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Tsai MH, Pollard E, Coughlin SS, Vernon M, Rao SS. The role of a social determinants of health summary measure on the association between cancer history status and colorectal cancer screening utilization among screening eligible adults. Prev Med Rep 2024; 45:102825. [PMID: 39070707 PMCID: PMC11283133 DOI: 10.1016/j.pmedr.2024.102825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 07/09/2024] [Accepted: 07/10/2024] [Indexed: 07/30/2024] Open
Abstract
Objective We sought to examine the influence of social needs on the relationship between cancer history and colorectal cancer (CRC) screening utilization among adults in the United States. Methods We conducted a cross-sectional analysis using data from the 2022 Behavioral Risk Factor Surveillance System. Our outcome of interest was utilization of guideline-concordant CRC screening and exposures of interest were cancer history/levels of social needs. Multivariable logistic regression was performed to examine the association. Results Among 74,743 eligible adults, a majority did not have a personal history of cancer (87.9 %), had at least one social need (58.4 %), and had undergone CRC screening (72.2 %). In multivariable analysis, a history of cancer was positively associated with use of CRC screening (OR = 1.59, 95 %CI, 1.35 - 1.87). Having at least one social need was associated with lower likelihood of being screened (one social need: OR = 0.85 95 %CI, 0.76 - 0.95; two + social needs: OR = 0.77, 95 % CI, 0.69 - 0.87). When exploring the effects of social needs, adults without a history of cancer who reported at least one need were 12-20 % less likely to be screened for CRC. Conclusions A personal history of cancer was associated with greater utilization of CRC screening, whilst having at least one social need had lower screening use. Having social needs plays an important role in reducing screening uptake among adults without a history of cancer. Integrated care that considers both cancer history and social needs may have implications for improved adherence of CRC screening recommendations.
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Affiliation(s)
- Meng-Han Tsai
- Georgia Prevention Institute, Augusta University, Augusta, GA, USA
- Cancer Prevention, Control, & Population Health Program, Georgia Cancer Center, Augusta University, Augusta, GA, USA
| | - Elinita Pollard
- Georgia Prevention Institute, Augusta University, Augusta, GA, USA
- Center for Health Equity Transformation, Department of Behavioral Science, College of Medicine, University of Kentucky, Lexington, KY, USA
| | - Steven S. Coughlin
- Department of Biostatistics, Data Science and Epidemiology, Augusta University, GA, USA
| | - Marlo Vernon
- Georgia Prevention Institute, Augusta University, Augusta, GA, USA
- Cancer Prevention, Control, & Population Health Program, Georgia Cancer Center, Augusta University, Augusta, GA, USA
| | - Satish S.C. Rao
- Division of Gastroenterology/Hepatology, Medical College of Georgia, Augusta University, GA, USA
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2
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Halmágyi SR, Ungureanu L, Trufin II, Apostu AP, Șenilă SC. Melanoma as Subsequent Primary Malignancy in Hematologic Cancer Survivors-A Literature Review. J Clin Med 2024; 13:4501. [PMID: 39124768 PMCID: PMC11313577 DOI: 10.3390/jcm13154501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Revised: 07/28/2024] [Accepted: 07/29/2024] [Indexed: 08/12/2024] Open
Abstract
The occurrence of second primary malignancies is becoming increasingly important among cancer survivors. Melanoma, an aggressive neoplasm originating from the melanocytes, is responsible for most skin cancer-related deaths. This review aims to explore the risk of melanoma occurrence as a second primary cancer after the most common subtypes of hematologic neoplasia, a malignant disease originating from myeloid or lymphocytic cell lineages. Chronic lymphocytic leukemia (CLL) and non-Hodgkin lymphoma (NHL) are among the most associated subtypes with melanoma development. We also discuss the underlying hypotheses that may explain the associations between these malignancies and the impact of melanoma on survival. The review emphasizes the importance of increasing awareness of melanoma risk in hematologic cancer survivors, as it can lead to prompt recognition, improved skin surveillance, and better survival outcomes.
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Affiliation(s)
- Salomea-Ruth Halmágyi
- Clinical Hospital of Infectious Diseases, 400000 Cluj-Napoca, Romania; (S.-R.H.); (I.-I.T.); (A.P.A.)
- Department of Dermatology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Loredana Ungureanu
- Department of Dermatology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
- Department of Dermatology, Emergency County Hospital, 400006 Cluj-Napoca, Romania
| | - Ioana-Irina Trufin
- Clinical Hospital of Infectious Diseases, 400000 Cluj-Napoca, Romania; (S.-R.H.); (I.-I.T.); (A.P.A.)
| | - Adina Patricia Apostu
- Clinical Hospital of Infectious Diseases, 400000 Cluj-Napoca, Romania; (S.-R.H.); (I.-I.T.); (A.P.A.)
- Department of Dermatology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Simona Corina Șenilă
- Department of Dermatology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
- Department of Dermatology, Emergency County Hospital, 400006 Cluj-Napoca, Romania
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3
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Jensen SØ, Moore DA, Surani AA, Crosbie PAJ, Rosenfeld N, Rintoul RC. Second Primary Lung Cancer - An Emerging Issue in Lung Cancer Survivors. J Thorac Oncol 2024:S1556-0864(24)00683-X. [PMID: 39059487 DOI: 10.1016/j.jtho.2024.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 06/22/2024] [Accepted: 07/18/2024] [Indexed: 07/28/2024]
Abstract
As a result of an increased focus on early detection including lung cancer screening, combined with more curative treatment options, the 5-year survival rates for lung cancer are improving. Welcome though this is, it brings new, hitherto unseen challenges. As more patients are cured and survive longer, they are at risk of developing second primary cancers, particularly lung cancer. In this review, we examine the challenges that surveillance, diagnosis, and management of second primary lung cancer (SPLC) bring and how these can be addressed. Recent data from prospective follow-up studies suggests that the incidence of SPLC may be higher than previously appreciated, partly due to an increase in multi-focal adenocarcinoma spectrum disease. Over 5 years, up to 1 in 6 long-term lung cancer survivors may develop a SPLC. Although not routinely used in clinical practice at present, genomic approaches for differentiating SPLC from intrapulmonary metastases of the first primary are emerging, and we highlight how this could be used to help differentiate lesions. An accurate distinction between SPLC and the recurrence of the first primary is of paramount importance due to the very different management strategies that may be required. Wrongly classifying an SPLC as a recurrence of the first primary may have significant consequences for patient management and overall survival. Updated approaches to the classification of SPLC combining clinical history, histopathological assessment, and genomic profiling are needed. Finally, we review the potential role of early detection biomarkers in the identification of SPLC, focusing in particular on blood-based biomarkers that are being examined in a multi-center prospective study recruiting lung cancer survivors.
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Affiliation(s)
- Sarah Østrup Jensen
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom; Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, United Kingdom
| | - David A Moore
- Department of Cellular Pathology, University College Hospital, London United Kingdom; Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, United Kingdom
| | - Arif A Surani
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom; Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, United Kingdom
| | - Philip A J Crosbie
- Division of Immunology, Immunity and Infection and Respiratory Medicine, University of Manchester, Manchester, United Kingdom
| | - Nitzan Rosenfeld
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom; Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - Robert C Rintoul
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom; Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, United Kingdom; Department of Oncology, University of Cambridge, Cambridge, United Kingdom; Department of Thoracic Oncology, Royal Papworth Hospital, Cambridge, United Kingdom.
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4
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Kwon JH, Kim H, Lee JK, Hong YJ, Kang HJ, Jang YJ. Incidence and Characteristics of Multiple Primary Cancers: A 20-Year Retrospective Study of a Single Cancer Center in Korea. Cancers (Basel) 2024; 16:2346. [PMID: 39001408 PMCID: PMC11240339 DOI: 10.3390/cancers16132346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 06/20/2024] [Accepted: 06/24/2024] [Indexed: 07/16/2024] Open
Abstract
Rising cancer survival rates have led to an increased risk of multiple primary cancers (MPCs). Data on MPCs in South Korea are limited. This study aimed to address incidence and clinical characteristics of MPCs in a single cancer center in Korea during a 20-year period. We retrospectively analyzed 96,174 cancer patients at the Korea Cancer Center Hospital between 2003 and 2022, identifying 2167 patients with metachronous MPCs based on Surveillance, Epidemiology, and End Results SEER criteria. We categorized patients by cancer type (15 major solid cancer groups and 3 major hematologic cancer groups), including pathological diagnosis, assessed latency periods, and relative risks (RRs) for developing MPCs. The overall MPC incidence was 2.3%. Breast cancer (15.7%) was the most common primary cancer, and lung cancer (15.2%) was the most frequent second primary cancer. The median latency period for second primary cancers was 4.1 years. Decreasing latency periods for third and fourth primary cancers were observed (2.1 years and 1.6 years, respectively). Most cancers maintained their dominant pathological type despite notable changes in the prevalence of specific pathologies for certain types of second primaries. Lymphoma showed the highest RR (2.1) for developing MPCs. Significant associations were found between specific primary and subsequent cancers, including breast-ovary, thyroid-breast, stomach-pancreas, colorectal-head and neck, lung-prostate, and lymphoma-myeloid neoplasms. These findings contribute to a better understanding of MPC occurrence. They can inform future research on their etiology and development of improved management strategies.
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Affiliation(s)
- Jin-Hee Kwon
- Medical Science Demonstration Center, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul 01812, Republic of Korea
| | - Heyjin Kim
- Medical Science Demonstration Center, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul 01812, Republic of Korea
- Department of Laboratory Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul 01812, Republic of Korea
| | - Jin Kyung Lee
- Department of Laboratory Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul 01812, Republic of Korea
| | - Young Jun Hong
- Department of Laboratory Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul 01812, Republic of Korea
| | - Hye Jin Kang
- Division of Hematology-Oncology, Department of Internal Medicine, Korea Cancer Center Hospital, Seoul 01812, Republic of Korea
| | - Yoon Jung Jang
- Division of Hematology-Oncology, Department of Internal Medicine, Korea Cancer Center Hospital, Seoul 01812, Republic of Korea
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5
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Raoof S, Kurzrock R. Turning the Knobs on Screening Liquid Biopsies for High-Risk Populations: Potential for Dialing Down Invasive Procedures. J Clin Oncol 2024:JCO2302665. [PMID: 38905582 DOI: 10.1200/jco.23.02665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 04/14/2024] [Accepted: 04/22/2024] [Indexed: 06/23/2024] Open
Affiliation(s)
- Sana Raoof
- Memorial Sloan Kettering Cancer Center, New York, NY
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6
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Krieg A, Krieg S, Al Natour OMS, Brünjes S, Schott M, Kostev K. Risk of Lymphoma and Leukemia in Thyroid Cancer Patients: A Retrospective Cohort Study in Germany. Horm Metab Res 2024. [PMID: 38870986 DOI: 10.1055/a-2319-4179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
Thyroid cancer is the ninth most common cancer worldwide. While differentiated thyroid cancer (DTC) has a high survival rate, concerns arise regarding optimal treatment strategies and potential long-term risks, including second primary malignancies (SPMs), associated with therapies such as radioiodine (RAI). The aim of the present study was to investigate the association between thyroid cancer and the incidence of subsequent lymphoma and leukemia in Germany. This retrospective cohort study used the IQVIA TM Disease Analyzer database and included adults with a first documented diagnosis of thyroid cancer between January 2005 and December 2021 as well as propensity score matched individuals without thyroid cancer in 1284 general practices. Univariate Cox regression models were performed to examine the association between thyroid cancer and the incidence of subsequent lymphoma and leukemia. A total of 4232 thyroid cancer patients (mean age: 54.2 years; 73.6% female) and 21 160 controls (mean age: 54.2 years; 72.6% female) were available for analyses. Thyroid cancer was significantly associated with a higher lymphoma incidence (HR: 3.35, 95% CI: 2.04-5.52), especially in men (HR: 5.37) and those aged 61-70 years. Leukemia incidence was not significantly associated with thyroid cancer (HR: 1.79, 95% CI: 0.91-3.53), although associations were notable in younger age groups. Thyroid cancer is positively associated with a risk of subsequent lymphoma, highlighting the need for vigilant surveillance and tailored treatment strategies. While the association with leukemia is less pronounced, close surveillance remains critical, especially in younger patients.
