Abstract:
Importance:Although the increased incidence of second primary malignant neoplasms (SPMs) is a well-known late effect after cancer, few studies have compared survival after an SPM to survival of the same cancer occurring as first primary malignant neoplasm (PM) by age. Objective:To assess the survival impact of SPMs in adolescents and young adults (AYAs) (15-39 years) compared with that of pediatric (<15 years) and older adult (≥40 years) patients with the same SPMs. Design, Setting, and Participants:This was a population-based, retrospective cohort study of patients with cancer in 13 Surveillance, Epidemiology and End Results regions in the United States diagnosed from 1992 to 2008 and followed through 2013. Data analysis was performed between June 2016 and January 2017. Main Outcomes and Measures:Five-year relative survival was calculated overall and for each cancer occurring as a PM or SPM by age at diagnosis. The impact of SPM status on cancer-specific death was examined using multivariable Cox proportional hazards regression. Results:A total of 15 954 pediatric, 125 750 AYAs, and 878 370 older adult patients diagnosed as having 14 cancers occurring as a PM or SPM were included. Overall, 5-year survival after an SPM was 33.1% lower for children, 20.2% lower for AYAs, and 8.3% lower for older adults compared with a PM at the same age. For the most common SPMs in AYAs, the absolute difference in 5-year survival was 42% lower for secondary non-Hodgkin lymphoma, 19% for secondary breast carcinoma, 15% for secondary thyroid carcinoma, and 13% for secondary soft-tissue sarcoma. Survival by SPM status was significantly worse in younger vs older patients for thyroid, Hodgkin lymphoma, non-Hodgkin lymphoma, acute myeloid leukemia, soft-tissue sarcoma, and central nervous system cancer. Adolescents and young adults with secondary Hodgkin lymphoma (hazard ratio [95% CI], 3.5 [1.7-7.1]); soft-tissue sarcoma (2.8 [2.1-3.9]); breast carcinoma (2.1 [1.8-2.4]); acute myeloid leukemia (1.9 [1.5-2.4]); and central nervous system cancer (1.8 [1.2-2.8]) experienced worse survival compared with AYAs with the same PMs. Conclusion and Relevance:The adverse impact of SPMs on survival is substantial for AYAs and may partially explain the relative lack of survival improvement in AYAs compared with other age groups. The impact of a particular SPM diagnosis on survival may inform age-specific prevention, screening, treatment, and survivorship recommendations.
journal_name
JAMA Oncoljournal_title
JAMA oncologyauthors
Keegan THM,Bleyer A,Rosenberg AS,Li Q,Goldfarb Mdoi
10.1001/jamaoncol.2017.0465subject
Has Abstractpub_date
2017-11-01 00:00:00pages
1554-1557issue
11eissn
2374-2437issn
2374-2445pii
2619709journal_volume
3pub_type
杂志文章相关文献
JAMA Oncology文献大全abstract:Importance:The association between increasing body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) and risk of breast cancer is unique in cancer epidemiology in that a crossover effect exists, with risk reduction before and risk increase after menopause. The inverse association w...
journal_title:JAMA oncology
pub_type: 杂志文章,多中心研究
doi:10.1001/jamaoncol.2018.1771
更新日期:2018-11-01 00:00:00
abstract:Importance:Financial conflicts of interest (FCOIs) among authors of clinical practice guidelines have the potential to influence treatment recommendations. Objective:To quantify FCOIs with industry among authors of the National Comprehensive Cancer Network (NCCN) guidelines. Design, Setting, and Participants:We asses...
journal_title:JAMA oncology
pub_type: 杂志文章
doi:10.1001/jamaoncol.2016.2710
更新日期:2016-12-01 00:00:00
abstract:Importance:Multiparametric magnetic resonance imaging (MRI) in conjunction with MRI-transrectal ultrasound (TRUS) fusion-guided biopsies have improved the detection of prostate cancer. It is unclear whether MRI itself adds additional value to multivariable prediction models based on clinical parameters. Objective:To d...
