Published October 19, 2021 | Version v1
Journal article Open

Types of second primary cancer influence overall survival in cutaneous melanoma

  • 1. Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, D-69120, Heidelberg, Germany; Center for Primary Health Care Research, Lund University, 205 02, Malmö, Sweden.
  • 2. Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, D-69120, Heidelberg, Germany
  • 3. Center for Primary Health Care Research, Lund University, 205 02, Malmö, Sweden; Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, USA; Center for Community-based Healthcare Research and Education (CoHRE), Department of Functional Pathology, School of Medicine, Shimane University, Matsue, Japan
  • 4. Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, D-69120, Heidelberg, Germany; Center for Primary Health Care Research, Lund University, 205 02, Malmö, Sweden; Hopp Children's Cancer Center (KiTZ), 69120, Heidelberg, Germany; Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), German Cancer Consortium (DKTK), Heidelberg, Germany
  • 5. Cancer Gene Therapy Group, Translational Immunology Research Program, University of Helsinki, Helsinki, Finland; Comprehensive Cancer Center, Helsinki University Hospital, Helsinki, Finland
  • 6. Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, D-69120, Heidelberg, Germany. K.Hemminki@dkfz.de; Center for Primary Health Care Research, Lund University, 205 02, Malmö, Sweden. K.Hemminki@dkfz.de; Faculty of Medicine and Biomedical Center in Pilsen, Charles University in Prague, 30605, Pilsen, Czech Republic. K.Hemminki@dkfz.de; Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, D-69120, Heidelberg, Germany. K.Hemminki@dkfz.de

Description

Background: Favorable survival in malignant cutaneous melanoma (melanoma) has increased the likelihood of
second primary cancer (SPC). We assess the influence of patient characteristics at diagnosis of first melanoma and
the type of SPC (second melanoma and other SPC) on overall survival.
Methods: We used the Swedish Cancer Registry data to assess overall survival in melanoma for the period 1990 to
2015. Kaplan-Meier curves were plotted and hazard ratios (HRs) were estimated with Cox regression models by
considering SPC diagnosis as a time-dependent variable.
Results: A total of 46,726 patients were diagnosed with melanoma, and 15.3% of them developed SPC, among
which, two thirds were other SPCs. Second melanomas were diagnosed early (31% during the first year) compared
to non-melanoma SPCs (9.5%). Survival for women with second melanoma or other SPC (56 and 21% alive after 25
years of follow-up, respectively) exceeded the male rates (21 and 10%, respectively) but all these figures were lower
than for females (60% alive) or males (48%) without SPC. Time dependent analysis showed vastly increased HRs for
cancer types that are fatal also as first cancers, but SPC-specific HRs remained relatively uniform, irrespective of SPC
diagnosed soon or late after first melanoma. In early-onset melanoma, SPC diagnosis after 10 years may not
negatively influence overall survival.
Conclusions: As the overall survival of patients with many types of SPCs is unfavorable, advice about health
lifestyle should benefit smoking patients and early detection methods may be recommended for SPCs of the
breast, prostate and colorectum.

Notes

G.Z is a doctoral student supported by the China Scholarship Council (201606100057). This work is supported by European Union's Horizon 2020 research and innovation programme, grant No 856620, Jane and Aatos Erkko Foundation, Sigrid Juselius Foundation, The Swedish Research Council, Finnish Cancer Organizations, University of Helsinki and Helsinki University Central Hospital. Open Access funding enabled and organized by Projekt DEAL.

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Additional details

Funding

European Commission
Chaperon - ERA Chair Position for Excellent Research in Oncology 856620