Table 4.
Incidence rate ratios* (IRR) and 95 percent confidence intervals (CI) of selected second primary cancers among uterine corpus cancer patients, by type of radiotherapy.
| Second cancer and latency time | Surgery only† | Surgery and radiotherapy |
||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Combination radiotherapy | External beam therapy | Brachytherapy | Total Excess Cases§ | |||||||||||
| N‡ | N‡ | IRR | 95% CI | Excess cases§ | N‡ | IRR | 95% CI | Excess cases§ | N‡ | IRR | 95% CI | Excess cases§ | ||
| ≥ 1 year latency: | ||||||||||||||
| All cancers¶ | 4136 | 734 | 1.26 | 1.16–1.36 | 151 | 1421 | 1.15 | 1.08–1.22 | 185 | 1048 | 1.07 | 1.00–1.16 | 69 | 405 |
| Solid cancers# | 3667 | 639 | 1.24 | 1.13–1.35 | 124 | 1237 | 1.14 | 1.06–1.21 | 152 | 914 | 1.06 | 0.98–1.14 | 52 | 327 |
| Lymphatic and hematopoietic | 335 | 67 | 1.57 | 1.20–2.05 | 24 | 115 | 1.24 | 1.00–1.55 | 22 | 92 | 1.23 | 0.95–1.60 | 17 | 64 |
| Hodgkin lymphoma | 7 | 2 | 1.82 | 0.37–9.00 | 1 | 2 | 1.06 | 0.22–5.20 | 0 | 4 | 1.89 | 0.46–7.83 | 2 | 3 |
| Non-Hodgkin lymphoma | 172 | 43 | 1.79 | 1.27–2.52 | 19 | 56 | 1.06 | 0.79–1.44 | 3 | 54 | 1.21 | 0.86–1.70 | 9 | 32 |
| Myeloma | 59 | 7 | 0.80 | 0.36–1.78 | −2 | 21 | 1.03 | 0.61–1.71 | 1 | 16 | 0.97 | 0.53–1.77 | 0 | −2 |
| Non-CLL leukemia** | 60 | 15 | 1.67 | 0.94–2.97 | 6 | 36 | 2.03 | 1.34–3.10 | 18 | 18 | 1.56 | 0.87–2.80 | 6 | 31 |
| ALL | 3 | 0 | N/A | N/A | 3 | 3.55 | 0.69–18.24 | 2 | 1 | 0.95 | 0.09–10.00 | 0 | 2 | |
| ANLL | 46 | 12 | 1.80 | 0.94–3.43 | 5 | 24 | 1.77 | 1.07–2.92 | 10 | 13 | 1.43 | 0.72–2.83 | 4 | 20 |
| CML | 11 | 3 | 1.73 | 0.47–6.34 | 1 | 9 | 2.80 | 1.15–6.85 | 6 | 4 | 2.49 | 0.67–9.26 | 2 | 9 |
| CLL | 37 | 6 | 1.03 | 0.43–2.47 | 0 | 8 | 0.63 | 0.29–1.36 | −5 | 9 | 0.82 | 0.37–1.80 | –2 | –6 |
| ≥ 5 year latency: | ||||||||||||||
| All cancers | 2946 | 524 | 1.30 | 1.18–1.43 | 121 | 1001 | 1.14 | 1.06–1.23 | 123 | 799 | 1.04 | 0.96–1.14 | 31 | 275 |
| Solid cancers | 2 604 | 453 | 1.28 | 1.15–1.42 | 99 | 870 | 1.13 | 1.05–1.22 | 100 | 689 | 1.02 | 0.93–1.12 | 14 | 213 |
| Buccal cavity and pharynx | 52 | 8 | 1.09 | 0.51–2.32 | 1 | 10 | 0.64 | 0.32–1.26 | −6 | 13 | 1.07 | 0.55–2.08 | 1 | −4 |
| Digestive system | 763 | 178 | 1.67 | 1.41–1.97 | 71 | 300 | 1.29 | 1.12–1.47 | 67 | 241 | 1.15 | 0.98–1.35 | 31 | 170 |
| Esophagus | 10 | 2 | 1.35 | 0.29–6.32 | 1 | 2 | 0.61 | 0.13–2.80 | −1 | 5 | 1.83 | 0.54–6.18 | 2 | 2 |
| Stomach | 40 | 9 | 1.48 | 0.71–3.09 | 3 | 19 | 1.42 | 0.82–2.46 | 6 | 23 | 1.95 | 1.10–3.48 | 11 | 20 |
| Small intestine | 18 | 3 | 0.99 | 0.28–3.45 | 0 | 8 | 1.50 | 0.65–3.48 | 3 | 4 | 0.80 | 0.25–2.57 | −1 | 2 |
| Colon | 398 | 103 | 1.81 | 1.45–2.26 | 46 | 178 | 1.44 | 1.21–1.73 | 54 | 117 | 1.03 | 0.82–1.29 | 3 | 104 |
| Rectum | 80 | 22 | 2.06 | 1.27–3.35 | 11 | 34 | 1.46 | 0.97–2.19 | 11 | 24 | 1.08 | 0.65–1.78 | 2 | 24 |
| Liver | 13 | 0 | N/A | N/A | 5 | 1.40 | 0.49–3.96 | 1 | 6 | 4.42 | 1.40–13.97 | 5 | 6 | |
| Gallbladder | 12 | 1 | 0.67 | 0.09–5.21 | 0 | 4 | 1.11 | 0.36–3.48 | 0 | 8 | 2.27 | 0.81–6.36 | 4 | 4 |
| Pancreas | 101 | 24 | 1.76 | 1.12–2.78 | 10 | 28 | 0.91 | 0.59–1.38 | –3 | 30 | 1.18 | 0.75–1.86 | 5 | 12 |