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Affiliation(s)
- Andreas Krieg
- Department of General and Visceral Surgery, Thoracic Surgery and Proctology, University Hospital Herford, Medical Campus OWL, Ruhr University Bochum, Herford, Germany
| | - Sarah Krieg
- Department of Inclusive Medicine, University Hospital Ostwestfalen-Lippe, Bielefeld University, Bielefeld, Germany
| | - Omar M S Al Natour
- Department of General and Visceral Surgery, Thoracic Surgery and Proctology, University Hospital Herford, Medical Campus OWL, Ruhr University Bochum, Herford, Germany
| | - Stephanie Brünjes
- Department of General and Visceral Surgery, Thoracic Surgery and Proctology, University Hospital Herford, Medical Campus OWL, Ruhr University Bochum, Herford, Germany
| | - Matthias Schott
- Division for Specific Endocrinology, Medical Faculty Heinrich-Heine-University and University Hospital Duesseldorf, Duesseldorf, Germany
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Diao Y, Wang R, Cui J, Jin C, Chen Y, Li X. Risk factors for secondary thyroid cancer in patients with breast cancer: a propensity‑matched SEER analysis. Sci Rep 2024; 14:12679. [PMID: 38830880 PMCID: PMC11148100 DOI: 10.1038/s41598-024-59209-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 04/08/2024] [Indexed: 06/05/2024] Open
Abstract
With the rapid development of imaging technology and comprehensive treatment in modern medicine, the early diagnosis rate of breast cancer is constantly improving, and the prognosis is also improving; As breast cancer patients survive longer, the risk of developing second primary cancers increases. Since both breast and thyroid are Hormone receptor sensitive organs, which are regulated by hypothalamus pituitary target gland endocrine axis, changes in body endocrine status may lead to the occurrence of these two diseases in succession or simultaneously. This study extracted clinical data and survival outcomes of breast cancer patients registered in the Surveillance, Epidemiology and End Results (SEER) database between 2010 and 2019. After matching the case and controls with propensity scores, the selected patients were randomly split into training and test datasets at a ratio of 7:3. Univariate and multivariate COX proportional regression analysis is used to determine independent risk factors for secondary thyroid cancer and construct a column chart prediction model. Age, ethnicity, whether radiotherapy, tumor primary location, N stage, M stage were identified by Cox regression as independent factors affecting secondary thyroid cancer in patients with breast cancer patients, and a risk factor nomogram was established to predict patients' 3 and 5 year survival probabilities. The AUC values for 3 and 5 years in the training set were 0.713, 0.707, and the c-index was 0.693 (95% CI 0.67144, 0.71456), and the AUC values for 3 and 5 years in the validation set were 0.681, 0.681, and the c-index was 0.673 (95% CI 0.64164, 0.70436), respectively.
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Affiliation(s)
- Yizhuo Diao
- Department of Epidemiology and Health Statistics, Dalian Medical University, 9 Lvshun South Road, Dalian, 116044, Liaoning, China
| | - Ruiqi Wang
- Department of Epidemiology and Health Statistics, Dalian Medical University, 9 Lvshun South Road, Dalian, 116044, Liaoning, China
| | - Jiaxue Cui
- Department of Epidemiology and Health Statistics, Dalian Medical University, 9 Lvshun South Road, Dalian, 116044, Liaoning, China
| | - Chenxin Jin
- Department of Epidemiology and Health Statistics, Dalian Medical University, 9 Lvshun South Road, Dalian, 116044, Liaoning, China
| | - Yongxing Chen
- Department of Epidemiology and Health Statistics, Dalian Medical University, 9 Lvshun South Road, Dalian, 116044, Liaoning, China
| | - Xiaofeng Li
- Department of Epidemiology and Health Statistics, Dalian Medical University, 9 Lvshun South Road, Dalian, 116044, Liaoning, China.
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8
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Tsai MH, Bevel MS, Andrzejak SE, Moore JX. Receipt of follow-up care plans on colorectal cancer screening among breast, prostate, and lung cancer survivors. J Cancer Surviv 2024; 18:781-790. [PMID: 36574189 PMCID: PMC10293471 DOI: 10.1007/s11764-022-01309-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 11/28/2022] [Indexed: 12/28/2022]
Abstract
PURPOSE Our study aimed to examine whether receipt of follow-up care plans is associated with greater guideline-concordant CRC screening stratified by breast, prostate, and lung cancer survivors. METHODS We used data from years 2016, 2018, and 2020 of the Behavioral Risk Factor Surveillance System on 3339 eligible treatment-utilizing cancer survivors with complete treatment. We performed descriptive statistics and multivariable logistic regression to examine the mentioned association. RESULTS We observed that 83.9% of breast and 88.2% of prostate cancer survivors with follow-care plans received CRC screening (p-value < 0.001). The lowest CRC screening use was observed among lung cancer (70.8%). In multivariable analysis, receipt of follow-up care plans was strongly associated with greater odds of receiving CRC screening in breast (OR, 2.67; 95% CI: 1.71-4.16) and prostate (OR, 3.81; 95% CI: 2.30-6.31) cancer survivors. Regardless of provider type, 84 to 88% reduced likelihood of receipt of CRC screening when they received follow-up care plans among lung cancer survivors. Among those without follow-up care plans, breast (OR, 0.29; 95% CI: 0.09-0.92) and lung (OR, 0.05; 95% CI: 0.01-0.25) cancer survivors who received care from general practices were less likely to receive CRC screening compared to those who received care from non-general practices. CONCLUSIONS Receipt of follow-up care plans was associated with greater CRC screening use in breast and prostate cancers. Lung cancer survivors demonstrated lower screening use despite receipt of follow-up care plans. IMPLICATION FOR CANCER SURVIVORS Patient and provider communication regarding CRC screening recommendation should be included in their follow-up care plans.
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Affiliation(s)
- Meng-Han Tsai
- Cancer Prevention, Control, & Population Health Program, Georgia Cancer Center, Department of Medicine, Medical College of Georgia, Augusta University, 1410 Laney Walker Boulevard CN-2116, Augusta, GA, 30912, USA.
- Georgia Prevention Institute, Augusta University, 1457 Walton Way, Augusta, GA, 30901, USA.
| | - Malcolm S Bevel
- Cancer Prevention, Control, & Population Health Program, Georgia Cancer Center, Department of Medicine, Medical College of Georgia, Augusta University, 1410 Laney Walker Boulevard CN-2116, Augusta, GA, 30912, USA
| | - Sydney E Andrzejak
- Cancer Prevention, Control, & Population Health Program, Georgia Cancer Center, Department of Medicine, Medical College of Georgia, Augusta University, 1410 Laney Walker Boulevard CN-2116, Augusta, GA, 30912, USA
| | - Justin X Moore
- Cancer Prevention, Control, & Population Health Program, Georgia Cancer Center, Department of Medicine, Medical College of Georgia, Augusta University, 1410 Laney Walker Boulevard CN-2116, Augusta, GA, 30912, USA
- Institute of Public and Preventive Health, Augusta University, 1120 15Th Street, Augusta, GA, 30912, USA
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Jhala K, Byrne SC, Hammer MM. Interpreting Lung Cancer Screening CTs: Practical Approach to Lung Cancer Screening and Application of Lung-RADS. Clin Chest Med 2024; 45:279-293. [PMID: 38816088 DOI: 10.1016/j.ccm.2023.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
Lung cancer screening via low-dose computed tomography (CT) reduces mortality from lung cancer, and eligibility criteria have recently been expanded to include patients aged 50 to 80 with at least 20 pack-years of smoking history. Lung cancer screening CTs should be interepreted with use of Lung Imaging Reporting and Data System (Lung-RADS), a reporting guideline system that accounts for nodule size, density, and growth. The revised version of Lung-RADS includes several important changes, such as expansion of the definition of juxtapleural nodules, discussion of atypical pulmonary cysts, and stepped management for suspicious nodules. By using Lung-RADS, radiologists and clinicians can adopt a uniform approach to nodules detected during CT lung cancer screening and reduce false positives.
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Affiliation(s)
- Khushboo Jhala
- Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02215, USA
| | - Suzanne C Byrne
- Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02215, USA
| | - Mark M Hammer
- Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02215, USA.
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10
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Watt KD, Rolak S, Foley DP, Plichta JK, Pruthi S, Farr D, Zwald FO, Carvajal RD, Dudek AZ, Sanger CB, Rocco R, Chang GJ, Dizon DS, Langstraat CL, Teoh D, Agarwal PK, Al-Qaoud T, Eggener S, Kennedy CC, D'Cunha J, Mohindra NA, Stewart S, Habermann TH, Schuster S, Lunning M, Shah NN, Gertz MA, Mehta J, Suvannasankha A, Verna E, Farr M, Blosser CD, Hammel L, Al-Adra DP. Cancer Surveillance in Solid Organ Transplant Recipients With a Pretransplant History of Malignancy: Multidisciplinary Collaborative Expert Opinion. Transplantation 2024:00007890-990000000-00757. [PMID: 38771067 DOI: 10.1097/tp.0000000000005056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
With improved medical treatments, the prognosis for many malignancies has improved, and more patients are presenting for transplant evaluation with a history of treated cancer. Solid organ transplant (SOT) recipients with a prior malignancy are at higher risk of posttransplant recurrence or de novo malignancy, and they may require a cancer surveillance program that is individualized to their specific needs. There is a dearth of literature on optimal surveillance strategies specific to SOT recipients. A working group of transplant physicians and cancer-specific specialists met to provide expert opinion recommendations on optimal cancer surveillance after transplantation for patients with a history of malignancy. Surveillance strategies provided are mainly based on general population recurrence risk data, immunosuppression effects, and limited transplant-specific data and should be considered expert opinion based on current knowledge. Prospective studies of cancer-specific surveillance models in SOT recipients should be supported to inform posttransplant management of this high-risk population.
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Affiliation(s)
| | - Stacey Rolak
- Department of Medicine, Mayo Clinic, Rochester, MN
| | - David P Foley
- Department of Surgery, University of Wisconsin, Madison, WI
| | | | | | - Deborah Farr
- Department of Surgery, University of Texas Southwestern, Dallas, TX
| | - Fiona O Zwald
- Department of Dermatology, Colorado University School of Medicine, Aurora, CO
| | - Richard D Carvajal
- Department of Medicine, Northwell Health Cancer Institute, Lake Success, NY
| | | | - Cristina B Sanger
- Department of Surgery, University of Wisconsin, Madison, WI
- Department of Surgery, William S.Middleton Memorial Veteran's Hospital, Madison, WI
| | - Ricciardi Rocco
- Department of Surgery, Massachusetts General Hospital, Boston MA
| | - George J Chang
- Department of Colon and Rectal Surgery, University of Texas, MD Anderson Cancer Center, Dallas, TX
| | - Don S Dizon
- Department of Medicine, Lifespan Cancer Institute and Brown University, Providence, RI
| | | | - Deanna Teoh
- Department of Obstetrics and Gynecology and Women's Health, University of Minnesota, Minneapolis, MN
| | - Piyush K Agarwal
- Department of Surgery, Section of Urology, University of Chicago, Chicago, IL
| | - Talal Al-Qaoud
- Department of Surgery, Medstar Georgetown Transplant Institute, Georgetown University Hospital, Washington DC
| | - Scott Eggener
- Department of Surgery, Section of Urology, University of Chicago, Chicago, IL
| | | | | | - Nisha A Mohindra
- Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Shelby Stewart
- Department of Thoracic Surgery, University of Maryland, Baltimore, MD
| | | | - Stephen Schuster
- Department of Medicine, Lymphoma Program, Abraham Cancer Center, University of Pennsylvania, Philadelphia, PA
| | - Matthew Lunning
- Department of Medicine, University of Nebraska Medical Center, Omaha, NE
| | - Nirav N Shah
- Department of Medicine, Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI
| | | | - Jayesh Mehta
- Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Attaya Suvannasankha
- Department of Medicine, Indiana University School of Medicine and Roudebush VAMC, Indianapolis, IN
| | | | - Maryjane Farr
- Department of Medicine, University of Texas Southwestern Medical Center, Dallas, TX
| | - Christopher D Blosser
- Department of Medicine, University of Washington and Seattle Children's Hospital, Seattle WA
| | - Laura Hammel
- Department of Anesthesiology, University of Wisconsin, Madison, WI
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11
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McGuire V, Lichtensztajn DY, Tao L, Yang J, Clarke CA, Wu AH, Wilkens L, Glaser SL, Park SL, Cheng I. Variation in patterns of second primary malignancies across U.S. race and ethnicity groups: a Surveillance, Epidemiology, and End Results (SEER) analysis. Cancer Causes Control 2024; 35:799-815. [PMID: 38206498 DOI: 10.1007/s10552-023-01836-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 11/25/2023] [Indexed: 01/12/2024]
Abstract
PURPOSE One in six incident cancers in the U.S. is a second primary cancer (SPC). Although primary cancers vary considerably by race and ethnicity, little is known about the population-based occurrence of SPC across these groups. METHODS Using Surveillance, Epidemiology, and End Results (SEER) 12 data and relative to the general population, we calculated standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) for SPC among 2,457,756 Hispanics, non-Hispanic Asian American/Pacific Islanders (NHAAPI), non-Hispanic black (NHB), and non-Hispanic whites (NHW) cancer survivors aged 45 years or older when diagnosed with a first primary cancer (FPC) from 1992 to 2015. RESULTS The risk of second primary bladder cancer after first primary prostate cancer was higher than expected in Hispanic (SIR = 1.18, 95% CI: 1.01-1.38) and NHAAPI (SIR = 1.41, 95% CI: 1.20-1.65) men than NHB and NHW men. Among women with a primary breast cancer, Hispanic, NHAAPI, and NHB women had a nearly 1.5-fold higher risk of a second primary breast cancer, while NHW women had a 6% lower risk. Among men with prostate cancer whose SPC was diagnosed 2 to <12 months, NHB men were at higher risk for colorectal cancer and Hispanic and NHW men for non-Hodgkin's lymphoma. In the same time frame for breast cancer survivors, Hispanic and NHAAPI women were significantly more likely than NHB and NHW women to be diagnosed with a second primary lung cancer. CONCLUSION Future studies of SPC should investigate the role of shared etiologies, stage of diagnosis, treatment, and lifestyle factors after cancer survival across different racial and ethnic populations.
