Increased risk of secondary uterine leiomyosarcoma in hereditary retinoblastoma Journal Article


Authors: Francis, J. H.; Kleinerman, R. A.; Seddon, J. M.; Abramson, D. H.
Article Title: Increased risk of secondary uterine leiomyosarcoma in hereditary retinoblastoma
Abstract: Objective: In the US, second non-ocular malignancies are the primary cause of death in retinoblastoma survivors with the germline RB1 mutation. Soft tissue sarcomas are one of the most likely malignancies to pose a risk to these patients, with leiomyosarcoma (LMS) being the most common subtype. As our cohort is followed for a longer period, we discover new second malignancy risks for these patients. Methods: We estimated the risk for uterine leiomyosarcoma (ULMS) in a cohort of 1854 patients with retinoblastoma who were diagnosed at two US institutions from 1914 through 1996. The standardized incidence ratio and excess absolute risk were calculated by comparison with population data from the Connecticut Tumor Registry or from National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) database. The cumulative risk at 50 years of age was also calculated. Results: Seven of 525 female hereditary retinoblastoma patients developed ULMS. Five of these patients were used in the risk analysis, resulting in an excess risk of 3.87 per 10,000 women. Among hereditary patients who developed ULMS the excess risk increases dramatically with age: to 20/10,000 for female hereditary retinoblastoma patients aged between 30 and 39 years, and to 27/10,000 for patients aged 40 + years. Conclusion: There is a substantial excess risk of ULMS in female hereditary retinoblastoma patients. As more patients survive into their thirties, this number is likely to increase. These findings raise the question of early childbearing, screening and prophylactic measures in hereditary retinoblastoma patients: all issues that would benefit from confirmation from other retinoblastoma cohorts, to allow for better guided counsel of these patients. © 2011 Elsevier Inc. All rights reserved.
Keywords: adult; major clinical study; cancer risk; cancer incidence; metastasis; retinoblastoma; age; risk assessment; cancer registry; genetic disorder; leiomyosarcoma; uterine leiomyosarcoma; hereditary retinoblastoma; secondary cancers
Journal Title: Gynecologic Oncology
Volume: 124
Issue: 2
ISSN: 0090-8258
Publisher: Elsevier Inc.  
Date Published: 2012-02-01
Start Page: 254
End Page: 259
Language: English
DOI: 10.1016/j.ygyno.2011.10.019
PROVIDER: scopus
PMCID: PMC3264733
PUBMED: 22027510
DOI/URL:
Notes: --- - "Export Date: 1 March 2012" - "CODEN: GYNOA" - "Source: Scopus"
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  1. Jasmine Helen Francis
    256 Francis
  2. David H Abramson
    389 Abramson