journal_title:JAMA oncology
pub_type: 杂志文章
doi:10.1001/jamaoncol.2017.5667
更新日期:2018-05-01 00:00:00
abstract:Importance:In clinical practice, patients with primary metastatic renal cell carcinoma (mRCC) have been offered cytoreductive nephrectomy (CN) followed by targeted therapy, but the optimal sequence of surgery and systemic therapy is unknown. Objective:To examine whether a period of sunitinib therapy before CN improves...
journal_title:JAMA oncology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1001/jamaoncol.2018.5543
更新日期:2019-02-01 00:00:00
abstract:Importance:Why some triple-negative breast cancers (TNBCs) have high and others have low immune cell infiltration is unknown. Understanding how immune surveillance shapes the cancer genome could help in the selection of patients and the development of more effective immunotherapy strategies. Objective:To examine the a...
journal_title:JAMA oncology
pub_type: 杂志文章
doi:10.1001/jamaoncol.2017.2140
更新日期:2017-12-01 00:00:00
abstract:Importance:The androgen receptor inhibitor enzalutamide prolongs survival in men with metastatic castration-resistant prostate cancer (mCRPC). In controlled clinical studies, 0.5% (10 of 2051) of patients experienced seizure, but patients with a history of or risk factors for seizure were excluded. Men with mCRPC and s...
journal_title:JAMA oncology
pub_type: 杂志文章,多中心研究
doi:10.1001/jamaoncol.2017.3361
更新日期:2018-05-01 00:00:00
abstract:Importance:The value of platinum-based adjuvant chemotherapy in patients with triple-negative breast cancer (TNBC) remains controversial, as does whether BRCA1 and BRCA2 (BRCA1/2) germline variants are associated with platinum treatment sensitivity. Objective:To compare 6 cycles of paclitaxel plus carboplatin (PCb) wi...
journal_title:JAMA oncology
pub_type: 杂志文章
doi:10.1001/jamaoncol.2020.2965
更新日期:2020-09-01 00:00:00
abstract:Importance:To date, there is no well-defined standard of care for early-stage pediatric Hodgkin lymphoma (HL), which may include chemotherapy alone or combined modality therapy (CMT) with chemotherapy followed by radiotherapy. Although the use of radiotherapy in pediatric HL is decreasing, this strategy remains controv...
journal_title:JAMA oncology
pub_type: 杂志文章
doi:10.1001/jamaoncol.2018.5911
更新日期:2019-05-01 00:00:00
abstract:Importance:Although stereotactic radiosurgery (SRS) is preferred for limited brain metastases from most histologies, whole-brain radiotherapy (WBRT) has remained the standard of care for patients with small cell lung cancer. Data on SRS are limited. Objective:To characterize and compare first-line SRS outcomes (withou...
journal_title:JAMA oncology
pub_type: 杂志文章,多中心研究
doi:10.1001/jamaoncol.2020.1271
更新日期:2020-07-01 00:00:00
abstract:Importance:Lay navigators in the Patient Care Connect Program support patients with cancer from diagnosis through survivorship to end of life. They empower patients to engage in their health care and navigate them through the increasingly complex health care system. Navigation programs can improve access to care, enhan...
journal_title:JAMA oncology
pub_type: 杂志文章
doi:10.1001/jamaoncol.2016.6307
更新日期:2017-06-01 00:00:00
abstract:IMPORTANCE:Multiple myeloma has been classified as exhibiting "limited or suggestive evidence" of an association with exposure to herbicides in Vietnam War veterans. Occupational studies have shown that other pesticides (ie, insecticides, herbicides, fungicides) are associated with excess risk of multiple myeloma and i...
journal_title:JAMA oncology
pub_type: 杂志文章
doi:10.1001/jamaoncol.2015.2938
更新日期:2015-11-01 00:00:00
abstract:IMPORTANCE:Positive phase 3 cancer clinical trials are widely hailed, while trials with negative results are often interpreted as scientific failures. We hypothesized that these interpretations would be reflected in the scientific literature. OBJECTIVE:To compare the scientific impact of positive vs negative phase 3 c...