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Affiliation(s)
- Valerie McGuire
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, 94158-2549, USA.
| | - Daphne Y Lichtensztajn
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, 94158-2549, USA
- Greater Bay Area Cancer Registry, Cancer Prevention Institute of California, Fremont, CA, USA
| | - Li Tao
- Greater Bay Area Cancer Registry, Cancer Prevention Institute of California, Fremont, CA, USA
| | - Juan Yang
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, 94158-2549, USA
- Greater Bay Area Cancer Registry, Cancer Prevention Institute of California, Fremont, CA, USA
| | - Christina A Clarke
- Greater Bay Area Cancer Registry, Cancer Prevention Institute of California, Fremont, CA, USA
| | - Anna H Wu
- Department of Population and Public Health Science, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Lynne Wilkens
- Epidemiology Program, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Sally L Glaser
- Greater Bay Area Cancer Registry, Cancer Prevention Institute of California, Fremont, CA, USA
| | | | - Iona Cheng
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, 94158-2549, USA
- Greater Bay Area Cancer Registry, Cancer Prevention Institute of California, Fremont, CA, USA
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12
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Thakur N, Kaur H, Sudan M, Jain N. Clinicopathological analysis of patients with dual malignancies: A retrospective study. J Cancer Res Ther 2024; 20:822-826. [PMID: 39023589 DOI: 10.4103/jcrt.jcrt_2321_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 12/08/2022] [Indexed: 07/20/2024]
Abstract
BACKGROUND This study aims to report the increasing incidence of second primary malignancies to better understand the association of multiple primary cancers and the duration of their occurrence. Keeping in view the current trends in dual malignancies and to further emphasize the importance of screening and follow-up diagnosis, we reviewed the records of patients who were diagnosed with dual malignancies. MATERIAL AND METHODS This is a retrospective observational study. We collected data from the hospital database, of patients presenting with either histologically proven synchronous or metachronous double primaries between January 1, 2017, and December 31, 2021. The time interval to differentiate between synchronous and metachronous has been taken as 6 months. RESULTS During the period of five years, twenty-three patients presented with dual malignancy. Out of 23 cases, seven were synchronous (30.43%), and 16 were metachronous (69.56%). In the synchronous malignancy group, the most common site of first and second primary malignancy was breast [5 cases (71.4%) and 3 cases (42.8%), respectively]. In the metachronous malignancy group, the most common site of the first primary was breast (7 cases; 43.75%), followed by the head and neck (4 cases; 25%), and the most common site of the second primary was also the breast (6 cases; 37.5%), followed by the lung (5 cases; 31.25%). CONCLUSION Second primary malignancies are not rare and can occur at any age. Regular follow-up and screening procedures by the treating oncologist can play a major role in early detection followed by appropriate treatment of second primary tumors.
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Affiliation(s)
- Niketa Thakur
- Department of Radiation Oncology, SGRD Institute of Medical Sciences and Research, Amritsar, Punjab, India
| | - Harkirat Kaur
- Department of Radiation Oncology, Patel Hospital, Civil Lines, Jalandhar, Punjab, India
| | - Meena Sudan
- Department of Radiation Oncology, SGRD Institute of Medical Sciences and Research, Amritsar, Punjab, India
| | - Neeraj Jain
- Department of Radiation Oncology, SGRD Institute of Medical Sciences and Research, Amritsar, Punjab, India
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13
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Yu N, Zhang W, Zhong X, Song X, Li W. Incidence and survival of second primary non-Hodgkin lymphoma: A Surveillance, Epidemiology, and End Results-based cohort study. PLoS One 2024; 19:e0300330. [PMID: 38466704 PMCID: PMC10927152 DOI: 10.1371/journal.pone.0300330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 02/26/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND The aim of this study was to investigate patient survival and factors associated with survival in second primary non-Hodgkin lymphoma (NHL) compared with the first primary NHL. METHODS The retrospective cohort study used data from the Surveillance, Epidemiology, and End Results (SEER) database between 2000 and 2014. Demographic characteristics, histological types, Ann Arbor stage, and treatment information were collected. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for factors associated with overall survival (OS) and cancer-specific survival (CSS) in the first and second primary NHLs. RESULTS Of 318,168 cases followed for 5 years, 299,248 patients developed the first primary NHL and 18,920 patients developed the second primary NHL. This study identified a rising incidence of first and second primary NHL from 2000 to 2014. For the second primary NHL, the OS risk was higher when compared to the first primary NHL (HR: 1.13, 95% CI: 1.11 to 1.15, P <0.001). Risk factors that negatively affected OS in the first primary NHL included being male, over 40 years of age, certain marital statuses, specific histological types, and advanced disease stages. In contrast, being of White race and having histological types such as Follicular Lymphoma (FL), Marginal Zone Lymphoma (MZL), and mantle B-cell NHL were associated with better OS outcomes. Treatments like surgery, radiation therapy, and chemotherapy were associated with a lower risk of OS and CSS in the first primary NHL. For the second primary NHL, the detrimental risk factors were similar but also included being over the age of 60. Certain histological types showed a lower OS risk relative to diffuse Large B-cell Lymphoma (DLBCL). While surgery and chemotherapy were beneficial for OS, radiation therapy did not improve survival in second primary NHL cases. Notably, undergoing chemotherapy for the first primary cancer increased the OS risk in the second primary NHL, whereas surgery and radiation seemed to offer a protective effect against OS risk in the second primary NHL (all P <0.05). CONCLUSION Our findings emphasize the need for tailored strategies in managing the second primary NHL, given the distinct survival patterns and risk factor profiles compared to the first primary NHL. Future research should aim to further elucidate these differences to improve prognosis and treatment approaches for second primary NHL patients.
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Affiliation(s)
- Nasha Yu
- Departments of Lymphatic and Hematological Oncology, Jiangxi Cancer Hospital (The Second Affiliated Hospital of Nanchang Medical College), Nanchang, Jiangxi, P.R. China
| | - Weiming Zhang
- Departments of Lymphatic and Hematological Oncology, Jiangxi Cancer Hospital (The Second Affiliated Hospital of Nanchang Medical College), Nanchang, Jiangxi, P.R. China
| | - Xing Zhong
- Departments of Lymphatic and Hematological Oncology, Jiangxi Cancer Hospital (The Second Affiliated Hospital of Nanchang Medical College), Nanchang, Jiangxi, P.R. China
| | - Xiangxiang Song
- Departments of Lymphatic and Hematological Oncology, Jiangxi Cancer Hospital (The Second Affiliated Hospital of Nanchang Medical College), Nanchang, Jiangxi, P.R. China
| | - Wuping Li
- Departments of Lymphatic and Hematological Oncology, Jiangxi Cancer Hospital (The Second Affiliated Hospital of Nanchang Medical College), Nanchang, Jiangxi, P.R. China
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Raje P, Sonal S, Boudreau C, Kunitake H, Goldstone RN, Bordeianou LG, Cauley CE, Francone TD, Ricciardi R, Lee GC, Berger DL. Incidence of Secondary Cancers After Neoadjuvant Therapy for Locally Advanced Rectal Cancer. J Surg Res 2024; 295:268-273. [PMID: 38048750 PMCID: PMC11010235 DOI: 10.1016/j.jss.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 09/20/2023] [Accepted: 11/08/2023] [Indexed: 12/06/2023]
Abstract
INTRODUCTION Whether neoadjuvant chemoradiation for locally advanced rectal cancer (LARC) induces secondary cancers is controversial. This retrospective cohort study describes the incidence of secondary cancers in LARC patients. METHODS We compared 364 LARC patients who received conventional (50.4 Gy) or short course neoadjuvant radiation (25 Gy x 5 fractions) followed by resection to 142 patients with surgically resected rectal cancer who did not receive radiation at a single institution from 2004 to 2018. Secondary cancer was defined as any nonmetastatic noncolorectal malignancy diagnosed via biopsy or definitive imaging criteria at least 6 mo after completion of neoadjuvant therapy or after resection in the comparison group. RESULTS Among the neoadjuvant radiation group (364 patients, 40% female, age 61 ± 13 y), 32 patients developed 34 (9.3%) secondary cancers. Three cases involved a pelvic organ. Among the comparison group (142 patients, 39% female, age 64 ± 15 y), 15 patients (10.6%) developed a secondary cancer. Five cases involved pelvic organs. Secondary cancer incidence did not differ between groups. Latency period to secondary cancer diagnosis was 6.7 ± 4.3 y. Patients who received radiation underwent longer median follow-up (6.8 versus 4.5 y, P < 0.01) and were significantly less likely to develop a pelvic organ cancer (odds ratio 0.18; 95% confidence interval, 0.04-0.83; P = 0.02). No genetic mutations or cancer syndromes were identified among patients with secondary cancers. CONCLUSIONS Neoadjuvant chemoradiation is not associated with increased secondary cancer risk in LARC patients and may have a local protective effect on pelvic organs, especially prostate. Ongoing follow-up is critical to continue risk assessment.
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Affiliation(s)
- Praachi Raje
- Division of Gastrointestinal and Oncologic Surgery, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
| | - Swati Sonal
- Division of Gastrointestinal and Oncologic Surgery, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Chloe Boudreau
- Division of Gastrointestinal and Oncologic Surgery, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Hiroko Kunitake
- Division of Gastrointestinal and Oncologic Surgery, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Robert N Goldstone
- Division of Gastrointestinal and Oncologic Surgery, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Liliana G Bordeianou
- Division of Gastrointestinal and Oncologic Surgery, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Christy E Cauley
- Division of Gastrointestinal and Oncologic Surgery, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Todd D Francone
- Division of Gastrointestinal and Oncologic Surgery, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Rocco Ricciardi
- Division of Gastrointestinal and Oncologic Surgery, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Grace C Lee
- Division of Gastrointestinal and Oncologic Surgery, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - David L Berger
- Division of Gastrointestinal and Oncologic Surgery, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
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Ebad Ur Rehman M, Faraz F, Cheema HA, Ashruf OS, Raheel H, Naqvi SZA, Jabeen N, Abid A, Mumtaz Malik H, Iftikhar A, Ibrahim A, Swed S. Impact of prior cancer history on survival in brain malignancy: A propensity score-adjusted, population-based study. Cancer Rep (Hoboken) 2024; 7:e1984. [PMID: 38389401 PMCID: PMC10884616 DOI: 10.1002/cnr2.1984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 12/06/2023] [Accepted: 01/08/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Individuals with a Prior Cancer History (PCH) are often excluded from clinical trials. However, a growing body of evidence suggests that prior cancer history does not present adverse outcomes on cancer patients. The evidence on the survival of brain cancer patients in this regard remains widely unknown. METHODS We conducted a retrospective cohort study to estimate the prevalence and impact of prior cancer on survival of patients diagnosed with brain cancer. Data of patients who were diagnosed with brain cancer as their first or second primary malignancy between 2000 and 2019 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Propensity Score Matching (PSM) was used to ensure comparable baseline characteristics among the patients. Survival analysis was conducted using the Kaplan-Meier method, as well as multivariate Cox proportional hazard and multivariate competing risk models. RESULTS Out of 42 726 patients, 1189 (2.78%) had PCH. Genitourinary (40.4%), Breast (13.6%), Hematologic and Lymphatic (11.4%), and Gastrointestinal malignancies (11.3%) were the most common types of prior cancer. PCH served as a significant risk factor for Overall Survival (OS) (Adjusted Hazard Ratio [AHR] 1.26; 95% CI [1.15-1.39]; p < .001) but did not have a statistically significant impact on Brain Cancer-Specific Survival (BCSS) (AHR 0.97; 95% CI [0.88-1.07]; p = .54). Glioblastoma exhibited the most substantial and statistically significant impact on survival as compared to other histological types. Of all the organs systems, only prior Gastrointestinal and Hematologic and Lymphatic malignancies had a statistically significant impact on OS of patients. CONCLUSION Our findings indicate that PCH does not exert a substantial impact on the survival of brain cancer patients, except in cases involving gastrointestinal or hematologic and lymphatic PCH, or when the brain cancer is glioblastoma.
