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Lewiston, ID, United States

Shah B.K.,Cancer Center and Blood Institute | Khanal A.,University of Illinois at Chicago
Anticancer Research | Year: 2015

Background/Aim: The risk of second primary malignancy (SPM) in mantle cell lymphoma (MCL) is not well-known. In this population-based study, we analyzed rates of SPM in adult patients with MCL. Patients and Methods: We selected adult (≥18 years) patients with MCL as first primary malignancy diagnosed during January 1992 to December 2011 from National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) 13 database. We used multiple standardized incidence ratio (MP-SIR) session of SEER∗ stat software to calculate the risk of second primary malignancies. Results: Among 3,149 patients, 261 (8.29%) developed 287 second primary malignancies with observed/expected (O/E) ratio of 1.32 (95% confidence interval (CI=1.17-1.48, p<0.001). The median time to SPM from the time of diagnosis was 47 months (range=6 months to 17.91 years). The significant excess risks were observed for skin, excluding basal and squamous cancer, (N=22, O/E=2.24, CI=1.4-3.39, p<0.001), thyroid malignancy (O/E=3, CI=1.1-6.52, p<0.01), acute myeloid leukemia (O/E=7.74, CI=4.54-13.94, p<0.001), chronic lymphocytic leukemia (O/E=7.27, CI=4.44-11.23, p<0.001) and Non-Hodgkin's lymphoma (NHL) (O/E=3.79, CI=2.64-5.27, p<0.001). The risk of malignancies of brain, thyroid, rectum and anal canal were higher within the first two years of diagnosis of MCL. Risk of skin cancer, excluding basal and squamous cancer, was higher after two years of latency. Conclusion: There is significantly higher risk of second primary malignancies in patients with mantle cell lymphoma compared to the general population. Patients may benefit from cancer-specific screening during follow-up. © 2015, International Institute of Anticancer Research. All rights reserved. Source


Ghimire K.B.,Mercy Medical Center North Iowa | Shah B.K.,Cancer Center and Blood Institute
Anticancer Research | Year: 2014

Background: Acute myeloid leukemia (AML) is the most common type of acute leukemia in adults. Long-term survivors from AML may be at higher risk of second primary malignancies. Patients and Methods: We selected adult patients with AML aged ≥18 years from the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER 13) database. We used the multiple primary standardized incidence ratio session of SEER∗stat software to calculate the risk of second primary malignancies in patients with AML. Results: Among 5,091 patients, 148 patients developed a total of 160 second primary malignancies, with an observed/expected (O/E) ratio of 1.17, (95% confidence interval=0.99-1.36), and an excess risk of 15.47 per 10,000 population. The risk of all-site cancer, cancer of gastrointestinal system, and oral and pharyngeal cancer in different age groups was found to be significantly higher among patients with AML compared to that of general US population. Conclusion: Adult patients with AML have a significantly higher risk of second primary malignancies compared to the general population. Source


Shah B.K.,Cancer Center and Blood Institute | Mandal R.,University of Wisconsin - Madison
Journal of Cancer Research and Therapeutics | Year: 2015

Background: To evaluate the relative survival rates for patients with metastatic bladder cancer (MBC) over the last two decades in the United States: 1991-2000 and 2001-2010. Materials and Methods: We used the Surveillance, Epidemiology, and End Results (SEERFNx01Stat) Program to analyze 6-month and 12-month relative survival rates of American Joint Committee on Cancer (AJCC) Stage IV bladder cancer patients included in the SEER database. We used Z-test in the SEERFNx01Stat Program to compare relative survival rates among cohorts of patients categorized by race, gender, and age groups (<60 and ≥60 years). Results: The dataset comprised 4195 and 7629 patients with AJCC Stage IV bladder cancer in the periods 1991-2000 and 2001-2010, respectively. There were statistically significant decreases in relative survival rates for pooled data across all races (67.8 ± 0.7% in 1991-2000 vs. 64.7 ± 0.5% in 2001-2010, P < 0.01), among Caucasian (CC) and other races (Oth) men + women, among CC and Oth men, and several cohorts among men and 60 + Oth-women when categorized by age. African American patients did not show significant changes in survival. Conclusions: This population-based study shows that decreases in 6-month and 12-month relative survival rates among patients with MBC in 2001-2010 compared to 1991-2000, specifically, more pronounced among CC men and Oth men. Source


Shah B.K.,Cancer Center and Blood Institute | Ghimire K.B.,Mercy Medical Center North Iowa
Indian Journal of Hematology and Blood Transfusion | Year: 2014

Survival of patients with chronic myeloid leukemia (CML) has improved with the use of imatinib and other tyrosine kinase inhibitors. There is limited data on second primary malignancies (SPM) in CML. We analyzed the SPMs rates among CML patients reported to Surveillance, Epidemiology, and End Results (SEER) database during pre-(1992–2000) and post-(2002–2009) era. We used SEER Multiple Primary-Standardized Incidence Ratio session to calculate standardized incidence ratios (SIRs). Among 8,511 adult CML patients, 446 patients developed 473 SPMs. The SIR for SPMs in CML patients was significantly higher with observed/expected ratio:1.27, P < 0.05 and absolute excess risk of 32.09 per 10,000 person years compared to general population. The rate of SPMs for cancers of all sites in post-imatinib era were significantly higher compared to pre-imatinib era with observed/expected ratio of 1.48 versus 1.06, P = 0.03. This study showed that risk of SPMs is higher among CML patients. The risk of SPMs is significantly higher in post-imatinib era compared to pre-imatinib era. © 2014, Indian Society of Haematology & Transfusion Medicine. Source


Shah B.K.,Cancer Center and Blood Institute | Budhathoki N.,Cancer Center and Blood Institute
Anticancer Research | Year: 2015

Background/Aim: To our knowledge, there are no data on second primary malignancies in anal cancer. This study was conducted to evaluate the risk of second primary malignancies in patients with anal carcinoma. Patients and Methods: We selected adult patients diagnosed with anal cancer from the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) 13 database. We calculated the risk of second primary malignancies in these patients using multiple primary standardized incidence ratio (MP-SIR) session of SEER statistical software. Results: Among 7,661 patients, 675 (9.07%) developed 747 second primary malignancies, with an observed/expected ratio of 1.41 (95% confidence interval=1.32-1.52, p<0.001), and an absolute excess risk of ∼55 per 10,000 population. Significant excess risks were observed for tumors of the oral cavity and pharynx, rectum and anal canal, larynx, lung and bronchus, ovary, vagina, and vulva, and Kaposi's sarcoma and hematological malignancies. The risk of specific second primary malignancies was related to the age of patients, exposure to radiotherapy and latency period. Conclusion: The risk of second primary malignancies in adult patients with anal cancer is significantly increased compared to the general population. Source

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