1. ¹Department of Oncology, Institute of Clinical Sciences, Lund University Hospital, Lund, Sweden
2. ²Department of Cancer Epidemiology, Institute of Clinical Sciences, Lund University Hospital, SE-221 85 Lund, Sweden
3. ³Department of Orthopedics, Institute of Clinical Sciences, Lund University Hospital, SE-221 85 Lund, Sweden

Correspondence: Dr J Fernebro, E-mail: Josefin.Fernebro@med.lu.se

Received 24 April 2006; Revised 4 September 2006; Accepted 4 September 2006; Published online 26 September 2006.

Abstract

Soft-tissue sarcomas (STS) have been associated with various rare cancer syndromes and occur at increased frequencies in survivors of childhood cancer. Also adult patients with STS have been suggested to be at an increased risk of additional malignancies. After exclusion of syndrome-associated and radiation-induced sarcomas, we studied multiple primary malignancies in a population-based cohort of 818 patients with primary STS of the extremities and the trunk wall. In total, 203 other malignancies developed in 164 (20%) patients median 10 (0–32) years before and median 4 (0–35) years after the sarcoma diagnosis. Standardised morbidity ratios (SMRs) were determined for primary malignancies following a STS. Hereby individuals who had developed a STS were identified to be at increased risk of second primary malignancies (SMR for all malignant tumours=1.3; 95% CI=1.0–1.5; P=0.02) with STS being the only specific tumour type that occurred at an increased risk (SMR=17.6; 95% CI=8.1–33.5; P<0.001). Hence, this population-based series demonstrates a high frequency of second primary tumours among STS patients and indicates a particularly increased risk of developing a new STS.