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Affiliation(s)
| | - Fatima Faraz
- Department of MedicineRawalpindi Medical UniversityRawalpindiPakistan
| | | | - Omer S. Ashruf
- Department of Internal MedicineNortheast Ohio Medical UniversityRootstownOhioUSA
| | - Hamna Raheel
- Department of MedicineDow University of Health SciencesKarachiPakistan
| | | | - Nimrah Jabeen
- Department of MedicineRawalpindi Medical UniversityRawalpindiPakistan
| | - Areesha Abid
- Department of MedicineRawalpindi Medical UniversityRawalpindiPakistan
| | | | - Ahmad Iftikhar
- Department of MedicineThe University of ArizonaTucsonArizonaUSA
| | | | - Sarya Swed
- Faculty of MedicineUniversity of AleppoAleppoSyria
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16
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Aguiar-Bujanda D, Croissier-Sánchez L, Pérez-Cabrera D, Galván-Ruiz S. Second Hematologic Malignancies Associated With Primary Mediastinal Germ Cell Tumors: A Population-based Study. Am J Clin Oncol 2024; 47:58-63. [PMID: 37853566 DOI: 10.1097/coc.0000000000001061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
BACKGROUND Studies addressing second hematologic malignancies (SHMs) in patients with primary mediastinal germ cell tumors (PMGCTs) are scarce. To better describe this phenomenon, we analyzed a large case series from a population-based registry. METHODS The Surveillance, Epidemiology, and End Results database was used to report the clinical characteristics and incidence of SHMs in patients with PMGCT. RESULTS Among 1297 PMGCTs, 27 cases (2.08%) of SHM were found, with a median latency period of 12 months (95% CI: 5-41). All SHM occurred in males, 20 of whom (74.1%) had a previous nonseminomatous tumor. Acute myeloid leukemia was the most frequent SHM, accounting for 13 cases, 4 of which were acute megakaryoblastic leukemia that occurred within 5 months of diagnosis. The median survival after the diagnosis of SHM was 6 months (95% CI: 2-41). The risk of SHM was significantly higher than expected for the reference population, with a standardized incidence ratio of 6.21 (95% CI: 3.31-10.62) and an absolute excess risk of 19.19 per 10,000 person-years. CONCLUSIONS Patients with PMGCT are at a higher risk of developing SHMs than the general population, particularly acute myeloid leukemia. This risk ranges from synchronous diagnosis of acute megakaryoblastic leukemia to the later onset of other hematological disorders that might be related to PMGCT therapies. Our findings may help create follow-up schedules for patients with PMGCT and raise the level of suspicion surrounding this association.
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Affiliation(s)
- David Aguiar-Bujanda
- Department of Medical Oncology, Hospital Universitario de Gran Canaria Dr Negrín, Las Palmas de Gran Canaria, Spain
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Ivan VS, Lighezan DF, Ardelean M, Balteș N, Faur AC, Ciubotaru PG, Cutina-Morgovan AF, Buzaș R. What to Do When There Is Something Unexpected? Life (Basel) 2024; 14:213. [PMID: 38398722 PMCID: PMC10890187 DOI: 10.3390/life14020213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/10/2024] [Accepted: 01/29/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Myocardial infarction is currently the leading cause of death worldwide, followed by malignant neoplasms. The presence of both within the same patient obviously increases the risk of death, as many coronary events are detected in patients diagnosed with cancer. Diagnosis of an occult digestive cancer in the acute phase of myocardial infarction is most frequently prompted by a hemorrhagic complication. CASE SUMMARY This case features an 81-year-old male patient diagnosed with acute myocardial infarction, treated with primary percutaneous intervention (PCI), who developed post-stenting hemorrhagic complications in the first 24 h due to the presence of two different concomitant malignant neoplasms. The outcome was favorable in the acute phase, even if de-escalation therapy was given immediately post-stenting, and intrastent residual thrombotic risk was high. CONCLUSIONS The presence of bleeding complications in patients with acute myocardial infarction should mobilize resources in search of a neoplastic cause, especially a digestive one. However, other locations should be looked for, depending on the source of bleeding.
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Affiliation(s)
- Vlad Sabin Ivan
- Department of Internal Medicine I, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania; (V.S.I.); (D.-F.L.); (M.A.); (A.-F.C.-M.); (R.B.)
- Center for Advanced Research in Cardiovascular Pathology and Hemostaseology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Daniel-Florin Lighezan
- Department of Internal Medicine I, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania; (V.S.I.); (D.-F.L.); (M.A.); (A.-F.C.-M.); (R.B.)
- Center for Advanced Research in Cardiovascular Pathology and Hemostaseology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Melania Ardelean
- Department of Internal Medicine I, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania; (V.S.I.); (D.-F.L.); (M.A.); (A.-F.C.-M.); (R.B.)
- Center for Advanced Research in Cardiovascular Pathology and Hemostaseology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Nicoleta Balteș
- Gastroenterology Unit, Emergency Clinical Municipal Hospital, 300079 Timișoara, Romania;
| | - Alexandra Corina Faur
- Department of Anatomy and Embriology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania;
| | - Paul-Gabriel Ciubotaru
- Department of Internal Medicine I, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania; (V.S.I.); (D.-F.L.); (M.A.); (A.-F.C.-M.); (R.B.)
- Center for Advanced Research in Cardiovascular Pathology and Hemostaseology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Adina-Flavia Cutina-Morgovan
- Department of Internal Medicine I, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania; (V.S.I.); (D.-F.L.); (M.A.); (A.-F.C.-M.); (R.B.)
| | - Roxana Buzaș
- Department of Internal Medicine I, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania; (V.S.I.); (D.-F.L.); (M.A.); (A.-F.C.-M.); (R.B.)
- Center for Advanced Research in Cardiovascular Pathology and Hemostaseology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
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Zhang B, He L, Zhou C, Cheng X, Li Q, Tang Y, Li F, Huang T, Tu S. A pancancer analysis of the clinical and genomic characteristics of multiple primary cancers. Sci Rep 2024; 14:2367. [PMID: 38287125 PMCID: PMC10825147 DOI: 10.1038/s41598-024-52659-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 01/22/2024] [Indexed: 01/31/2024] Open
Abstract
Multiple primary cancer (MPC) denotes individuals with two or more malignant tumors occurring simultaneously or successively. Herein, a total of 11,000 pancancer patients in TCGA database (1993-2013) were divided into MPC or non-MPC groups based on their history of other malignant tumors. The incidence of MPC has risen to 8.5-13.1% since 2000. Elderly individuals, males, early-stage cancer patients, and African Americans and Caucasians are identified as independent risk factors (p < 0.0001). Non-MPC patients exhibit significantly longer overall survival (OS) and disease-free survival (DFS) (p = 0.0038 and p = 0.0014). Age (p < 0.001) and tumor staging at initial diagnosis (p < 0.001) contribute to this difference. In our center, MPC was identified in 380 out of 801 tumor events based on SEER criteria. The peak occurrence of secondary primary was about 1-5 years after the first primary tumor, with a second small peak around 10-15 years. Multiple tumors commonly occur in the same organ (e.g., breast and lung), constituting 12.6%. Certain cancer types, notably skin cutaneous melanoma (SKCM), exhibit significantly higher tumor mutational burden (TMB) in the MPC group (17.31 vs. 6.55 mutations/MB, p < 0.001), with high TMB associated with improved survival (p < 0.001). High TMB in MPC may serve as a predictor for potential immunotherapy application.
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Affiliation(s)
- Baiwen Zhang
- Department of Oncology, State Key Laboratory of Systems Medicine for Cancer, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lina He
- Department of Oncology, State Key Laboratory of Systems Medicine for Cancer, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Cong Zhou
- Department of Oncology, State Key Laboratory of Systems Medicine for Cancer, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaojiao Cheng
- Department of Oncology, State Key Laboratory of Systems Medicine for Cancer, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qingli Li
- Department of Oncology, State Key Laboratory of Systems Medicine for Cancer, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yao Tang
- Department of Oncology, State Key Laboratory of Systems Medicine for Cancer, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fuli Li
- Department of Oncology, State Key Laboratory of Systems Medicine for Cancer, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tinglei Huang
- Department of Oncology, State Key Laboratory of Systems Medicine for Cancer, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shuiping Tu
- Department of Oncology, State Key Laboratory of Systems Medicine for Cancer, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Zhao T, Jia W, Zhao C, Wu Z. Survival benefit of surgery for second primary esophageal cancer following gastrointestinal cancer: a population-based study. J Gastrointest Surg 2024; 28:1-9. [PMID: 38353068 DOI: 10.1016/j.gassur.2023.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 11/14/2023] [Indexed: 02/16/2024]
Abstract
BACKGROUND The incidence of second primary malignancy is increasing. However, although there is some information on second primary esophageal cancer (SPEC) itself, there is no study or guideline on the use of surgery for SPEC after gastrointestinal cancer (SPEC-GC). Thus, this study aimed to gather evidence for the benefits of surgery by analyzing a national cohort and determining the prognostic factors and clinical treatment decisions for SPEC-GC. METHODS Data for patients with SPEC-GC were obtained from the Surveillance, Epidemiology, and End Results (SEER) database between 2000 and 2019. The prognostic factors of SPEC-GC were investigated by stepwise Cox proportional hazards regression and Kaplan-Meier analyses for overall survival and cancer-specific survival. RESULTS A total of 8308 patients with SPEC were selected, including 582 patients with SPEC-GC. Multivariate analysis revealed that surgery, year of diagnosis, scope of regional lymph node surgery, tumor differentiation grade, SEER historic stage, and triple therapy were significant predictors of survival outcomes (P < .05). Surgery seemed to improve the prognosis of patients with SPEC-GC significantly compared with no surgery and chemoradiotherapy (P < .001). CONCLUSIONS Surgery should be considered as the main treatment for SPEC-GC. Surgery, year of diagnosis, scope of regional lymph node surgery, tumor differentiation grade, SEER historic stage, and triple therapy were found to be independent prognostic factors for these patients. These factors should be considered in the clinical diagnosis and treatment of SPEC-GC.
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Affiliation(s)
- Tianhao Zhao
- Department of Cardiothoracic Surgery, Lishui Municipal Central Hospital, Lishui, Zhejiang, China
| | - Wenxin Jia
- Department of Mental Health, The Second People's Hospital of Lishui, Lishui, Zhejiang, China
| | - Chun Zhao
- Department of Cardiothoracic Surgery, Lishui Municipal Central Hospital, Lishui, Zhejiang, China
| | - Zhijun Wu
- Department of Cardiothoracic Surgery, Lishui Municipal Central Hospital, Lishui, Zhejiang, China.
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Zhang F, Yu P, Xu L, Chen X, Du J. Differences of characteristics, influencing factors, and treatment effects on the survival in patients with first and second primary cervical cancer. Prev Med Rep 2023; 36:102504. [PMID: 38116255 PMCID: PMC10728444 DOI: 10.1016/j.pmedr.2023.102504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 11/06/2023] [Accepted: 11/07/2023] [Indexed: 12/21/2023] Open
Abstract
To explore the characteristics, influencing factors, and effect of different treatments on the survival in patients with first primary cervical cancer (CC) and second primary CC. Data of 33,934 eligible patients with CC were extracted from the Surveillance, Epidemiology, and End Results (SEER) database in 2004-2015. We also included 176 patients with CC from the Affiliated Dongyang Hospital of Wenzhou Medical University. Univariate and multivariate Cox proportional hazard models were used to screen the potential influencing factors associated with the survival in patients with hazard ratios (HRs) and 95 % confidence intervals (CIs). Subgroup analyses of age, American Joint Committee on Cancer (AJCC) stages, tumor grades and histologic types were conducted to explore the association between different treatments and survival in different populations. The 5-year mortality was 43.08 % for patients with first primary CC and that was 58.13 % for patients with second primary CC. We found that the relationships between age, histologic type, tumor grade, tumor size, AJCC tumor-node-metastasis (TNM) stage, surgery, chemotherapy, radiotherapy and the first primary CC and second primary CC were different (all P < 0.05). Additionally, the results of subgroup analyses indicated that the choice of surgery, chemotherapy, and radiotherapy should be adjusted according to the different health conditions of the patients. In conclusion, the causal relationship between characteristics, influencing factors, and treatments and survival in patients with primary CC diagnosed as different time periods are needed further exploration.
