Different situations of identifying second primary malignant tumors in lymphoma patients with synchronous solid tumors. (9th January 2023)

• Record Type: Journal Article
• Authors: Gao, Hongye; Wang, Xiaogan; Lai, Yumei; Zhang, Chen; Mi, Lan; Ji, Xinqiang; Wang, Xiaopei; Song, Yuqin; Zhu, Jun; Liu, Weiping
• Is Part Of: Cancer medicine. Volume 12:Number 7(2023)
• Page Start: 8038
• Page End: 8049
• Publication Date: 2023-01-09
• Subjects: cancer treatment -- lymphoma -- survival -- synchronous multiple primary neoplasms; 616.994005
• DOI: 10.1002/cam4.5592
• Languages: English
• ISSNs: 2045-7634

Abstract

Abstract: 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. Abstract : In the real‐world setting, there were three distinct situations in identifying second primary malignant tumors (SPMTs) in lymphoma patients with synchronous solid tumors. Only less than half of the patients confirmed twomalignancies at baseline. Others were unexpectedly identified SPMTs during surgery or chemotherapy.