Ann Dermatol.  2018 Jun;30(3):335-341. 10.5021/ad.2018.30.3.335.

The Incidence of Other Primary Cancers in Patients with Cutaneous Lymphoma

• Kim YJ
• Shin HJ
• Won CH
• Chang SE
• Lee MW
• Choi JH
• Lee WJ

• KMID: 2419176
• DOI: http://doi.org/10.5021/ad.2018.30.3.335

Abstract

BACKGROUND
Skin cancer is the most common other primary cancer in patients with lymphoma. However, an intriguing association between cutaneous lymphoma and other primary cancers has been suggested in a few studies.
OBJECTIVE
This study investigated other primary cancers in patients with cutaneous lymphoma to evaluate the risk for occurrence of each type of cancer.
METHODS
We screened for other primary cancers in 428 patients with cutaneous lymphoma. Clinical features were analyzed according to the lineage and origin of the lymphomas. We calculated the standardized incidence ratio with statistical analysis for each group according to age.
RESULTS
Among 330 patients with cutaneous T cell lymphoma and 98 with cutaneous B cell lymphoma, a total of 43 cancers in 38 patients were finally included. Other primary cancers were prevalent in patients with cutaneous B cell lymphoma and patients with secondary cutaneous lymphoma. However, those differences were not significant when the age was calibrated by multiple logistic regression. Metachronously higher standardized incidence ratios were observed for primary lung (standardized incidence ratio [SIR], 14.81; 95% confidence interval [CI], 3.05~39.54), skin (SIR, 68.05; 95% CI, 14.03~181.62), and breast (SIR, 12.91; 95% CI, 1.56~41.41) cancers with statistical significance.
CONCLUSION
Other primary cancers more preferentially occurred in patients with cutaneous lymphoma. Clinicians should carefully examine patients with cutaneous lymphoma for other cancers, especially lung, skin, and breast cancers.

Keyword

Incidence; Lymphoma; Neoplasms; Skin

MeSH Terms

Breast
Humans
Incidence*
Logistic Models
Lung
Lymphoma*
Lymphoma, B-Cell
Lymphoma, T-Cell, Cutaneous
Skin
Skin Neoplasms

Reference

1. Lee JH, Lee JH, Yoo DS, Kang H, Kim GM, Park HJ, et al. Characteristics of primary cutaneous lymphoma according to WHO-EORTC classification in Korea. Clin Exp Dermatol. 2013; 38:457–463. PMID: 23611304.

2. Jenni D, Karpova MB, Seifert B, Golling P, Cozzio A, Kempf W, et al. Primary cutaneous lymphoma: two-decade comparison in a population of 263 cases from a Swiss tertiary referral centre. Br J Dermatol. 2011; 164:1071–1077. PMID: 21083546.

3. Lee WJ, Won KH, Won CH, Chang SE, Choi JH, Moon KC, et al. Secondary cutaneous lymphoma: comparative clinical features and survival outcome analysis of 106 cases according to lymphoma cell lineage. Br J Dermatol. 2015; 173:134–145. PMID: 25556641.

4. Amber KT, Bloom R, Nouri K. Second primary malignancies in CTCL patients from 1992 to 2011: a SEER-based, population-based study evaluating time from CTCL diagnosis, age, sex, stage, and CD30+ subtype. Am J Clin Dermatol. 2016; 17:71–77. PMID: 26386881.

5. Huang KP, Weinstock MA, Clarke CA, McMillan A, Hoppe RT, Kim YH. Second lymphomas and other malignant neoplasms in patients with mycosis fungoides and Sezary syndrome: evidence from population-based and clinical cohorts. Arch Dermatol. 2007; 143:45–50. PMID: 17224541.

6. Scarisbrick JJ, Child FJ, Evans AV, Fraser-Andrews EA, Spittle M, Russell-Jones R. Secondary malignant neoplasms in 71 patients with Sézary syndrome. Arch Dermatol. 1999; 135:1381–1385. PMID: 10566838.

