Second primary malignancies in renal cortical neoplasms: an updated evaluation from a single institution.
OBJECTIVE
To examine the incidence of secondary primary malignancies in patients with renal cortical neoplasms.


METHODS
Between January 1989 and July 2010, 3647 patients underwent surgery at our institution for a renal cortical neoplasm and were followed through 2012. Occurrence of other malignancies was classified as antecedent, synchronous, or subsequent. All patients with antecedent malignancies (n = 498) and a randomly selected half of those with synchronous malignancies (n = 83) were excluded. The expected number of second primaries was calculated by multiplying Surveillance, Epidemiology, and End Results Program incidence rates of renal cortical neoplasms by person-years at risk within categories of age, sex, and year of diagnosis. The standardized incidence ratio (SIR) was calculated as observed cancers divided by expected incidence of the cancer, with approximation to the exact Poisson test used to obtain confidence intervals (CI) and p values.


RESULTS
Of 3066 patients with renal cortical neoplasms, 267 had a second primary cancer; the five most common in men were prostate, colorectal, bladder, lung, and non-Hodgkin's lymphoma; the five most common in women were breast, colorectal, lung, endometrium, and thyroid. Men demonstrated higher than expected thyroid cancer rate (SIR 5.0; 95 % CI 1.83-10.88, p = 0.002), and women had higher than expected rates of stomach cancer (SIR 5.0; 95 % CI 1.61-11.67, p = 0.004) and thyroid cancer (SIR 4.62; 95 % CI 1.69-10.05, p = 0.003).


CONCLUSIONS
The incidence of certain types of second malignancies may be higher in patients after diagnosis of renal cortical neoplasms compared to the general population. These observations can inform clinical follow-up in kidney cancer survivorship and future research studies.
Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA. murrayk3@mskcc.org.
Katie S
KS
Murray
Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
Emily C
EC
Zabor
Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
Massimiliano
M
Spaliviero
Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.|Weill Cornell Medical College, 1300 York Avenue, New York, NY, 10065, USA.
Paul
P
Russo
Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
Wassim M
WM
Bazzi
Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
John E
JE
Musser
Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.|Weill Cornell Medical College, 1300 York Avenue, New York, NY, 10065, USA.
A
A
Ari Hakimi
Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
Melanie L
ML
Bernstein
Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.|Weill Cornell Medical College, 1300 York Avenue, New York, NY, 10065, USA.
Guido
G
Dalbagni
Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.|Weill Cornell Medical College, 1300 York Avenue, New York, NY, 10065, USA.
Jonathan A
JA
Coleman
Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
Helena
H
Furberg
D000368:Aged; D002292:Carcinoma, Renal Cell / Q000175:diagnosis*; D005260:Female; D006801:Humans; D015994:Incidence; D007672:Kidney Cortex / Q000473:pathology*; D007680:Kidney Neoplasms / Q000175:diagnosis*; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
Kidney neoplasms; Renal cell carcinoma; Second malignancy