title: Characteristics and Outcomes of Second Malignant Neoplasms after Childhood Cancer Treatment: Multi-Center Retrospective Survey.
abstract: This retrospective study investigated the clinical characteristics and outcomes of second malignant neoplasms (SMNs) in survivors of childhood cancer from multiple institutions in Korea. A total of 102 patients from 11 institutions who developed SMN after childhood cancer treatment between 1998 and 2011 were retrospectively enrolled. The most common primary malignant neoplasms (PMNs) were central nervous system (CNS) tumors (n = 17), followed by acute lymphoblastic leukemia (n = 16), non-Hodgkin lymphoma (n = 13), and osteosarcoma (n = 12). The most common SMNs were therapy-related myeloid neoplasms (t-MNs; acute myeloid leukemia [AML], 29 cases; myelodysplastic syndrome [MDS], 12 cases), followed by thyroid carcinomas (n = 15) and CNS tumors (n = 10). The median latency period was 4.9 years (range, 0.5-18.5 years). Among 45 patients with solid tumors defined as an SMN, 15 (33%) developed the lesion in a field previously subjected to radiation. The 5-year overall survival (OS) rate of patients with an SMN was 45% with a median follow-up time of 8.6 years. Patients with AML, MDS, and CNS tumors exhibited the poorest outcomes with 5-year OS rates of 18%, 33%, and 32%, respectively, whereas those with second osteosarcoma showed comparable outcomes (64%) to patients with primary counterpart and those with second thyroid carcinoma had a 100% OS rate. Further therapeutic efforts are recommended to improve the survival outcomes in patients with SMNs, especially in cases with t-MNs and CNS tumors.
authors.affiliation: Division of Pediatric Hematology/Oncology, Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea .
authors.forename: Kyung-Nam
authors.identifier: 0000-0002-6376-672X
authors.initials: KN
authors.lastname: Koh
authors.affiliation: Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea .
authors.forename: Keon Hee
authors.identifier: 0000-0002-5980-7912
authors.initials: KH
authors.lastname: Yoo
authors.affiliation: Division of Pediatric Hematology/Oncology, Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea .
authors.forename: Ho Joon
authors.identifier: 0000-0001-8799-4068
authors.initials: HJ
authors.lastname: Im
authors.affiliation: Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea .
authors.forename: Ki Woong
authors.identifier: 0000-0001-5989-4772
authors.initials: KW
authors.lastname: Sung
authors.affiliation: Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea .
authors.forename: Hong Hoe
authors.identifier: 0000-0001-8082-1412
authors.initials: HH
authors.lastname: Koo
authors.affiliation: Department of Pediatrics, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea .
authors.forename: Hyo Sun
authors.identifier: 0000-0003-1260-7814
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea .
authors.forename: Jung Woo
authors.identifier: 0000-0001-8936-1205
authors.initials: JW
authors.lastname: Han
authors.affiliation: Center for Pediatric Oncology, National Cancer Center, Goyang, Korea .
authors.forename: Jong Hyung
authors.identifier: 0000-0001-7871-1548
authors.initials: JH
authors.lastname: Yoon
authors.affiliation: Center for Pediatric Oncology, National Cancer Center, Goyang, Korea .
authors.forename: Hyeon Jin
authors.identifier: 0000-0002-9557-3412
authors.initials: HJ
authors.lastname: Park
authors.affiliation: Center for Pediatric Oncology, National Cancer Center, Goyang, Korea .
authors.forename: Byung-Kiu
authors.identifier: 0000-0001-9743-0610
authors.initials: BK
authors.lastname: Park
authors.affiliation: Department of Pediatrics, Chonnam National University College of Medicine, Gwangju, Korea .
authors.forename: Hee Jo
authors.identifier: 0000-0003-2301-9823
authors.initials: HJ
authors.lastname: Baek
authors.affiliation: Department of Pediatrics, Chonnam National University College of Medicine, Gwangju, Korea .
authors.forename: Hoon
authors.identifier: 0000-0002-9135-5821
authors.initials: H
authors.lastname: Kook
authors.affiliation: Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea .
authors.forename: Jun Ah
authors.identifier: 0000-0003-3310-9566
authors.initials: JA
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Yeungnam University College of Medicine, Daegu, Korea .
authors.forename: Jae Min
authors.identifier: 0000-0001-6822-1051
authors.initials: JM
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Korea University College of Medicine, Seoul, Korea .
authors.forename: Kwang Chul
authors.identifier: 0000-0003-3552-8721
authors.initials: KC
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Inha University College of Medicine, Incheon, Korea .
authors.forename: Soon Ki
authors.identifier: 0000-0002-4785-1705
authors.initials: SK
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Chungbuk National University College of Medicine, Cheongju, Korea .
authors.forename: Meerim
authors.identifier: 0000-0002-6847-9447
authors.initials: M
authors.lastname: Park
authors.affiliation: Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea .
authors.forename: Young-Ho
authors.identifier: 0000-0003-1498-2773
authors.initials: YH
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea .
authors.forename: Chuhl Joo
authors.identifier: 0000-0001-7124-7818
authors.initials: CJ
authors.lastname: Lyu
authors.affiliation: Division of Pediatric Hematology/Oncology, Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea .
authors.forename: Jong Jin
authors.identifier: 0000-0002-0191-7836
authors.initials: JJ
authors.lastname: Seo
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000627:therapeutic use; D016543:Central Nervous System Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000532:radiotherapy; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D006761:Hospitals; D006801:Humans; D007223:Infant; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality / Q000628:therapy; D009190:Myelodysplastic Syndromes / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality / Q000628:therapy; D016609:Neoplasms, Second Primary / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality / Q000628:therapy; D012516:Osteosarcoma / Q000175:diagnosis / Q000453:epidemiology; D012189:Retrospective Studies; D033581:Stem Cell Transplantation; D015996:Survival Rate; D014182:Transplantation, Autologous; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents
keywords: Cancer; Childhood; Second Neoplasm; Survivors