journal_title:JAMA oncology
pub_type: 杂志文章
doi:10.1001/jamaoncol.2015.6487
更新日期:2016-07-01 00:00:00
abstract:IMPORTANCE:BRCA testing is recommended for young women diagnosed as having breast cancer, but little is known about decisions surrounding testing and how results may influence treatment decisions in young patients. OBJECTIVES:To describe the use of BRCA testing and to evaluate how concerns about genetic risk and use o...
journal_title:JAMA oncology
pub_type: 杂志文章
doi:10.1001/jamaoncol.2015.5941
更新日期:2016-06-01 00:00:00
abstract:IMPORTANCE:Time to surgery (TTS) is of concern to patients and clinicians, but controversy surrounds its effect on breast cancer survival. There remains little national data evaluating the association. OBJECTIVE:To investigate the relationship between the time from diagnosis to breast cancer surgery and survival, usin...
journal_title:JAMA oncology
pub_type: 杂志文章
doi:10.1001/jamaoncol.2015.4508
更新日期:2016-03-01 00:00:00
abstract:Importance:Programmed cell death 1 (PD-1) inhibitor-related pneumonitis is a rare but clinically serious and potentially life-threatening adverse event. Little is known about its incidence across different tumor types and treatment regimens. Objective:To compare the incidence of PD-1 inhibitor-related pneumonitis amon...
journal_title:JAMA oncology
pub_type: 杂志文章,meta分析,评审
doi:10.1001/jamaoncol.2016.2453
更新日期:2016-12-01 00:00:00
abstract:Importance:RAS wild-type (wt) status is necessary but not sufficient for response to anti-epidermal growth factor receptor (EGFR) agents in advanced colorectal cancer (aCRC). RNA expression of EGFR ligands epiregulin (EREG) and amphiregulin (AREG) may correlate with EGFR-targeted therapy efficacy in aCRC, so may repres...
journal_title:JAMA oncology
pub_type: 杂志文章
doi:10.1001/jamaoncol.2015.6065
更新日期:2016-05-01 00:00:00
abstract:Importance:Aromatase inhibitors (AI) are associated with significant urogenital atrophy, affecting quality of life and drug compliance. Objective:To evaluate safety of intravaginal testosterone cream (IVT) or an estradiol-releasing vaginal ring (7.5 μg/d) in patients with early-stage breast cancer (BC) receiving an AI...
journal_title:JAMA oncology
pub_type: 杂志文章,随机对照试验
doi:10.1001/jamaoncol.2016.3904
更新日期:2017-03-01 00:00:00
abstract:Importance:To date, the benefit of genome-driven cancer therapy has not been quantified. Objective:We sought to estimate the annual percentage of patients in the United States with advanced or metastatic cancer who could be eligible for and benefit from US Food and Drug Administration (FDA)-approved genome-driven ther...
journal_title:JAMA oncology
pub_type: 杂志文章
doi:10.1001/jamaoncol.2018.1660
更新日期:2018-08-01 00:00:00
abstract:IMPORTANCE:Time to events, or survival end points, are common end points in randomized clinical trials. They are usually analyzed under the assumption of proportional hazards, and the treatment effect is reported as a hazard ratio, which is neither an intuitive measure nor a meaningful one if the assumption of proporti...
journal_title:JAMA oncology
pub_type: 杂志文章
doi:10.1001/jamaoncol.2015.6359
更新日期:2016-07-01 00:00:00
abstract:Importance:Single-agent immune checkpoint inhibition has not shown activities in advanced refractory colorectal cancer (CRC), other than in those patients who are microsatellite-instability high (MSI-H). Objective:To evaluate whether combining programmed death-ligand 1 (PD-L1) and cytotoxic T-lymphocyte-associated pro...
journal_title:JAMA oncology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1001/jamaoncol.2020.0910
更新日期:2020-06-01 00:00:00
abstract:Importance:Randomized trials in breast cancer have demonstrated the clinical benefits of adjuvant endocrine therapy (AET) in preventing recurrence and death. The examination of concordance with AET guidelines at a national level as a measure of quality of care is important. Objective:To investigate temporal trends and...
