Pelvic inflammatory disease increases the risk of a second primary malignancy in patients with cervical cancer treated by surgery alone
Identifieur interne : 000D00 ( Main/Exploration ); précédent : 000C99; suivant : 000D01Pelvic inflammatory disease increases the risk of a second primary malignancy in patients with cervical cancer treated by surgery alone
Auteurs : Wen-Yen Chiou ; Chien-An Chen ; Moon-Sing Lee ; Hon-Yi Lin ; Chung-Yi Li ; Yu-Chieh Su [Taïwan] ; Shiang-Jiun Tsai ; Shih-Kai HungSource :
- Medicine [ 0025-7974 ] ; 2016.
Abstract
As the number of long-term cervical cancer survivors continues to increase because of improvements in treatment, concerns about second primary malignancy have grown. The high-risk area of second primary cancers in cervical cancer survivors is the pelvis. Pelvic inflammatory disease (PID) could be a useful marker for gynecological cancers. Thus, we designed a large-scale, nationwide, controlled cohort study to investigate whether PID or other risk factors increased the risk of second primary cancers in patients with cervical cancer treated by surgery alone.
Between 2000 and 2010, a total of 24,444 cervical cancer patients were identified using the Registry Data for Catastrophic Illness and the National Health Insurance Research Database (NHIRD) of Taiwan. Patients who received definite surgery were selected. To exclude the effect on second primary malignancy by treatment modalities, all cervical patients who ever having received adjuvant or definite radiotherapy or chemotherapy for primary cervical cancer were excluded. Finally, 3860 cervical cancer patients treated by surgery alone without adjuvant treatments were analyzed.
Cox proportional hazards model was used for multivariate analysis and the Kaplan–Meier method was used to assess the cumulative risks. Regarding the incidence of second primary cancers, the standardized incidence ratio (SIR) was used.
The median follow-up time was 56.6 months. The 6-year cumulative risk of second primary cancers is 0.16% and 0.12% for PID and without PID, respectively. After adjustment for confounders, age of less than 50 years, the presence of diabetes mellitus, and PID were significantly positivity associated with the risk of second primary cancers. The hazard ratios (HRs) of age less than 50 years, diabetes mellitus, and PID were 1.38 (95% CI = 1.11–2.04), 1.40 (95% CI = 1.06–1.85), and 1.35 (95% CI = 1.00–1.81), respectively. A higher incidence of second primary cancers was observed in the genitals, bladder, and colon.
In conclusion, the incidence of second primary cancers was higher in the genitals, bladder, and colon in patients with cervical cancer treated with surgery alone. The patients with PID had a higher risk of second primary cancers.
Url:
DOI: 10.1097/MD.0000000000005409
PubMed: 27893679
PubMed Central: 5134872
Affiliations:
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code="subfield">Chiayi</wicri:noCountry></affiliation><affiliation><nlm:aff id="aff2">School of Medicine, Tzu Chi University, Hualian</nlm:aff><wicri:noCountry code="subfield">Hualian</wicri:noCountry></affiliation><affiliation><nlm:aff id="aff3">Department of Public Health, College of Medicine, National Cheng Kung University, Tainan</nlm:aff><wicri:noCountry code="subfield">Tainan</wicri:noCountry></affiliation></author><author><name sortKey="Chen, Chien An" sort="Chen, Chien An" uniqKey="Chen C" first="Chien-An" last="Chen">Chien-An Chen</name><affiliation><nlm:aff id="aff4">Department of Radiation Oncology, Zhongxing Branch, Taipei City Hospital, Taipei</nlm:aff><wicri:noCountry code="subfield">Taipei</wicri:noCountry></affiliation></author><author><name sortKey="Lee, Moon Sing" sort="Lee, Moon Sing" uniqKey="Lee M" first="Moon-Sing" last="Lee">Moon-Sing Lee</name><affiliation><nlm:aff id="aff1">Department of Radiation Oncology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi</nlm:aff><wicri:noCountry