Prevention of Second Primary Tumors by an Acyclic Retinoid in Patients with Hepatocellular Carcinoma

To the Editor: Chemoprevention can prevent second primary cancers in patients with cancer, 1 but the effect of secondary cancer prevention on absolute survival has not been established. In 1996 we reported in the Journal that oral administration of an acyclic retinoid for 12 months significantly reduced the incidence of second primary cancers in patients who had received curative treatment for hepatocellular carcinomas, 2 but the effect on survival did not reach statistical significance after a median follow-up period of 38 months. We have subsequently reexamined the patients every three months. Patients in whom a second primary hepatocellular carcinoma developed received mainly . . .