphohematologic malignancies (SIR 5.28, 95% CI 2.12 to 10.88) compared with the general population. There is a higher incidence of lymphoma (SIR 4.25, 95% CI 1.16 to 10.89) and acute nonlymphocytic leukemia (SIR 19.65, 95% CI 4.05 to 57.42), following initial diagnosis of ovarian malignancy during childhood or adolescence.
  
  
  CONCLUSIONS
  The association between ovarian malignancy during childhood or adolescence and lymphoma has not been previously described. Increased incidence of acute nonlymphocytic leukemia supports previous data, underlying the need for long-term follow-up and surveillance of these patients.
authors.affiliation: Department of Gynecology, General Military Hospital of Athens, Athens, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Nasioudis
authors.affiliation: Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Ilana
authors.initials: I
authors.lastname: Ramer
authors.affiliation: Department of Science for Woman and Child Health, University of Florence, Florence, Italy. Electronic address: giovanni83@email.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Sisti
authors.affiliation: Department of Science for Woman and Child Health, University of Florence, Florence, Italy.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Fambrini
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008223:Lymphoma / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D016609:Neoplasms, Second Primary / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D010051:Ovarian Neoplasms / Q000453:epidemiology* / Q000473:pathology; D012189:Retrospective Studies; D012307:Risk Factors; D018426:SEER Program; D014481:United States; D055815:Young Adult
keywords: Acute nonlymphocytic leukemia; Childhood neoplasia; Lymphoma; Malignant ovarian neoplasia; Second primary tumors