Different situations of identifying second primary malignant tumors in lymphoma patients with synchronous solid tumors

BACKGROUND To our knowledge, the different situations of identifying second primary malignant tumors (SPMTs) in lymphoma patients with synchronous solid tumors remain to be comprehensively investigated. METHODS We retrospectively collected information pertaining to lymphoma patients with synchronous solid tumors (diagnosed within 6 months) at Peking University Cancer Hospital & Institute between 2009 and 2019. The non-parametric Aalen-Johansen estimator was applied to calculate cumulative incidence function in the competing risk model. Furthermore, propensity score-matched analysis was performed to compare survival differences in lymphoma patients with or without synchronous solid tumors. RESULTS Thirty-eight patients were enrolled. There were three situations of identifying SPMTs. First, in 15 patients (39.5%), SPMTs were identified before the initiation of any treatment. Among them, priority was given to anti-lymphoma treatment in case of only three patients. Second, in 17 patients (44.7%), SPMTs were unexpectedly detected on surgical specimen assessment; of them, 13 received anti-lymphoma treatment after surgery. Third, in six patients (15.8%), SPMTs were identified after the outset of treatment for the primary tumor; in this population, three of four patients with lymphoma switched toward the treatment plan for SPMTs. The 5-year overall survival was 58.7%. The cumulative incidence function within 5 years was 26.6% for lymphoma and 14.7% for other solid tumors. The early identification of SPMTs was associated with better outcomes (p = 0.048). After balancing the baseline characteristics, no differences in survival were observed between lymphoma patients with and without synchronous solid tumors (p = 0.664). CONCLUSIONS This is the first study to present the different situations of identifying SPMTs in lymphoma patients with synchronous solid tumors. In only <50% patients, SPMTs were identifiable at baseline. SPMT identification at different situations may make it difficult to choose the optimal therapeutic option, which may consequently impact patient survival.

[1]  Weili Zhao,et al.  A Multi-Center, Real-World Study of Chidamide for Patients With Relapsed or Refractory Peripheral T-Cell Lymphomas in China , 2021, Frontiers in Oncology.

[2]  B. Suktitipat,et al.  Risks and cancer associations of metachronous and synchronous multiple primary cancers: a 25-year retrospective study , 2021, BMC Cancer.

[3]  L. Gergely,et al.  Cell-Free Total Nucleic Acid-Based Genotyping of Aggressive Lymphoma: Comprehensive Analysis of Gene Fusions and Nucleotide Variants by Next-Generation Sequencing , 2021, Cancers.

[4]  Hui Liu,et al.  Relmacabtagene autoleucel (relma‐cel) CD19 CAR‐T therapy for adults with heavily pretreated relapsed/refractory large B‐cell lymphoma in China , 2020, Cancer medicine.

[5]  Changqing Zeng,et al.  Germline variants of DNA repair genes in early onset mantle cell lymphoma , 2020, Oncogene.

[6]  R. Tsang,et al.  Value of oesophagoscopy and bronchoscopy in diagnosis of synchronous malignancies in patients with head and neck squamous cell carcinomas , 2020, BMC Cancer.

[7]  K. Kodeda,et al.  Synchronous small bowel neuroendocrine tumour and lymphoma in a centenarian , 2020, ANZ journal of surgery.

[8]  I. Carvalho,et al.  Antitumour Anthracyclines: Progress and Perspectives , 2020, ChemMedChem.

[9]  Jun Zhu,et al.  Improving survival of 3760 patients with lymphoma: Experience of an academic center over two decades , 2020, Cancer medicine.

[10]  C. Cipolla,et al.  Cardiotoxicity of Anthracyclines , 2020, Frontiers in Cardiovascular Medicine.

[11]  Zhitong Bing,et al.  Survival between synchronous and non-synchronous multiple primary cutaneous melanomas—a SEER database analysis , 2020, PeerJ.

[12]  F. M. Garcia,et al.  Potential biomarkers of ductal carcinoma in situ progression , 2019, BMC Cancer.

[13]  Gang Wu,et al.  Diagnosis and Treatment of Synchronous Lymphoma and Digestive System Carcinoma: Report of Four Cases and Literature Review , 2019, Front. Oncol..

[14]  Jun Zhu,et al.  Burden of lymphoma in China, 2006–2016: an analysis of the Global Burden of Disease Study 2016 , 2019, Journal of Hematology & Oncology.

[15]  K. Muro,et al.  Risk of second primary malignancies after definitive treatment for esophageal cancer: A competing risk analysis , 2019, Cancer medicine.