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Affiliation(s)
- Fan Zhang
- Department of Gynecology, Affiliated Dongyang Hospital of Wenzhou Medical University, Jinhua 322100, Zhejiang, PR China
| | - Ping Yu
- Department of Gynecology, Affiliated Dongyang Hospital of Wenzhou Medical University, Jinhua 322100, Zhejiang, PR China
| | - Lixia Xu
- Department of Gynecology, Affiliated Dongyang Hospital of Wenzhou Medical University, Jinhua 322100, Zhejiang, PR China
| | - Xuwei Chen
- Department of Gynecology, Affiliated Dongyang Hospital of Wenzhou Medical University, Jinhua 322100, Zhejiang, PR China
| | - Junqiang Du
- Department of Gynecology, Affiliated Dongyang Hospital of Wenzhou Medical University, Jinhua 322100, Zhejiang, PR China
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21
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Rogers LQ, Courneya KS, Oster RA, Anton PM, Phillips S, Ehlers DK, McAuley E. Physical activity intervention benefits persist months post-intervention: randomized trial in breast cancer survivors. J Cancer Surviv 2023; 17:1834-1846. [PMID: 36723801 DOI: 10.1007/s11764-022-01329-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 12/30/2022] [Indexed: 02/02/2023]
Abstract
PURPOSE Determine durable effects of the 3-month Better Exercise Adherence after Treatment for Cancer (BEAT Cancer) physical activity (PA) behavior change intervention 12 months post-baseline (i.e., 9 months after intervention completion). METHODS This 2-arm multicenter trial randomized 222 post-primary treatment breast cancer survivors to BEAT Cancer (individualized exercise and group education) vs. usual care (written materials). Assessments occurred at baseline, 3, 6, and 12 months, with the 12 months assessment reported here. Measures included PA (accelerometer, self-report), cardiorespiratory fitness, muscle strength, body mass index, Functional Assessment of Cancer Therapy (FACT), SF-36, fatigue, depression, anxiety, satisfaction with life, Pittsburgh Sleep Quality Index (PSQI), lower extremity joint dysfunction, and perceived memory. RESULTS Adjusted linear mixed-model analyses demonstrated statistically significant month 12 between-group differences favoring BEAT Cancer for weekly minutes of moderate-to-vigorous self-report PA (mean between-group difference (M) = 44; 95% confidence interval (CI) = 12 to 76; p = .001), fitness (M = 1.5 ml/kg/min; CI = 0.4 to 2.6; p = .01), FACT-General (M = 3.5; CI = 0.7 to 6.3; p = .014), FACT-Breast (M = 3.6; CI = 0.1 to 7.1; p = .044), social well-being (M = 1.3; CI = 0.1 to 2.5; p = .037), functional well-being (M = 1.2; CI = 0.2 to 2.3; p = .023), SF-36 vitality (M = 6.1; CI = 1.4 to 10.8; p = .011), fatigue (M = - 0.7; CI = - 1.1 to - 0.2; p = .004), satisfaction with life (M = 1.9; CI = 0.3 to 3.5; p = .019), sleep duration (M = - 0.2; CI = - 0.4 to - 0.03, p = .028), and memory (M = 1.1; CI = 0.2 to 2.1; p = .024). CONCLUSIONS A 3-month PA intervention resulted in statistically significant and clinically important benefits compared to usual care at 12 months. IMPLICATIONS FOR CANCER SURVIVORS Three months of individualized and group PA counseling causes benefits detectable 9 months later. TRIAL REGISTRATION ClinicalTrials.gov NCT00929617 ( https://clinicaltrials.gov/ct2/show/NCT00929617 ; registered June 29, 2009).
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Affiliation(s)
- Laura Q Rogers
- Department of Medicine, School of Medicine, University of Alabama at Birmingham, 1720 2nd Ave S, MT 614, AL, 35294-4410, Birmingham, USA.
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Robert A Oster
- Department of Medicine, School of Medicine, University of Alabama at Birmingham, 1720 2nd Ave S, MT 614, AL, 35294-4410, Birmingham, USA
| | - Philip M Anton
- Department of Kinesiology, Southern Illinois University Carbondale, Carbondale, IL, USA
| | - Siobhan Phillips
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Diane K Ehlers
- Department of Quantitative Health Sciences, Mayo Clinic, Phoenix, AZ, USA
| | - Edward McAuley
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Cancer Center at Illinois, University of Illinois at Urbana-Champaign, Urbana, IL, USA
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22
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Nolazco JI, Tang Y, Alkhatib KY, King AJ, Mossanen M, Chang SL. Smoking status among cancer patients by specialty: A U.S. nationwide representative analysis. Cancer Med 2023; 12:21389-21399. [PMID: 37986671 PMCID: PMC10726820 DOI: 10.1002/cam4.6684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/07/2023] [Accepted: 10/23/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Persistence in tobacco use among cancer survivors has been associated with a multitude of clinicodemographic factors. However, there is a paucity of understanding regarding the role the healthcare professional's specialty plays in tobacco cessation in tobacco-related cancer survivors. METHODS We conducted a cross-sectional analysis of data from cancer survivors with a smoking history using the Behavioral Risk Factor Surveillance System (BRFSS) database to examine differences in the proportion of patients continuing tobacco use among patients with a diagnosis of cancer segregated by cancer site specialty over the 2016-2020 period. We accounted for complex survey design and used sampling weights to obtain a nationwide representative sample. We employed modified Poisson regression adjusting for age, gender, education, income, race, marital status, and medical specialty. RESULTS We analyzed 19,855 cancer survivors with a current or past history of tobacco use, of whom 5222 (26,3%) self-reported to be current smokers. Patients with urological and gynecological tobacco-related malignancies had a higher relative risk (RR) of being current smokers with a RR of 1.30 (95% confidence interval, 1.12-1.51) and 1.25 (95% confidence interval, 1.12-1.39) respectively. Malignant Hematology had the lowest RR of smoking status among all other specialties RR 0.85 (95% confidence interval, 0.59-1.21). CONCLUSIONS Continuing smoking rates among tobacco-related cancer survivors were different between specialties. One in four cancer survivors were current smokers; this emphasizes health professionals' paramount role in tobacco cessation counseling.
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Affiliation(s)
- José Ignacio Nolazco
- Division of Urological SurgeryBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
- Servicio de Urología, Hospital Universitario Austral, Universidad AustralPilarArgentina
| | - Yuzhe Tang
- Division of Urological SurgeryBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
- Urology Department, Beijing Tsinghua Changgung Hospital School of Clinical MedicineTsinghua UniversityBeijingChina
| | - Khalid Y. Alkhatib
- Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
- Division of UrologyUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Andrew J. King
- Department of Health Care PolicyHarvard Medical SchoolBostonMassachusettsUSA
| | - Matthew Mossanen
- Division of Urological SurgeryBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
- Department of Radiation OncologyBrigham and Women's HospitalBostonMassachusettsUSA
| | - Steven Lee Chang
- Division of Urological SurgeryBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
- Lank Center for Genitourinary Oncology, Dana‐Farber Cancer InstituteBostonMassachusettsUSA
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23
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Wang H, Gong F, Kong W, Chen Y, Zhang J. Homologous recombination repair gene-based risk model predicts prognosis and immune microenvironment for primary lung cancer after previous malignancies. J Gene Med 2023; 25:e3533. [PMID: 37243581 DOI: 10.1002/jgm.3533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 04/22/2023] [Accepted: 05/01/2023] [Indexed: 05/29/2023] Open
Abstract
BACKGROUND Homologous recombination repair (HRR) plays an important role in cancer development, drug resistance, and immune escape, but the role of HRR genes in primary lung cancer (PLC) after previous malignancies is unclear. METHODS We used HRR-related score constrcted by HRR genes to classify patients into two groups and compared clinical progression, differential genes, and their functions between them. Then, we constructed a prognostic risk model based on HRR-related score and screened key differentially expressed genes. We evaluated the potential roles, mutational information, and immune correlations of key genes. Finally, we compared the long-term prognosis and immune correlations of different prognostic risk subgroups. RESULTS We found that HRR-related score was associated with T-stage, immunotherapy sensitivity, and prognosis of PLC after previous malignancies. Differential genes between HRR-related low-score and high-score groups are mainly involved in DNA replication and repair processes, such as the cell cycle. We identified three key genes, ABO, SERPINE2, and MYC, by machine learning, and MYC had the highest amplification mutation frequency. We verified that the key gene-based prognostic model can better assess the prognosis of patients. The risk score of the prognostic model was associated with immune microenvironment and efficacy of immunotherapy. CONCLUSIONS Overall, we identified three key genes ABO, SERPINE2, and MYC associated with HRR status in PLC after previous malignancies. The risk model based on key genes is associated with immune microenvironment and can well predict the prognosis for PLC after previous malignancies.
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Affiliation(s)
- Haoran Wang
- Department of Thoracic Surgery and State Key Laboratory of Genetic Engineering, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Fangxiao Gong
- Emergency and Critical Care Center, Intensive Care Unit, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China
| | - Weicheng Kong
- Department of Thoracic Surgery, Putuo District People's Hospital, Zhoushan, China
| | - Yanyan Chen
- Division of Pulmonary, SinoUnited Health, Shanghai, China
| | - Jie Zhang
- Department of Thoracic Surgery and State Key Laboratory of Genetic Engineering, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
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24
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Senthil P, Kuhan S, Potter AL, Jeffrey Yang CF. Update on Lung Cancer Screening Guideline. Thorac Surg Clin 2023; 33:323-331. [PMID: 37806735 DOI: 10.1016/j.thorsurg.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Lung cancer screening has been shown to reduce lung cancer mortality and is recommended for individuals meeting age and smoking history criteria. Despite the expansion of lung cancer screening guidelines in 2021, racial/ethnic and sex disparities persist. High-risk racial minorities and women are more likely to be diagnosed with lung cancer at younger ages and have lower smoking histories when compared with White and male counterparts, resulting in higher rates of ineligibility for screening. Risk prediction models, biomarkers, and deep learning may help refine the selection of individuals who would benefit from screening.
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Affiliation(s)
- Priyanka Senthil
- Division of Thoracic Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
| | - Sangkavi Kuhan
- Division of Thoracic Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
| | - Alexandra L Potter
- Division of Thoracic Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
| | - Chi-Fu Jeffrey Yang
- Division of Thoracic Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
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25
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Shang J, Kulabieke D, Zhu J, Guo B, Zheng X, Qian J. Prognostic factors, treatment decisions, and nomograms for patients with second primary lung cancer following colorectal cancer: a population-based study. Updates Surg 2023; 75:1827-1842. [PMID: 37535188 DOI: 10.1007/s13304-023-01605-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 07/19/2023] [Indexed: 08/04/2023]
Abstract
Colorectal cancer (CRC) survival rates continue to improve, but the risk of developing a second primary malignancy (SPM) has also increased. The most common type of SPM observed after CRC is lung cancer. In this study, we explored the prognostic factors and clinical management decisions of patients with second primary lung cancer after colorectal cancer (SPLC-CRC). We identified the data of 1637 patients with SPLC-CRC from the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2015. Cox regression modeling was used to construct a nomogram for predicting the prognosis of SPLC-CRC patients. The Fine-Gray competing risk model was used to determine the association between factors and cancer-specific mortality. After this, survival analyses were performed to assess the benefit of each treatment method on overall survival (OS). According to a multivariate analysis, age, gender, surgery, and chemotherapy were independent prognostic factors for the first primary malignancy (FPM), whereas age, primary site, TNM stage, tumor size, and treatment were independent prognostic factors for the second primary malignancy (SPM). For the training cohort column chart as well as the validation cohort column chart, using the concordance index of OS, 0.7611 and 0.7605 were calculated. A Fine-Gray competing risk model and survival analysis showed that there is a significant correlation between the treatment of FPM and the improvement in SPM survival rates, FPM-diagnosed patients who undergo surgery in different pathological stages exhibit higher overall survival rates, Patients in stages II, III, and IV benefit from combined surgery and chemotherapy. SPM surgery (P < 0.001, HR = 0.230, 95%CI 0.032-0.426) was a protective factor for lung cancer-specific mortality. Patients with local, regional, and even distant metastases may benefit more from SPM surgery (P < 0.001, P < 0.001, and P < 0.001, respectively). In patients who did not undergo SPM surgery, radiotherapy (P < 0.001) and chemotherapy (P = 0.008) improved OS. Treatment strategy for the first tumor affects the prognosis of the second tumor significantly. SPLC-CRC is treated primarily with surgery, regardless of whether the patient has metastases, as surgery may improve outcomes. In the event that a patient is unable to undergo surgery, chemotherapy or radiotherapy should be considered. Treatment decisions for SPLC-CRC patients may be influenced by these findings.
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Affiliation(s)
- Jiarong Shang
- Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Delida Kulabieke
- Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Jin Zhu
- Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Bingyang Guo
- Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Xia Zheng
- Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Jun Qian
- Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.
