A1 Journal article – refereed
Distinctive Cancer Associations in Patients With Neurofibromatosis Type 1




List of Authors: Elina Uusitalo, Matti Rantanen, Roope A. Kallionpää, Minna Pöyhönen, Jussi Leppävirta, Heli Ylä-Outinen, Vincent M. Riccardi, Eero Pukkala, Janne Pitkäniemi, Sirkku Peltonen, Juha Peltonen
Publisher: AMER SOC CLINICAL ONCOLOGY
Publication year: 2016
Journal: Journal of Clinical Oncology
Journal name in source: JOURNAL OF CLINICAL ONCOLOGY
Journal acronym: J CLIN ONCOL
Volume number: 34
Issue number: 17
ISSN: 0732-183X

Abstract
PurposeThe current study was designed to determine the risk of cancer in patients with neurofibromatosis type 1 (NF1) by cancer type, age, and sex with unprecedented accuracy to be achieved by combining two total population-based registers.Patients and MethodsA population-based series of patients with NF1 (N = 1,404; 19,076 person-years) was linked to incident cancers recorded in the Finnish Cancer Registry and deaths recorded in the national Population Register Centre between 1987 and 2012. Standardized incidence ratios (SIRs) and standardized mortality ratios (SMRs) were calculated for selected cancer types. Survival of the patients with cancer with and without NF1 was compared.ResultsIn malignant peripheral nerve sheath tumors and CNS tumors, the cancers traditionally associated with NF1, we observed SIRs of 2,056 (95% CI, 1,561 to 2,658), and 37.5 (95% CI, 30.2 to 46.0), respectively, and SMRs of 2,301 (95% CI, 1,652 to 3,122) and 30.2 (95% CI, 19.1 to 45.2), respectively. We found an unequivocally increased risk for breast cancer. In particular, SIR was 11.1 (95% CI, 5.56 to 19.5) for breast cancer in women with NF1 age, 40 years; the overall SMR for breast cancer was 5.20 (95% CI, 2.38 to 9.88). Particularly high overall SIRs were observed in patients with NF1 age, 15 years: women, 87.6 (95% CI, 58.6 to 125); men, 45.6 (95% CI, 28.4 to 68.5). An estimated lifetime cancer risk for patients with NF1 was 59.6%. The 5-year survival of patients with cancer and NF1, excluding nervous tissue cancers, was worse than that of comparable patients with cancers without NF1 (54.0% v 67.5%; P = .01).ConclusionOur results emphasize the general cancer proclivity of patients with NF1. These findings should translate to clinical practices to determine clinical interventions and focused follow-up of patients with NF1. (C) 2016 by American Society of Clinical Oncology

Last updated on 2019-20-07 at 04:01