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This retrospective, population-based cohort study evaluated SPM occurrence among 18,383 colon cancer survivors treated from 2010–2022, comparing no chemotherapy, fluorouracil/capecitabine alone, and fluorouracil/capecitabine with oxaliplatin. Cox-derived standardized incidence ratios from national registries quantified differences over up to 11.5 years. Results showed higher overall SPM risk and a stronger signal for second colorectal cancers with oxaliplatin-based therapy, with elevated cumulative incidence at 10 years and persistent risk across stages.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/risk-of-second-primary-malignancies-after-adjuvant-chemotherapy-for-colon-cancer/370974/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/risk-of-second-primary-malignancies-after-adjuvant-chemotherapy-for-colon-cancer/370974.png","ImageObject",300,407,{"name":92,"@type":93},"Well Done","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-03","2026-09-23",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What was the purpose of this study on colon cancer survivors?","Question",{"text":112,"@type":113},"To evaluate the incidence of second and subsequent primary malignancies (SPMs) among colon cancer survivors and how the risk relates to the type of adjuvant chemotherapy received.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were patients grouped according to adjuvant chemotherapy type?",{"text":117,"@type":113},"Patients were categorized as receiving no chemotherapy; fluorouracil or capecitabine alone; or fluorouracil/capecitabine combined with oxaliplatin.",{"name":119,"@type":110,"acceptedAnswer":120},"What did the study find about SPM risk after oxaliplatin-based chemotherapy?",{"text":121,"@type":113},"Oxaliplatin-based therapy was associated with a higher overall SPM risk and the most pronounced increase for colorectal SPMs, with elevated cumulative incidence by 10 years and the highest second colon cancer risk among the groups.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},370974,1790330811,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":39,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":46},5909892210082,"https://ap-avatar.wpscdn.com/avatar/56001069da27c9f41e8?x-image-process=image/resize,m_fixed,w_180,h_180&k=1789614185077863061","DOI: 10. 1002/cncr.70116  \nORIGINAL ARTICLE  \nRisk of second primary malignancies after adjuvant chemotherapy for colon cancer  \nTomas Buchler MD, PhD1 | Monika Ambrozova MSc (Eng)2,3 | Ondrej Majek PhD2,3  | Tereza Dianova MSc2 | Petr Klika MSc2,3 | Ladislav Dusek PhD2,3  \n1Department of Oncology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic 2 Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic 3 Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic  \nCorrespondence  \nTomas Buchler, Department of Oncology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic.  \nEmail: [tomas.buchler@fnmotol.cz](tomas.buchler@fnmotol.cz)  \nAbstract  \nBackground: Advances in adjuvant chemotherapy have improved survival in patients with stage II–III colon cancer (CC). However, concerns have emerged regarding the risk of second and subsequent primary malignancies (SPMs) based on preclinical data and registry-based studies. This study evaluated the incidence of SPMs among CC survivors in relation to adjuvant chemotherapy type.  \nMethods: This retrospective, population-based cohort study included 18,383 patients with stage II–III CC who were treated between 2010 and 2022. Patients were categorized based on three adjuvant treatments: (1) no chemotherapy,(2) fluorouracil or capecitabine alone, and (3) fluorouracil or capecitabine with oxaliplatin. Standardized incidence ratios (SIRs) for SPMs were calculated using national cancer registry data.  \nResults: In an analysis of all 18,383 patients with stage II and III CC who had up to 11.5 years of follow-up, those who received with fluorouracil or capecitabine plus oxaliplatin had a higher overall risk of SPMs (SIR, 1. 5; 95% confidence interval, 1.4– 1. 6) compared with SIRs of 1.1 (95% confidence interval, 1.0–1. 2) in patients who did not receive chemotherapy or who received treatment without oxaliplatin. This elevated risk persisted across both stages and was most pronounced for colorectal SPMs. At 10 years, the cumulative SPM incidence reached 14. 6% in the oxaliplatin group versus 12. 5% and 11.0% in the other two groups, respectively. Oxaliplatintreated patients had the highest second CC risk (SIR, 2. 2).  \nConclusions: Oxaliplatin-based adjuvant chemotherapy was associated with a heightened long-term risk of SPMs, particularly second colorectal cancers. These findings highlight the need for risk-adapted survivorship care strategies.  \nKEYWORDS  \ncancer surveillance, chemotherapy, epidemiology, second primary malignancies  \nThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.  \n© 2025 The Author(s). Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.  \nCancer. 2025;e70116.  \n[https://doi.org/10.1002/cncr.70116](https://doi.org/10.1002/cncr.70116)  \nwi[leyonlinelibrary.com/journal/cncr](leyonlinelibrary.com/journal/cncr)  \n1 of 8  \nINTRODUCTION  \nColorectal cancer (CRC) is among the most prevalent malignancies worldwide. Advances in adjuvant treatment have significantly improved survival rates, leading to increasing numbers of long-term survivors.  \nThe evolution of adjuvant chemotherapy for resected, stage II– III CRC spans 4 decades. Proof of principle arrived when the National Surgical Adjuvant Breast and Bowel C-01 (NSABP C-01) randomized study demonstrated that postoperative 5-fluorouracil (5-FU)–based chemotherapy improved both disease-free and overall survival versus surgery alone.1 This was soon confirmed by a North Central Cancer Treatment Group trial in which 1 year of 5-FU plus levamisole cut the recurrence rate by 41% and cut mortality by 33% in patients with stage III","cbCailILvqkbV2xu","https://ap.wps.com/l/cbCailILvqkbV2xu","pdf",324941,"English","# Background\n## Advances in adjuvant chemotherapy and survival in stage II–III colon cancer\n# Methods\n## Study design and patient cohort\n## Adjuvant chemotherapy groups\n## Standardized incidence ratio calculation\n# Results\n## Overall SPM risk by treatment type\n## Stage-specific persistence\n## Colorectal SPMs and cumulative incidence\n## Second colon cancer risk\n# Conclusions\n## Oxaliplatin-associated long-term SPM risk\n## Implications for survivorship care","[{\"question\":\"What was the purpose of this study on colon cancer survivors?\",\"answer\":\"To evaluate the incidence of second and subsequent primary malignancies (SPMs) among colon cancer survivors and how the risk relates to the type of adjuvant chemotherapy received.\"},{\"question\":\"How were patients grouped according to adjuvant chemotherapy type?\",\"answer\":\"Patients were categorized as receiving no chemotherapy; fluorouracil or capecitabine alone; or fluorouracil/capecitabine combined with oxaliplatin.\"},{\"question\":\"What did the study find about SPM risk after oxaliplatin-based chemotherapy?\",\"answer\":\"Oxaliplatin-based therapy was associated with a higher overall SPM risk and the most pronounced increase for colorectal SPMs, with elevated cumulative incidence by 10 years and the highest second colon cancer risk among the groups.\"}]","Risk of second primary malignancies after adjuvant chemotherapy for colon cancer | PDF",1790190928]