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26
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Deng R, Zhou J, Qiu J, Cai L, Gong K. Clinical characteristics analysis and prognostic nomogram for predicting survival in patients with second primary prostate cancer: a population study based on SEER database. J Cancer Res Clin Oncol 2023; 149:11791-11806. [PMID: 37405473 DOI: 10.1007/s00432-023-05086-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 06/29/2023] [Indexed: 07/06/2023]
Abstract
BACKGROUND AND AIMS Second primary prostate cancer (SPPCa) is a common type of secondary malignancy that negatively impacts patient prognosis. This study aimed to identify prognostic factors for SPPCa patients and develop nomograms to assess their prognosis. METHODS Patients diagnosed with SPPCa between 2010 and 2015 were identified from the Surveillance, Epidemiology, and End Results (SEER) database. The study cohort was randomly divided into a training set and a validation set. Cox regression analysis, Kaplan‒Meier survival analysis, and least absolute shrinkage and selection operator regression analysis were used to identify independent prognostic factors and develop the nomogram. The nomograms were evaluated using the concordance index (C-index), calibration curve, area under the curve (AUC), and Kaplan-Meier analysis. RESULTS A total of 5342 SPPCa patients were included in the study. Independent prognostic factors for overall survival (OS) and cancer-specific survival (CSS) were identified as age, interval between diagnoses, first primary tumor site, and AJCC stage, N stage, M stage, PSA, Gleason score, and SPPCa surgery. Nomograms were constructed based on these prognostic factors, and the performance was evaluated using the C-index (OS: 0.733, CSS: 0.838), AUC, calibration curve, and Kaplan-Meier analysis, which demonstrated excellent predictive accuracy. CONCLUSION We successfully established and validated nomograms to predict OS and CSS in SPPCa patients using the SEER database. These nomograms provide an effective tool for risk stratification and prognosis assessment in SPPCa patients, which will aid clinicians in optimizing treatment strategies for this patient population.
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Affiliation(s)
- Ruiyi Deng
- Department of Urology, Peking University First Hospital, 8 Xishiku Street, Beijing, 100034, People's Republic of China
| | - Jingcheng Zhou
- Department of Urology, Peking University First Hospital, 8 Xishiku Street, Beijing, 100034, People's Republic of China
| | - Jianhui Qiu
- Department of Urology, Peking University First Hospital, 8 Xishiku Street, Beijing, 100034, People's Republic of China
| | - Lin Cai
- Department of Urology, Peking University First Hospital, 8 Xishiku Street, Beijing, 100034, People's Republic of China
| | - Kan Gong
- Department of Urology, Peking University First Hospital, 8 Xishiku Street, Beijing, 100034, People's Republic of China.
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27
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Subramanian A, Su S, Moding EJ, Binkley MS. Investigating the tissue specificity and prognostic impact of cis-regulatory cancer risk variants. Hum Genet 2023; 142:1395-1405. [PMID: 37474751 DOI: 10.1007/s00439-023-02586-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 07/07/2023] [Indexed: 07/22/2023]
Abstract
The tissue-specific incidence of cancers and their genetic basis are poorly understood. Although prior studies have shown global correlation across tissues for cancer risk single-nucleotide polymorphisms (SNPs) identified through genome-wide association studies (GWAS), any shared functional regulation of gene expression on a per SNP basis has not been well characterized. We set to quantify cis-mediated gene regulation and tissue sharing for SNPs associated with eight common cancers. We identify significant tissue sharing for individual SNPs and global enrichment for breast, colorectal, and Hodgkin lymphoma cancer risk SNPs in multiple tissues. In addition, we observe increasing tissue sharing for cancer risk SNPs overlapping with super-enhancers for breast cancer and Hodgkin lymphoma providing further evidence of tissue specificity. Finally, for genes under cis-regulation by breast cancer SNPs, we identify a phenotype characterized by low expression of tumor suppressors and negative regulators of the WNT pathway associated with worse freedom from progression and overall survival in patients who eventually develop breast cancer. Our results introduce a paradigm for functionally annotating individual cancer risk SNPs and will inform the design of future translational studies aimed to personalize assessment of inherited cancer risk across tissues.
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Affiliation(s)
- Ajay Subramanian
- Department of Radiation Oncology, Stanford Cancer Institute and Stanford University School of Medicine, Stanford, CA, USA
| | - Shengqin Su
- Department of Radiation Oncology, Stanford Cancer Institute and Stanford University School of Medicine, Stanford, CA, USA
| | - Everett J Moding
- Department of Radiation Oncology, Stanford Cancer Institute and Stanford University School of Medicine, Stanford, CA, USA
| | - Michael Sargent Binkley
- Department of Radiation Oncology, Stanford Cancer Institute and Stanford University School of Medicine, Stanford, CA, USA.
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28
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Hallgren E, Narcisse MR, Andersen JA, Willis DE, Thompson T, Bryant-Smith G, McElfish PA. Medical Financial Hardship and Food Security among Cancer Survivors in the United States. Cancer Epidemiol Biomarkers Prev 2023; 32:1038-1047. [PMID: 37255367 PMCID: PMC10524473 DOI: 10.1158/1055-9965.epi-22-1044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/21/2022] [Accepted: 05/05/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND Some cancer survivors experience medical financial hardship, which may reduce their food security. The purpose of this study was to explore whether medical financial hardship is related to food security among cancer survivors. METHODS The study was based on cross-sectional data from the 2020 National Health Interview Survey. We used ordinal logistic regression to examine the relationship between material, psychological, and behavioral medical financial hardships and household food security (i.e., high, marginal, low, or very low) among individuals ages ≥18 years who reported a cancer diagnosis from a health professional (N = 4,130). RESULTS The majority of the sample reported high household food security (88.5%), with 4.8% reporting marginal, 3.6% reporting low, and 3.1% reporting very low household food security. In the adjusted model, the odds of being in a lower food security category were higher for cancer survivors who had problems paying or were unable to pay their medical bills compared with those who did not [OR, 1.73; 95% confidence interval (CI), 1.06-2.82, P = 0.027], who were very worried about paying their medical bills compared with those who were not at all worried (OR, 2.88; 95% CI, 1.64-5.07; P < 0.001), and who delayed medical care due to cost compared with those who did not (OR, 2.56; 95% CI, 1.29-5.09; P = 0.007). CONCLUSIONS Food insecurity is rare among cancer survivors. However, medical financial hardship is associated with an increased risk of lower household food security among cancer survivors. IMPACT A minority of cancer survivors experience medical financial hardship and food insecurity; social needs screenings should be conducted.
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Affiliation(s)
- Emily Hallgren
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48 St., Springdale, AR 72762, USA
| | - Marie-Rachelle Narcisse
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48 St., Springdale, AR 72762, USA
| | - Jennifer A. Andersen
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48 St., Springdale, AR 72762, USA
| | - Don E. Willis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48 St., Springdale, AR 72762, USA
| | - Tess Thompson
- Brown School, Washington University, One Brookings Drive, St. Louis, MO 63130, USA
| | - Gwendolyn Bryant-Smith
- Department of Radiology, University of Arkansas for Medical Sciences, 4301 W. Markham St. – Slot 556, Little Rock, AR 72205, USA
| | - Pearl A. McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48 St., Springdale, AR 72762, USA
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29
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Lun W, Luo C. Second primary colorectal cancer in adults: a SEER analysis of incidence and outcomes. BMC Gastroenterol 2023; 23:253. [PMID: 37495987 PMCID: PMC10373234 DOI: 10.1186/s12876-023-02893-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 07/18/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND At present, there was no large epidemiological study exploring the actual incidence and survival of second primary colorectal cancer (spCRC). The different characteristics and survival of patients with spCRC and initial primary colorectal cancer (ipCRC) still need to be elucidated. In addition, the factors leading to different survival status of spCRC and ipCRC were still unclear. Our study plan to explore the annual incidence trend of spCRC as well as the factors influencing the occurrence and survival outcome of spCRC. METHODS This cohort study analyzed the data of 4680 spCRC patients and 330,937 initial primary colorectal cancer (ipCRC) patients. Whether patients had spCRC and whether spCRC patients survived or died were regarded as outcomes. The annual incidence of spCRC from 2004 to 2016 was analyzed by Jointpoint regression analysis. The truncation points were found, and the annual percentage change (APC) of each segment was calculated to explore the trend of spCRC change in the United States. Univariate and multivariable cox regression analyses were conducted to identify factors associated with the occurrence and prognosis of spCRC patients. RESULTS The total incidence of spCRC was decreased during 2000-2016 on the whole. The overall incidence of spCRC was lowered in both males and females despite 2013-2014, in the left colon, right colon, rectum and others. The incidence of spCRC was decreased in both 18-49 years' people and ≥ 50 years' people during 2000-2016, and the incidence of spCRC in the ≥ 50 years' people group was higher than those of 18-49 years. Insured (OR = 0.867 (0.778-0.966), initial primary site of other digestive (OR = 0.46, 95%CI: 0.42-0.50), rectum (OR = 0.74, 95%CI: 0.66-0.82), or right colon (OR = 0.73, 95%CI: 0.68-0.79), N 1 stage (OR = 0.87, 95%CI: 0.76-0.99), M 1 stage (OR = 0.49, 95%CI: 0.30-0.80), AJCC II stage (OR = 0.70, 95%CI: 0.60-0.82), AJCC III stage (OR = 0.69, 95%CI: 0.56-0.84), and radiation (OR = 0.69, 95%CI: 0.57-0.83) were associated with the risk of spCRC. At the end of follow-up, 2,246 spCRC patients were survived and 2,434 spCRC patients were dead. Patients with spCRC had poor survival probability than patients with ipCRC. Older age (HR = 1.02, 95%CI: 1.02-1.03), male (HR = 1.13, 95%CI: 1.04-1.23), Black (HR = 1.20, 95%CI: 1.06-1.35), uninsured (HR = 1.36, 95%CI: 1.16-1.59), Signet ring cell carcinoma (HR = 1.64, 95%CI: 1.19-2.25), T4 stage (HR = 1.63, 95%CI: 1.32-2.01), N2 stage (HR = 1.36, 95%CI: 1.08-1.72), M1 stage (HR = 4.51, 95%CI: 2.00-10.18), AJCC III (HR = 1.47, 95%CI: 1.08-1.98), and radiation (HR = 1.82, 95%CI: 1.43-2.33) were associated with increased risk of mortality in spCRC patients. CONCLUSION The incidence of spCRC was decreased except in people with initial primary tumor grade IV and those aged 15-39 years. The overall survival of spCRC patients was lower than ipCRC patients. Cancer patients with older age, high tumor grade, TNM stage, and AJCC stage should be caution to the occurrence of spCRC and timely interventions should be provided for spCRC patients to improve their outcomes.
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Affiliation(s)
- Weijian Lun
- Gastroenterology department of The Sixth Affiliated Hospital, School of Medicine, South China University of Technology, 120# Guidan Road, Nanhai District, Foshan, 528200, Guangdong Province, China.
| | - Canhua Luo
- Gastroenterology department of The Sixth Affiliated Hospital, School of Medicine, South China University of Technology, 120# Guidan Road, Nanhai District, Foshan, 528200, Guangdong Province, China
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30
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Zhang C, Tang X, Liu W, Zheng K, Li X, Ma N, Zhao J. Impact of previous extra-pulmonary malignancies on surgical outcomes of sequential primary non-small cell lung cancer. Heliyon 2023; 9:e17898. [PMID: 37519717 PMCID: PMC10372209 DOI: 10.1016/j.heliyon.2023.e17898] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 06/27/2023] [Accepted: 06/30/2023] [Indexed: 08/01/2023] Open
Abstract
Reduced cancer deaths have led to an increase in the number of cancer survivors and the risk of the second primary tumor. This study explored the surgical outcomes of patients with non-small cell lung cancer as the second primary tumor and the impact of previous extra-pulmonary malignancies. Patients' data were obtained from Surveillance, Epidemiology and End Results database. The patients were divided into lung surgery and non-surgery groups. Propensity-score matching was used to balance potential confounders. Kaplan-Meier curves were generated to test the overall survival and lung-cancer-specific survival. Cox regression analysis was performed to calculate death risk. In total 3054 lung surgery and 1094 non-surgery patients with stage I-II non-small cell lung cancer as the second primary tumor were included. The surgery group showed longer overall survival (68 vs. 22 months) and lung cancer-specific survival (not reached vs. 37 months) than those of non-surgery groups (both P < 0.001). Patients with previous hormone-dependent malignancies had similar survival rates (overall survival: 22 vs. 20 months, P = 0.666; lung cancer-specific survival: 38 vs. 37 months, P = 0.292) as those with non-hormone dependent malignancies in the non-surgery group. Significantly longer overall survival (90 vs. 60 months, P = 0.001) was observed in patients with hormone-dependent malignancies in the surgery group; however, there was no difference in lung cancer-specific survival (P = 0.225). Competing risk analysis showed that for patients undergoing lung surgery, there was higher previous malignancy-induced mortality in patients with non-hormone dependent malignancies than in patients with hormone-dependent malignancies. However, there was no difference in lung cancer-induced mortality between the two groups. Patients who underwent lobectomy showed longer survival than those who underwent pneumonectomy and other resection types (89, 27.5 and 65 months, P < 0.001). In summary, lung surgery is beneficial for patients with stage I-II non-small cell lung cancer as the second primary tumor after hormone-dependent malignancy resection.