[16]  A. Bennani,et al.  Synchronous colonic adenoma and intestinal marginal zone B-cell lymphoma associated with Crohn’s disease: a case report and literature review , 2019, BMC Cancer.

[17]  T. Yen,et al.  Comparison of 18F-FDG PET/MRI, MRI, and 18F-FDG PET/CT for the detection of synchronous cancers and distant metastases in patients with oropharyngeal and hypopharyngeal squamous cell carcinoma , 2019, European Journal of Nuclear Medicine and Molecular Imaging.

[18]  R. Elstrom,et al.  Treatment of relapsed or refractory classical Hodgkin lymphoma with the anti-PD-1, tislelizumab: results of a phase 2, single-arm, multicenter study , 2019, Leukemia.

[19]  J. Pfeifer.  Identity determination in diagnostic surgical pathology. , 2019, Seminars in diagnostic pathology.

[20]  Sumit Ghosh.  Cisplatin: The first metal based anticancer drug. , 2019, Bioorganic chemistry.

[21]  Haifeng Song,et al.  A safe and potent anti-CD19 CAR T cell therapy , 2019, Nature Medicine.

[22]  Z. Zhao,et al.  Clinical characteristics and prognosis associated with multiple primary malignant tumors in non-Hodgkin lymphoma patients , 2019, Tumori.

[23]  Jun Zhu,et al.  Mortality of lymphoma and myeloma in China, 2004–2017: an observational study , 2019, Journal of Hematology & Oncology.

[24]  F. Yuan,et al.  [Synchronous lymphoma and carcinoma-clinical analyses of 17 patients]. , 2018, Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi.

[25]  G. Collins,et al.  Handling time varying confounding in observational research , 2017, British Medical Journal.

[26]  E. Braham,et al.  Synchronous mantle cell lymph node lymphoma and pulmonary adenocarcinoma: a case report with literature review , 2017, The clinical respiratory journal.

[27]  L. Lix,et al.  Long-term time trends in incidence, survival and mortality of lymphomas by subtype among adults in Manitoba, Canada: a population-based study using cancer registry data , 2017, BMJ Open.

[28]  A. Alavi,et al.  Head-to-Head Comparison of Chest X-Ray/Head and Neck MRI, Chest CT/Head and Neck MRI, and 18F-FDG PET/CT for Detection of Distant Metastases and Synchronous Cancer in Oral, Pharyngeal, and Laryngeal Cancer , 2017, The Journal of Nuclear Medicine.

[29]  H. Frick,et al.  Multiple primary tumours: challenges and approaches, a review , 2017, ESMO Open.

[30]  M. Schootman,et al.  Competing causes of death in the head and neck cancer population. , 2017, Oral oncology.

[31]  J. Ajani,et al.  Gastric adenocarcinoma , 2017, Nature Reviews Disease Primers.

[32]  Cheng‐Chung Wu,et al.  Treatment of synchronous adenocarcinoma and lymphoma of the stomach: A case report. , 2016, Molecular and clinical oncology.

[33]  R. Advani,et al.  The World Health Organization Classification of Lymphoid Neoplasms , 2013 .

[34]  C. van Walraven,et al.  Competing risk bias was common in Kaplan-Meier risk estimates published in prominent medical journals. , 2016, Journal of clinical epidemiology.

[35]  W. Guo,et al.  Clinical Analysis of 152 Cases of Multiple Primary Malignant Tumors in 15,398 Patients with Malignant Tumors , 2015, PloS one.

[36]  Zhen-Wei Peng,et al.  Multidisciplinary treatment based on surgery leading to long-term survival of a patient with multiple asynchronous rare primary malignant neoplasms: A case report and literature review , 2014, Oncology letters.

[37]  K. Hanazaki,et al.  Clinicopathological characteristics and therapeutic outcomes of synchronous gastric adenocarcinoma and gastric lymphoma. , 2014, Anticancer research.

[38]  Mark Lunt,et al.  Selecting an Appropriate Caliper Can Be Essential for Achieving Good Balance With Propensity Score Matching , 2013, American journal of epidemiology.

[39]  Martin Schumacher,et al.  A Note on Variance Estimation of the Aalen–Johansen Estimator of the Cumulative Incidence Function in Competing Risks, with a View towards Left‐Truncated Data , 2010, Biometrical journal. Biometrische Zeitschrift.

[40]  G. Snow,et al.  Second primary tumors and field cancerization in oral and oropharyngeal cancer: Molecular techniques provide new insights and definitions , 2002 .

[41]  Robert Gray,et al.  A Proportional Hazards Model for the Subdistribution of a Competing Risk , 1999 .

[42]  S. Warren.  Multiple primary malignant tumors. A survey of the literature and a statistical study , 1932 .