code="subfield">Chiayi</wicri:noCountry></affiliation><affiliation><nlm:aff id="aff2">School of Medicine, Tzu Chi University, Hualian</nlm:aff><wicri:noCountry code="subfield">Hualian</wicri:noCountry></affiliation></author><author><name sortKey="Lin, Hon Yi" sort="Lin, Hon Yi" uniqKey="Lin H" first="Hon-Yi" last="Lin">Hon-Yi Lin</name><affiliation><nlm:aff id="aff1">Department of Radiation Oncology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi</nlm:aff><wicri:noCountry code="subfield">Chiayi</wicri:noCountry></affiliation><affiliation><nlm:aff id="aff2">School of Medicine, Tzu Chi University, Hualian</nlm:aff><wicri:noCountry code="subfield">Hualian</wicri:noCountry></affiliation></author><author><name sortKey="Li, Chung Yi" sort="Li, Chung Yi" uniqKey="Li C" first="Chung-Yi" last="Li">Chung-Yi Li</name><affiliation><nlm:aff id="aff3">Department of Public Health, College of Medicine, National Cheng Kung University, Tainan</nlm:aff><wicri:noCountry code="subfield">Tainan</wicri:noCountry></affiliation><affiliation><nlm:aff id="aff5">Department of Public Health, China Medical University, Taichung</nlm:aff><wicri:noCountry code="subfield">Taichung</wicri:noCountry></affiliation></author><author><name sortKey="Su, Yu Chieh" sort="Su, Yu Chieh" uniqKey="Su Y" first="Yu-Chieh" last="Su">Yu-Chieh Su</name><affiliation><nlm:aff id="aff6">Division of Hematology and Oncology, E-Da Hospital, Kaohsiung</nlm:aff><wicri:noCountry code="subfield">Kaohsiung</wicri:noCountry></affiliation><affiliation wicri:level="1"><nlm:aff id="aff7">School of Medicine, I-Shou University, Kaohsiung, Taiwan.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Taïwan</country><wicri:regionArea>School of Medicine, I-Shou University, Kaohsiung</wicri:regionArea><wicri:noRegion>Kaohsiung</wicri:noRegion></affiliation></author><author><name sortKey="Tsai, Shiang Jiun" sort="Tsai, Shiang Jiun" uniqKey="Tsai S" first="Shiang-Jiun" last="Tsai">Shiang-Jiun Tsai</name><affiliation><nlm:aff id="aff1">Department of Radiation Oncology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi</nlm:aff><wicri:noCountry code="subfield">Chiayi</wicri:noCountry></affiliation></author><author><name sortKey="Hung, Shih Kai" sort="Hung, Shih Kai" uniqKey="Hung S" first="Shih-Kai" last="Hung">Shih-Kai Hung</name><affiliation><nlm:aff id="aff1">Department of Radiation Oncology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi</nlm:aff><wicri:noCountry code="subfield">Chiayi</wicri:noCountry></affiliation><affiliation><nlm:aff id="aff2">School of Medicine, Tzu Chi University, Hualian</nlm:aff><wicri:noCountry code="subfield">Hualian</wicri:noCountry></affiliation></author></analytic><series><title level="j">Medicine</title><idno type="ISSN">0025-7974</idno><idno type="eISSN">1536-5964</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>Abstract</title><p>As the number of long-term cervical cancer survivors continues to increase because of improvements in treatment, concerns about second primary malignancy have grown. The high-risk area of second primary cancers in cervical cancer survivors is the pelvis. Pelvic inflammatory disease (PID) could be a useful marker for gynecological cancers. Thus, we designed a large-scale, nationwide, controlled cohort study to investigate whether PID or other risk factors increased the risk of second primary cancers in patients with cervical cancer treated by surgery alone.</p><p>Between 2000 and 2010, a total of 24,444 cervical cancer patients were identified using the Registry Data for Catastrophic Illness and the National Health Insurance Research Database (NHIRD) of Taiwan. Patients who received definite surgery were selected. To exclude the effect on second primary malignancy by treatment modalities, all cervical patients who ever having received adjuvant or definite radiotherapy or chemotherapy for primary cervical cancer were excluded. Finally, 3860 cervical cancer patients treated by surgery alone without adjuvant treatments were analyzed.