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Affiliation(s)
- Chenxi Zhang
- Department of Thoracic Surgery, Tangdu Hospital, Air Force Medical University. No.569, Xinsi Road, Xi'an, Shaanxi, 710038, China
- Department of Cardio-thoracic Surgery, 900 Hospital of PLA, Fuzhou, Fujian, 350001, China
| | - Xiyang Tang
- Department of Thoracic Surgery, Tangdu Hospital, Air Force Medical University. No.569, Xinsi Road, Xi'an, Shaanxi, 710038, China
| | - Wenhao Liu
- Department of Cardio-thoracic Surgery, 900 Hospital of PLA, Fuzhou, Fujian, 350001, China
| | - Kaifu Zheng
- Department of Thoracic Surgery, Tangdu Hospital, Air Force Medical University. No.569, Xinsi Road, Xi'an, Shaanxi, 710038, China
| | - Xiaofei Li
- Department of Thoracic Surgery, Chest Hospital, Xi'an International Medical Center, No.777, Xitai Road, Xi'an, Shaanxi, 710100, China
| | - Nan Ma
- Department of Ophthalmology, Tangdu Hospital, Air Force Medical University, No.569, Xinsi Road, Xi'an, Shaanxi, 710038, China
| | - Jinbo Zhao
- Department of Thoracic Surgery, Tangdu Hospital, Air Force Medical University. No.569, Xinsi Road, Xi'an, Shaanxi, 710038, China
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Arena GO, Forte S, Abdouh M, Vanier C, Corbeil D, Lorico A. Horizontal Transfer of Malignant Traits and the Involvement of Extracellular Vesicles in Metastasis. Cells 2023; 12:1566. [PMID: 37371036 PMCID: PMC10297028 DOI: 10.3390/cells12121566] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 05/31/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023] Open
Abstract
Metastases are responsible for the vast majority of cancer deaths, yet most therapeutic efforts have focused on targeting and interrupting tumor growth rather than impairing the metastatic process. Traditionally, cancer metastasis is attributed to the dissemination of neoplastic cells from the primary tumor to distant organs through blood and lymphatic circulation. A thorough understanding of the metastatic process is essential to develop new therapeutic strategies that improve cancer survival. Since Paget's original description of the "Seed and Soil" hypothesis over a hundred years ago, alternative theories and new players have been proposed. In particular, the role of extracellular vesicles (EVs) released by cancer cells and their uptake by neighboring cells or at distinct anatomical sites has been explored. Here, we will outline and discuss these alternative theories and emphasize the horizontal transfer of EV-associated biomolecules as a possibly major event leading to cell transformation and the induction of metastases. We will also highlight the recently discovered intracellular pathway used by EVs to deliver their cargoes into the nucleus of recipient cells, which is a potential target for novel anti-metastatic strategies.
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Affiliation(s)
- Goffredo O. Arena
- Department of Surgery, McGill University, Montréal, QC H3A 0G4, Canada;
- Fondazione Istituto G. Giglio, 90015 Cefalù, Italy
- Mediterranean Institute of Oncology, 95029 Viagrande, Italy;
| | - Stefano Forte
- Mediterranean Institute of Oncology, 95029 Viagrande, Italy;
| | - Mohamed Abdouh
- Cancer Research Program, Research Institute, McGill University Health Centre, Montréal, QC H3A 0G4, Canada;
| | - Cheryl Vanier
- Touro University Nevada College of Medicine, Henderson, NV 89014, USA;
| | - Denis Corbeil
- Biotechnology Center (BIOTEC) and Center for Molecular and Cellular Bioengineering, Technische Universität Dresden, 01307 Dresden, Germany;
| | - Aurelio Lorico
- Mediterranean Institute of Oncology, 95029 Viagrande, Italy;
- Touro University Nevada College of Medicine, Henderson, NV 89014, USA;
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Yang J, Wu F, An H, Gan H. Incidence and risk outcomes of second primary malignancy of patients with post-operative colorectal cancer. Int J Colorectal Dis 2023; 38:88. [PMID: 36995483 DOI: 10.1007/s00384-023-04366-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/03/2023] [Indexed: 03/31/2023]
Abstract
BACKGROUND AND AIMS This study aimed to investigate the incidence and the risk factors of incidence for second primary malignancies (SPMs) onset among survivors diagnosed with colorectal cancer (CRC). METHODS A large population-based cohort study was performed. Data of patients diagnosed with CRC was identified and extracted from 8 cancer registries of Surveillance, Epidemiology, and End Results database from January 1990 to December 2017. The outcome of interest was percentage and common sites of SPM onset after primary CRC diagnosis. The cumulative incidence and standardize incidence rates (SIRs) were also reported. Afterwards, we estimated sub-distribution hazards ratios (SHRs) and relative risks (RRs) for SPM occurrence using multivariable competing-risk and Poisson regression models, respectively. RESULTS A total of 152,402 patients with CRC were included to analyze. Overall, 23,816 patients of all CRC survivors (15.6%) were reported SPM occurrence. The highest proportion of SPMs development after primary CRC diagnosis was second CRC, followed by lung and bronchus cancer among all survivors. Also, CRC survivors were more susceptible to develop second gastrointestinal cancers (GICs). Besides, pelvic cancers were analyzed with a relative high proportion among patients who received RT in comparison to those without RT. The cumulative incidence of all SPMs onset was 22.16% (95% CI: 21.82-22.49%) after near 30-year follow-up. Several factors including older age, male, married status, and localized stage of CRC were related to the high risk of SPMs onset. In treatment-specific analyses, RT was related to a higher cumulative incidence of SPMs occurrence (all SPMs: 14.08% vs. 8.72%; GICs: 2.67% vs. 2.04%; CRC: 1.01% vs. 1.57%; all p < 0.01). Furthermore, the increased risk of SPMs onset was found among patients who received RT than patients within the NRT group (SHR: 1.50, 95% CI: 1.32-1.71), p < 0.01; RR: 1.61, 95% CI: 1.45-1.79, p < 0.01). CONCLUSION The present study described the incidence pattern of SPM among CRC survivors and identified the risk factors of the SPM onset. RT treatment for patients diagnosed with CRC may increase the risk of SPMs occurrence. The findings suggest the need for long-term follow-up surveillance for these patients.
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Affiliation(s)
- Jiahui Yang
- Department of Geriatrics and National Clinical Research Center for Geriatric, West China Hospital, Sichuan University, Chengdu, China
- Lab of Inflammatory Bowel Disease, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Fangli Wu
- Department of Gastroenterology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Hongjin An
- Lab of Inflammatory Bowel Disease, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
- Department of Gastroenterology and the Center of Inflammatory Bowel Disease, West China Hospital, Sichuan University, Chengdu, China
| | - Huatian Gan
- Department of Geriatrics and National Clinical Research Center for Geriatric, West China Hospital, Sichuan University, Chengdu, China.
- Lab of Inflammatory Bowel Disease, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China.
- Department of Gastroenterology and the Center of Inflammatory Bowel Disease, West China Hospital, Sichuan University, Chengdu, China.
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Jing Y, Wang X, Sun B. Clinical characteristics and survival of second primary breast carcinoma with extramammary malignancies. Front Oncol 2023; 13:1160370. [PMID: 37007094 PMCID: PMC10064009 DOI: 10.3389/fonc.2023.1160370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 03/06/2023] [Indexed: 03/19/2023] Open
Abstract
ObjectivesTo investigate the characteristics, diagnosis, survival and prognosis of second primary breast carcinoma (SPBC).Materials and methodsRecords of 123 patients with SPBC in Tianjin Medical University Cancer Institute & Hospital between December 2002 and December 2020 were retrospectively reviewed. Clinical characteristics, imaging features and survival were analyzed and comparisons between SPBC and breast metastases (BM) were made.ResultsOf 67156 newly diagnosed breast cancer patients, 123 patients (0.18%) suffered previous extramammary primary malignancies. Of the 123 patients with SPBC, approximately 98.37%(121/123)were female. The median age was 55 years old (27-87). The average diameter of breast mass was 2.7 cm (0.5-10.7). Approximately 77.24% (95/123) of the patients presented with symptoms. The most common types of extramammary primary malignancies were thyroid, gynecological cancers, lung, and colorectal. Patients with the first primary malignant tumor of lung cancer were more likely to develop synchronous SPBC, and those with the first primary malignant tumor of ovarian cancer were more likely to develop metachronous SPBC. When comparing with BM, patients with SPBC were more often older (≥45 years old), at earlier stages (I/II), more microcalcification and less multiple breast masses in imaging. More than half (55.88%) of patients in the metachronous group developed primary breast cancer within 5 years after diagnosis of extramammary primary cancer. The median overall survival time was 71 months. Within 90 months, the prognosis of patients with synchronous SPBC was worse than that of patients with metachronous SPBC (p=0.014). Patients with BM had the worst outcome compared with patients with synchronous SPBC and metachronous SPBC (p<0.001).ER/PR-negative status, an interval of less than 6 months between the onset of two tumors, a late stage of first primary malignancy, and an age of diagnosis of first primary malignancy greater than 60 years predicted a worse prognosis for patients with SPBC.ConclusionThe possibility of SPBC should be considered during the follow-up of patients with primary extramammary malignancy, especially within 5 years of the onset of the first tumor. The stage of first primary malignancy and the age at diagnosis of first primary malignancy have an impact on the prognosis of patients with SPBC.
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Affiliation(s)
- Yaoyao Jing
- Department of Day Ward, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China
- Tianjin’s Clinical Research Center for Cancer, Tianjin, China
- Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, China
- Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Xiaofang Wang
- Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China
- Tianjin’s Clinical Research Center for Cancer, Tianjin, China
- Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, China
- Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
- Department of Hematology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- *Correspondence: Xiaofang Wang, ; Bei Sun,
| | - Bei Sun
- Department of Day Ward, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China
- Tianjin’s Clinical Research Center for Cancer, Tianjin, China
- Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, China
- Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
- *Correspondence: Xiaofang Wang, ; Bei Sun,
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Robsahm TE, Falk RS, Eide NA. Additional malignancies and mortality in uveal melanoma: A 20-year follow-up of a Norwegian patient cohort. Acta Ophthalmol 2023. [PMID: 36924309 DOI: 10.1111/aos.15659] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 02/17/2023] [Accepted: 02/26/2023] [Indexed: 03/18/2023]
Abstract
PURPOSE The purpose of this study is to explore the frequency of additional primary malignancies in uveal melanoma (UM) patients and cause-specific mortality, to help guide surveillance strategies after UM. METHODS All patients diagnosed with UM at Oslo University Hospital during 1990-2017 were eligible for inclusion. Linkage to the Cancer Registry of Norway obtained information on additional malignancies and cause of death throughout 2019. UM patients were categorized according to timing of additional malignancy (prior/simultaneously or after UM) or no additional cancer, and by UM stage at diagnosis. Age-adjusted mortality rates were presented per 1000 person-years with 95% confidence intervals (CI). RESULTS The study population included 960 UM patients: 77% were diagnosed in stage and I/II and 56% were men. Mean age at diagnosis was 63 years. Additional malignancies were observed in 152 patients prior/simultaneous to UM, and in 120 patients >1 year after UM. Overall, mortality per 1000 person-years was 3.5 (95% CI 3.1-3.9) for UM and 3.0 (2.6-3.4) for other causes. Lowest UM mortality [1.3 (0.60-2.1)] was seen in patients with a second malignancy after UM, regardless of stage. Highest UM mortality was seen for UM patients in stage III/IV, both without [16.1 (13.2-19.1)] and with any additional malignancy [16.9 (6.6-27.3)]. CONCLUSION Our results support that UM patients frequently have additional malignancies, both before and after UM. Low-UM mortality in patients with a primary malignancy after UM, might indicate less aggressive UM. The cumulative UM mortality flattens about 10 years after diagnosis and annual follow-up of patients for 10 years seems adequate.
