Secondary Primary Malignancy Risk in Patients With Ovarian Cancer in Taiwan

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 Secondary Primary Malignancy Risk in Patients With Ovarian Cancer in Taiwan: A Nationwide Population-Based Study

DISCUSSION

This present study is the first to distinctly demonstrate a significantly increased SIR for metachronous SPM among ovarian cancer patients in Asia.

.... Several studies have focused on the issue of SPM after ovarian cancer.^{5–9,11–21} Most of these studies demonstrated an increased risk of SPM,^{5–8,12,14,15,17,18,20} but others did not.^9,11,13 Bergfeldt et al⁹ proposed that findings of increased occurrence of secondary primary cancer in patients with ovarian cancer have been biased by misclassification. A study conducted in the UK confirmed the high incidence of synchronous cancer in patients with ovarian cancer, which may also bias estimates of SPM incidence.¹⁴ In addition, most previous studies were single-institute case series; few nationwide or multiple-institute cohort studies have been conducted with reference groups to examine the SIR or relative risk of SPM. Furthermore, recent changes in chemotherapy regimens may also influence the risk of SPM. To avoid surveillance bias, we strictly excluded SPMs occurring within 1 year after ovarian cancer diagnosis.....