journal_title:JAMA oncology
pub_type: 杂志文章
doi:10.1001/jamaoncol.2016.6380
更新日期:2017-07-01 00:00:00
abstract:Importance:Colorectal cancer (CRC) incidence and mortality among individuals younger than 50 years (early-onset CRC) are increasing. The reasons for such increases are largely unknown, although the increasing prevalence of obesity may be partially responsible. Objective:To investigate prospectively the association bet...
journal_title:JAMA oncology
pub_type: 杂志文章
doi:10.1001/jamaoncol.2018.4280
更新日期:2019-01-01 00:00:00
abstract:Importance:The benefit of adjuvant chemotherapy after resection of pancreatic cancer following neoadjuvant combination treatment with folinic acid, fluorouracil, irinotecan, and oxaliplatin (FOLFIRINOX) is unclear. Objective:To assess the association of adjuvant chemotherapy with overall survival (OS) in patients afte...
journal_title:JAMA oncology
pub_type: 杂志文章
doi:10.1001/jamaoncol.2020.3537
更新日期:2020-09-10 00:00:00
abstract:Importance:The role of epidermal growth factor receptor (EGFR) inhibition in chemoradiation strategies in the nonoperative treatment of patients with esophageal cancer remains uncertain. Objective:To evaluate the benefit of cetuximab added to concurrent chemoradiation therapy for patients undergoing nonoperative treat...
journal_title:JAMA oncology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1001/jamaoncol.2017.1598
更新日期:2017-11-01 00:00:00
abstract:IMPORTANCE:Substantial progress has been made in cancer diagnosis and treatment, resulting in a steady improvement in cancer survival. The degree of improvement by age, race, and sex remains unclear. OBJECTIVE:To quantify the degree of survival improvement over time by age, race, and sex in the United States. DESIGN,...
journal_title:JAMA oncology
pub_type: 杂志文章
doi:10.1001/jamaoncol.2014.161
更新日期:2015-04-01 00:00:00
abstract:Importance:Remarkable progress has occurred in understanding the pathophysiology and in developing improved personalized therapies in adult acute lymphoblastic leukemia (ALL). Observations:We searched MEDLINE (1990-2018), the American Society of Clinical Oncology, and American Society of Hematology websites (2010-2018...
journal_title:JAMA oncology
pub_type: 杂志文章
doi:10.1001/jamaoncol.2018.1915
更新日期:2018-10-01 00:00:00
abstract:Importance:Currently, preoperative radiotherapy for all soft-tissue sarcomas is identical at a 50-Gy dose level, which can be associated with morbidity, particularly wound complications. The observed clinical radiosensitivity of the myxoid liposarcoma subtype might offer the possibility to reduce morbidity. Objective:...
journal_title:JAMA oncology
pub_type: 杂志文章
doi:10.1001/jamaoncol.2020.5865
更新日期:2021-01-01 00:00:00
abstract:Importance:Chemoradiotherapy (CRT), followed by surgery, is the recommended approach for stage II and III rectal cancer. While CRT decreases the risk of local recurrence, it does not improve survival and leads to poorer functional outcomes than surgery alone. Therefore, new approaches to better select patients for CRT ...
journal_title:JAMA oncology
pub_type: 杂志文章
doi:10.1001/jamaoncol.2019.0186
更新日期:2019-07-01 00:00:00
abstract:Importance:Approximately 50% of the risk for the development of testicular germ cell tumors (TGCTs) is estimated to be heritable, but no mendelian TGCT predisposition genes have yet been identified. It is hypothesized that inherited pathogenic DNA repair gene (DRG) alterations may drive susceptibility to TGCTs. Object...
journal_title:JAMA oncology
pub_type: 杂志文章,多中心研究
doi:10.1001/jamaoncol.2018.6477
更新日期:2019-04-01 00:00:00
abstract:Importance:Although aspirin is recommended for the prevention of colorectal cancer (CRC) among adults aged 50 to 59 years, recent data from a randomized clinical trial suggest a lack of benefit and even possible harm among older adults. Objective:To examine the association between aspirin use and the risk of incident ...
journal_title:JAMA oncology
pub_type: 杂志文章
doi:10.1001/jamaoncol.2020.7338
更新日期:2021-01-21 00:00:00