7. Kantor AF, Curtis RE, Vonderheid EC, van Scott EJ, Fraumeni JF Jr. Risk of second malignancy after cutaneous T-cell lymphoma. Cancer. 1989; 63:1612–1615. PMID: 2924268.

8. Brownell I, Etzel CJ, Yang DJ, Taylor SH, Duvic M. Increased malignancy risk in the cutaneous T-cell lymphoma patient population. Clin Lymphoma Myeloma. 2008; 8:100–105. PMID: 18501103.

9. Olsen EA, Delzell E, Jegasothy BV. Second malignancies in cutaneous T cell lymphoma. J Am Acad Dermatol. 1984; 10:197–204. PMID: 6609176.

10. Chan SA, Shah F, Chaganti S, Stevens A, Amel-Kashipaz R, Vydianath B, et al. Primary cutaneous B-cell lymphoma: systemic spread is rare while cutaneous relapses and secondary malignancies are frequent. Br J Dermatol. 2017; 177:287–289. PMID: 27641754.

11. Bae SH, Seon HJ, Choi YD, Shim HJ, Lee JB, Yun SJ. Other primary systemic cancers in patients with melanoma: analysis of balanced acral and nonacral melanomas. J Am Acad Dermatol. 2016; 74:333–340. PMID: 26584878.

12. Breslow NE, Day NE. Statistical methods in cancer research. IARC Workshop 25–27 May 1983. IARC Sci Publ. 1987; (82):1–406.

13. Jung KW, Won YJ, Oh CM, Kong HJ, Lee DH, Lee KH. Community of Population-Based Regional Cancer Registries. Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2014. Cancer Res Treat. 2017; 49:292–305. PMID: 28279062.

14. Väkevä L, Pukkala E, Ranki A. Increased risk of secondary cancers in patients with primary cutaneous T cell lymphoma. J Invest Dermatol. 2000; 115:62–65. PMID: 10886509.

15. Lee BN, Duvic M, Tang CK, Bueso-Ramos C, Estrov Z, Reuben JM. Dysregulated synthesis of intracellular type 1 and type 2 cytokines by T cells of patients with cutaneous T-cell lymphoma. Clin Diagn Lab Immunol. 1999; 6:79–84. PMID: 9874668.

16. Rook AH, Kubin M, Cassin M, Vonderheid EC, Vowels BR, Wolfe JT, et al. IL-12 reverses cytokine and immune abnormalities in Sezary syndrome. J Immunol. 1995; 154:1491–1498. PMID: 7822812.

17. Thestrup-Pedersen K. Cutaneous T-cell lymphoma. A hypothesis on disease pathophysiology involving deficiency in DNA repair. J Eur Acad Dermatol Venereol. 2016; 30:1682–1685. PMID: 27501224.

18. Alshareeda AT, Negm OH, Albarakati N, Green AR, Nolan C, Sultana R, et al. Clinicopathological significance of KU70/KU80, a key DNA damage repair protein in breast cancer. Breast Cancer Res Treat. 2013; 139:301–310. PMID: 23624778.

19. Ferenczi K, Ohtola J, Aubert P, Kessler M, Sugiyama H, Somani AK, et al. Malignant T cells in cutaneous T-cell lymphoma lesions contain decreased levels of the antiapoptotic protein Ku70. Br J Dermatol. 2010; 163:564–571. PMID: 20408834.

20. Tseng RC, Hsieh FJ, Shih CM, Hsu HS, Chen CY, Wang YC. Lung cancer susceptibility and prognosis associated with polymorphisms in the nonhomologous end-joining pathway genes: a multiple genotype-phenotype study. Cancer. 2009; 115:2939–2948. PMID: 19408343.

21. Kumar A, Purohit S, Sharma NK. Aberrant DNA double-strand break repair threads in breast carcinoma: orchestrating genomic insult survival. J Cancer Prev. 2016; 21:227–234. PMID: 28053956.

22. Feehan RP, Shantz LM. Molecular signaling cascades involved in nonmelanoma skin carcinogenesis. Biochem J. 2016; 473:2973–2994. PMID: 27679857.