Abstract:  Background and purpose: With the progress of tumor diagnosis and treatment, the survival time of tumor patients continues to prolong, and there are increasing number of clinical reports about second primary carcinoma. The purpose of this study was to investigate the clinical and pathological features of renal cell carcinoma (RCC) with second primary estrogen-related tumors. Methods: A total of 520 female RCC patients undergoing surgery in Fudan University Shanghai Cancer Center from Jan. 2008 to Jan. 2019 were retrospectively enrolled, including 39 cases carrying second primary estrogen-related tumors and 481 cases with only primary RCC. This study compared clinicopathological features in two groups, including age, body mass index (BMI), family history of cancer, TNM staging and American Joint Committee on Cancer (AJCC) clinical staging. Propensity score matching (PSM) was applied to match two groups in 1:5 ratio. In addition, the Kaplan-Meier method was performed to assess the prognosis of the two groups. Results: After construction of PSM algorithm, 38 patients carrying second primary estrogen-related tumor and 185 single RCC patients were enrolled for analysis. Before PSM analysis, statistically significant difference was found between two groups in family history of cancer (P=0.012). After performing PSM algorithm, there was still statistically significant difference between the two groups of patients (P=0.042). Before PSM analysis, statistically significant difference was found between two groups in overall survival (P=0.014). After performing PSM algorithm, a total of 223 female RCC patients were enrolled and followed up for 3-130 months. Among the 38 patients carrying second primary estrogen-related tumor, 8 patients died, while 30 patients were still alive with a median survival time of 34.5 months. Among the 185 single RCC patients, 57 patients died, while 128 patients were still alive with a median survival time of 59.0 months. During the follow-up, the survival rate of patients carrying second primary estrogen-related tumor was always lower than that of single RCC patients. Statistically significant difference was found between two groups in overall survival (P=0.041). Conclusion: RCC patient carrying second primary estrogen-related tumor is not uncommon, and family history of cancer may increase the risk of RCC in patient carrying second primary estrogen-related tumor. The prognosis of RCC patient carrying second primary estrogen-related tumor is worse than that of patients with only RCC.

Key words: Renal cell carcinoma, Estrogen-related tumors, Second primary carcinoma, Propensity score matching analysis