| Respiratory system | 383 | 75 | 1.57 | 1.22–2.02 | 27 | 128 | 1.14 | 0.93–1.40 | 16 | 89 | 1.08 | 0.83–1.38 | 7 | 50 |
| Lung and bronchus | 371 | 73 | 1.58 | 1.23–2.04 | 27 | 126 | 1.17 | 0.95–1.43 | 18 | 86 | 1.08 | 0.83–1.40 | 6 | 51 |
| Larynx | 6 | 2 | 2.34 | 0.44–12.48 | 1 | 1 | 0.52 | 0.62–4.34 | –1 | 2 | 1.04 | 0.18–6.12 | 0 | 0 |
| Breast | 1096 | 132 | 0.88 | 0.73–1.05 | −18 | 285 | 0.89 | 0.78–1.02 | −35 | 236 | 0.80 | 0.69–0.94 | −59 | −112 |
| Urinary system | 155 | 45 | 2.04 | 1.45–2.88 | 23 | 85 | 1.83 | 1.40–2.39 | 39 | 63 | 1.57 | 1.13–2.18 | 23 | 84 |
| Urinary bladder and ureter | 98 | 38 | 2.66 | 1.81–3.93 | 24 | 69 | 2.30 | 1.68–3.14 | 39 | 44 | 1.73 | 1.16–2.58 | 19 | 81 |
| Kidney | 51 | 6 | 0.90 | 0.38–2.12 | −1 | 13 | 0.91 | 0.49–1.69 | −1 | 10 | 0.82 | 0.39–1.72 | −2 | −4 |
| Renal pelvis | 6 | 1 | 1.21 | 0.14–10.35 | 0 | 3 | 1.53 | 0.38–6.22 | 1 | 7 | 2.71 | 0.83–8.83 | 4 | 6 |
| Bone†† | 0 | 0 | N/A | N/A | 5 | N/A | N/A | 0 | N/A | N/A | N/A | |||
| Soft tissue‡‡ | 2 | 1 | 2.48 | 0.12–50.90 | 1 | 7 | 10.96 | 2.23–53.89 | 6 | 0 | N/A | N/A | 7 | |
| Melanoma | 75 | 6 | 0.65 | 0.28–1.51 | −3 | 22 | 1.09 | 0.67–1.75 | 2 | 20 | 1.18 | 0.68–2.06 | 3 | 2 |
| Thyroid | 11 | 1 | 0.78 | 0.10–6.22 | 0 | 5 | 2.05 | 0.69–6.06 | 3 | 10 | 4.22 | 1.56–11.46 | 8 | 10 |
| Non-Hodgkin lymphoma | 127 | 35 | 2.00 | 1.36–2.95 | 18 | 42 | 1.06 | 0.74–1.51 | 2 | 44 | 1.09 | 0.75–1.59 | 4 | 24 |
| Non-CLL leukemia** | 42 | 7 | 1.15 | 0.51–2.59 | 1 | 24 | 1.91 | 1.15–3.18 | 11 | 16 | 1.80 | 0.94–3.44 | 7 | 19 |
Poisson regression analysis stratified for age at UCC diagnosis, calendar year of diagnosis, cancer registry, and race.
The “surgery only” category (no radiotherapy) is the reference group.
N = number of observed second cancers. The sum of the observed second cancers for each type of radiotherapy does not necessarily match exactly the total number of cases for any radiotherapy because there are cases with unknown type of radiotherapy.
The number of excess second primary cancers cases associated with each specific radiotherapy was calculated as: [(IRR−1)/IRR] × number of observed cases in the exposure group of interest. Deficits are also presented to equal to the sum of excess.
All second cancers (excluding female genetic tract and non-melanoma skin cancer).
All solid second cancers (excluding female genital system and non-melanoma skin cancer)
Non-chronic lymphocytic leukemia (CLL) includes acute lymphocytic leukemia (ALL), acute non-lymphocytic leukemia (ANLL), and chronic myeloid Leukemia (CML). Four patients in the surgery only group were initially treated with chemotherapy (SIR=7.08, 95% CI=2.66–18.87); 2 patients in the radiotherapy group were initially treated with chemotherapy (SIR=3.63, 95% CI=0.91–14.52).
The bone category includes: vertebral column; rib, sternum, clavicle and associated joints; pelvic bones, sacrum, coccyx and associated joints.
The soft tissue category includes: connective, subcutaneous and other soft tissues of abdomen; connective, subcutaneous and other soft tissues of pelvis; connective, subcutaneous and other soft tissues of trunk.
Note: P <0.05 are in bold.