</p><p>Cox proportional hazards model was used for multivariate analysis and the Kaplan–Meier method was used to assess the cumulative risks. Regarding the incidence of second primary cancers, the standardized incidence ratio (SIR) was used.</p><p>The median follow-up time was 56.6 months. The 6-year cumulative risk of second primary cancers is 0.16% and 0.12% for PID and without PID, respectively. After adjustment for confounders, age of less than 50 years, the presence of diabetes mellitus, and PID were significantly positivity associated with the risk of second primary cancers. The hazard ratios (HRs) of age less than 50 years, diabetes mellitus, and PID were 1.38 (95% CI = 1.11–2.04), 1.40 (95% CI = 1.06–1.85), and 1.35 (95% CI = 1.00–1.81), respectively. A higher incidence of second primary cancers was observed in the genitals, bladder, and colon.</p><p>In conclusion, the incidence of second primary cancers was higher in the genitals, bladder, and colon in patients with cervical cancer treated with surgery alone. The patients with PID had a higher risk of second primary cancers.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Tsai, Sj" uniqKey="Tsai S">SJ Tsai</name></author><author><name sortKey="Huang, Ys" uniqKey="Huang Y">YS Huang</name></author><author><name sortKey="Tung, Ch" uniqKey="Tung C">CH Tung</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chiang, Cj" uniqKey="Chiang C">CJ Chiang</name></author><author><name sortKey="Chen, Yc" uniqKey="Chen Y">YC Chen</name></author><author><name sortKey="Chen, Cj" uniqKey="Chen C">CJ Chen</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Lang, Hc" uniqKey="Lang H">HC Lang</name></author><author><name sortKey="Wu, Sl" uniqKey="Wu S">SL Wu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chaturvedi, Ak" uniqKey="Chaturvedi A">AK 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sortKey="Forte, V" uniqKey="Forte V">V Forte</name></author><author><name sortKey="Abdallah, M" uniqKey="Abdallah M">M Abdallah</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hammer, A" uniqKey="Hammer A">A Hammer</name></author><author><name sortKey="Rositch, A" uniqKey="Rositch A">A Rositch</name></author><author><name sortKey="Qeadan, F" uniqKey="Qeadan F">F Qeadan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Tay, Sk" uniqKey="Tay S">SK Tay</name></author><author><name sortKey="Ngan, Hy" uniqKey="Ngan H">HY Ngan</name></author><author><name sortKey="Chu, Ty" uniqKey="Chu T">TY Chu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Crotty Alexander, Le" uniqKey="Crotty Alexander L">LE Crotty Alexander</name></author><author><name sortKey="Shin, S" uniqKey="Shin S">S Shin</name></author><author><name sortKey="Hwang, Jh" uniqKey="Hwang J">JH Hwang</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Taïwan</li></country></list><tree><noCountry><name sortKey="Chen, Chien An" sort="Chen, Chien An" uniqKey="Chen C" first="Chien-An" last="Chen">Chien-An Chen</name><name sortKey="Chiou, Wen Yen" sort="Chiou, Wen Yen" uniqKey="Chiou W" first="Wen-Yen" last="Chiou">Wen-Yen Chiou</name><name sortKey="Hung, Shih Kai" sort="Hung, Shih Kai" uniqKey="Hung S" first="Shih-Kai" last="Hung">Shih-Kai Hung</name><name sortKey="Lee, Moon Sing" sort="Lee, Moon Sing" uniqKey="Lee M" first="Moon-Sing" last="Lee">Moon-Sing Lee</name><name sortKey="Li, Chung Yi" sort="Li, Chung Yi" uniqKey="Li C" first="Chung-Yi" last="Li">Chung-Yi Li</name><name sortKey="Lin, Hon Yi" sort="Lin, Hon Yi" uniqKey="Lin H" first="Hon-Yi" last="Lin">Hon-Yi Lin</name><name sortKey="Tsai, Shiang Jiun" sort="Tsai, Shiang Jiun" uniqKey="Tsai S" first="Shiang-Jiun" last="Tsai">Shiang-Jiun Tsai</name></noCountry><country name="Taïwan"><noRegion><name sortKey="Su, Yu Chieh" sort="Su, Yu Chieh" uniqKey="Su Y" first="Yu-Chieh" last="Su">Yu-Chieh Su</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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