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Affiliation(s)
- Trude E Robsahm
- Research Department, Cancer Registry of Norway, Oslo, Norway
| | - Ragnhild S Falk
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Nils A Eide
- Department of Ophthalmology, Oslo University Hospital, Oslo, Norway
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Garcia JL, Rosa I, da Silva JP, Moleiro J, Claro I. Incidence and risk factors for neoplasia in inflammatory bowel disease. Asia Pac J Clin Oncol 2023. [PMID: 36915954 DOI: 10.1111/ajco.13908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 10/22/2022] [Accepted: 11/24/2022] [Indexed: 03/15/2023]
Abstract
INTRODUCTION Inflammatory Bowel Disease (IBD) patients may have an increased risk of neoplasia. The aim was to evaluate the incidence of malignant neoplasia in IBD patients, associated risk factors and therapy adjustments. METHODS Unicentric retrospective cohort study. All patients followed for IBD in a tertiary portuguese hospital and oncological centre during 2015-2020 were included. RESULTS 318 patients were included female 55.0%, age at diagnosis = 37.24(±15,28), Crohn's disease 52.5%, Primary Sclerosing Cholangitis n = 7, family history of cancer n = 12, previous diagnosis of neoplasia n = 23(7.2%). 42 cancers were diagnosed in 35 patients (11.0%) - median of 12.0(IQR = 7.5-21.0) years after IBD diagnosis. Most affected organs were the skin (n = 15 in 11 patients; melanoma = 1), colon/rectum (n = 8 in 6 patients), prostate (n = 4), breast (n = 3) and anal canal (n = 2). In those with non-melanoma skin cancer, 6 were under active treatment with azathioprine and 2 had stopped it for more than two years. In the univariate analysis, the occurrence of neoplasia was positively associated with tobacco exposure (p = 0.022), age at IBD diagnosis (p = 0.021), and negatively with infliximab exposure (p = 0.046). In 9 cases, cancer treatment was different because of the IBD, while IBD treatment was changed in 9 patients. In those affected by cancer, in the univariate analysis, its cure/remission was negatively associated with tobacco exposure (p = 0.004) and positively with salicylates use (p = 0.007). CONCLUSION In IBD patients, cancer mostly affected the skin and the lower digestive system. As in the general population, tobacco exposure was a risk factor for the development of neoplasia.
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Affiliation(s)
- Joana Lemos Garcia
- Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisboa, Portugal
| | - Isadora Rosa
- Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisboa, Portugal
| | | | - Joana Moleiro
- Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisboa, Portugal
| | - Isabel Claro
- Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisboa, Portugal
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Nguyen NH, Shin SJ, Dodd-Eaton EB, Ning J, Wang W. Personalized Risk Prediction for Cancer Survivors: A Bayesian Semi-parametric Recurrent Event Model with Competing Outcomes. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.02.28.530537. [PMID: 36909464 PMCID: PMC10002693 DOI: 10.1101/2023.02.28.530537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Multiple primary cancers are increasingly more frequent due to improved survival of cancer patients. Characteristics of the first primary cancer largely impact the risk of developing subsequent primary cancers. Hence, model-based risk characterization of cancer survivors that captures patient-specific variables is needed for healthcare policy making. We propose a Bayesian semi-parametric framework, where the occurrence processes of the competing cancer types follow independent non-homogeneous Poisson processes and adjust for covariates including the type and age at diagnosis of the first primary. Applying this framework to a historically collected cohort with families presenting a highly enriched history of multiple primary tumors and diverse cancer types, we have derived a suite of age-to-onset penetrance curves for cancer survivors. This includes penetrance estimates for second primary lung cancer, potentially impactful to ongoing cancer screening decisions. Using Receiver Operating Characteristic (ROC) curves, we have validated the good predictive performance of our models in predicting second primary lung cancer, sarcoma, breast cancer, and all other cancers combined, with areas under the curves (AUCs) at 0.89, 0.91, 0.76 and 0.68, respectively. In conclusion, our framework provides covariate-adjusted quantitative risk assessment for cancer survivors, hence moving a step closer to personalized health management for this unique population.
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Affiliation(s)
- Nam H Nguyen
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX
- Department of Statistics, Rice University, Houston, TX
| | - Seung Jun Shin
- Department of Statistics, Korea University, Seoul, Korea
| | - Elissa B Dodd-Eaton
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Jing Ning
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Wenyi Wang
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX
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Triple Primary Malignancies: Tumor Associations, Survival, and Clinicopathological Analysis: A 25-Year Single-Institution Experience. Healthcare (Basel) 2023; 11:healthcare11050738. [PMID: 36900742 PMCID: PMC10001057 DOI: 10.3390/healthcare11050738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 02/18/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023] Open
Abstract
The detection of multiple primary malignancies is on the rise despite their rare occurrence rate. This research aims to determine the prevalence, tumor association patterns, overall survival, and the correlation between survival time and independent factors in patients with triple primary malignancies. This single-center retrospective study included 117 patients with triple primary malignancies admitted to a tertiary cancer center between 1996 and 2021. The observed prevalence was 0.082%. The majority of patients (73%) were over the age of fifty at the first tumor diagnosis, and regardless of gender, the lowest median age occurred in the metachronous group. The most common tumor associations were found between genital-skin-breast, skin-skin-skin, digestive-genital-breast, and genital-breast-lung cancer. The male gender and being over the age of fifty at the first tumor diagnosis are associated with a higher risk of mortality. Compared with the metachronous group, patients with three synchronous tumors demonstrate a risk of mortality 6.5 times higher, whereas patients with one metachronous and two synchronous tumors demonstrate a risk of mortality three times higher. The likelihood of subsequent malignancies should always be considered throughout cancer patients' short- and long-term surveillance to ensure prompt tumor diagnosis and treatment.
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Chen YH, Cabanillas M, Sperling J, Xu L, Goswami M, Maniakas A, Williams MD, Lai SY, Busaidy N, Dadu R, Zafereo ME, Wang JR. Prior Thyroid and Nonthyroid Cancer History Do Not Significantly Alter Overall Survival in Patients Diagnosed with Anaplastic Thyroid Cancer. Thyroid 2023; 33:321-329. [PMID: 36511380 DOI: 10.1089/thy.2022.0350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background: A history of thyroid and nonthyroid malignancies has traditionally been an exclusion criterion in patients with anaplastic thyroid cancer (ATC) seeking to enroll in clinical trials. In this study, we examined the impact of prior malignancies on overall survival (OS) in patients diagnosed with ATC. Methods: In our retrospective cohort study, we identified 451 patients with ATC treated at MD Anderson between 2000 and 2019. Clinical and pathological information was obtained through chart review. Survival analyses were conducted using the Kaplan-Meier method and multivariable Cox proportional hazard models. Results: A history of clinically documented differentiated thyroid cancer (DTC) was reported in 14% of patients with ATC (n = 62), most commonly papillary thyroid cancer (81%, n = 50). The median time from diagnosis of prior DTC to ATC diagnosis was 3.5 years (range: 6 months to 35 years). Concomitant DTC was found on pathology in a higher proportion of patients (52%, n = 234). A history of nonthyroid cancer was reported in 23% of patients (n = 102), where 19% (n = 87) had one, 2% (n = 10) had two, and 1% (n = 5) had three prior cancers. The median time from diagnosis of prior nonthyroid cancer to ATC diagnosis was 8 years (range: 3 months to 53 years). The most common prior nonthyroid cancers were nonmelanoma skin (28.4%), prostate (19.6%), and breast cancers (16.7%). In a subgroup analysis performed in patients with available tumor mutation information (n = 183), the frequency of detected tumor driver mutations (BRAF, RAS, TP53) was not significantly different between patients with ATC with and without a history of nonthyroid cancer. On multivariate analysis after adjusting for age and overall stage, prior DTC, concomitant DTC, and prior nonthyroid cancers, all had no significant impact on OS. Conclusions: The presence of prior malignancy does not significantly impact OS in patients with ATC. Revision of eligibility criteria for enrollment of patients with ATC into clinical trials is warranted.
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Affiliation(s)
- Yu Han Chen
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Maria Cabanillas
- Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Jared Sperling
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Li Xu
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Maitrayee Goswami
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Anastasios Maniakas
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Michelle D Williams
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Stephen Y Lai
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Naifa Busaidy
- Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Ramona Dadu
- Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Mark E Zafereo
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Jennifer Rui Wang
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Abe S, Nozawa H, Sasaki K, Murono K, Emoto S, Yokoyama Y, Matsuzaki H, Nagai Y, Yoshioka Y, Shinagawa T, Sonoda H, Ishihara S. Sarcopenia is Associated With Oncological Prognosis and the Incidence of Secondary Cancer in Patients With Middle/Lower Rectal Cancer. Clin Colorectal Cancer 2023; 22:143-152. [PMID: 36418196 DOI: 10.1016/j.clcc.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 09/26/2022] [Accepted: 10/04/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE This study evaluated the clinical implications of sarcopenia for patients with rectal cancer according to cancer progression. SUMMARY BACKGROUND DATA The negative impact of body composition on long-term outcome has been demonstrated for various malignancies. METHODS We retrospectively reviewed 708 patients with rectal cancer who underwent curative resection at our institution between 2003 and 2020. Factors contributing to long-term outcomes and the incidence of secondary cancer (ISC) were analyzed. Psoas muscle mass index (PMI) was assessed using preoperative computed tomography. Sarcopenia was defined using the PMI cut-off values for Asian adults (6.36 cm2/m2 for males and 3.92 cm2/m2 for females). RESULTS Sarcopenia was identified in 306 patients (43.2%). Sarcopenia was associated with advanced age, low body mass index, smoking history, and advanced T-stage. Multivariate analysis showed sarcopenia was an independent poor prognostic factor for OS (HR 1.71; P = .0102) and cancer-specific survival (HR 1.64; P = .0490). Patients with sarcopenia had significantly higher mortality due to cancer-related death in stages III and IV, whereas non-rectal cancer-related death, including secondary cancer, was markedly increased in stage 0-II sarcopenic rectal patients. Five-year cumulative ISC in patients with and without sarcopenia was 11.8% and 5.9%, respectively. Multivariate analysis revealed that sarcopenia was an independent predictive factor for ISC (HR 2.05; P = .0063). CONCLUSIONS Sarcopenia helps predict survival outcomes and cause of death according to cancer stage for patients with middle/lower rectal cancer who underwent radical surgery. Furthermore, sarcopenia increased the development of secondary cancer in those patients.
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Affiliation(s)
- Shinya Abe
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.
| | - Hiroaki Nozawa
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Kazuhito Sasaki
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Koji Murono
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Shigenobu Emoto
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Yuichiro Yokoyama
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Hiroyuki Matsuzaki
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Yuzo Nagai
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Yuichiro Yoshioka
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Takahide Shinagawa
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Hirofumi Sonoda
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Soichiro Ishihara
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
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Adams SJ, Stone E, Baldwin DR, Vliegenthart R, Lee P, Fintelmann FJ. Lung cancer screening. Lancet 2023; 401:390-408. [PMID: 36563698 DOI: 10.1016/s0140-6736(22)01694-4] [Citation(s) in RCA: 89] [Impact Index Per Article: 89.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 07/26/2022] [Accepted: 08/25/2022] [Indexed: 12/24/2022]
Abstract
Randomised controlled trials, including the National Lung Screening Trial (NLST) and the NELSON trial, have shown reduced mortality with lung cancer screening with low-dose CT compared with chest radiography or no screening. Although research has provided clarity on key issues of lung cancer screening, uncertainty remains about aspects that might be critical to optimise clinical effectiveness and cost-effectiveness. This Review brings together current evidence on lung cancer screening, including an overview of clinical trials, considerations regarding the identification of individuals who benefit from lung cancer screening, management of screen-detected findings, smoking cessation interventions, cost-effectiveness, the role of artificial intelligence and biomarkers, and current challenges, solutions, and opportunities surrounding the implementation of lung cancer screening programmes from an international perspective. Further research into risk models for patient selection, personalised screening intervals, novel biomarkers, integrated cardiovascular disease and chronic obstructive pulmonary disease assessments, smoking cessation interventions, and artificial intelligence for lung nodule detection and risk stratification are key opportunities to increase the efficiency of lung cancer screening and ensure equity of access.
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Affiliation(s)
- Scott J Adams
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
| | - Emily Stone
- Faculty of Medicine, University of New South Wales and Department of Lung Transplantation and Thoracic Medicine, St Vincent's Hospital, Sydney, NSW, Australia
| | - David R Baldwin
- Respiratory Medicine Unit, David Evans Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | | | - Pyng Lee
- Division of Respiratory and Critical Care Medicine, National University Hospital and National University of Singapore, Singapore
| | - Florian J Fintelmann
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
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Hensley PJ, Duan Z, Bree K, Sood A, Zhao H, Lobo N, Contieri R, Campbell MT, Guo CC, Navai N, Williams SB, Dinney CP, Kamat AM. Competing mortality risk from second primary malignancy in bladder cancer patients following radical cystectomy: Implications for survivorship. Urol Oncol 2023; 41:108.e11-108.e17. [PMID: 36404232 DOI: 10.1016/j.urolonc.2022.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 09/16/2022] [Accepted: 10/13/2022] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Muscle-invasive bladder cancer (BC) often occurs in patients with competing mortality risks, while also being associated with the highest rate of second primary nonurothelial cancers (SNUC) of all solid malignancies. We investigated the incidence, risk factors, and timing of SNUC as a competing mortality risk factor in patients with BC who were treated with curative intent radical cystectomy (RC). METHODS We performed a retrospective cohort study assessing patients who underwent RC for cT2-4 N0M0 BC from January 1, 2005 to December 31, 2018 at a single, high volume tertiary care referral center. The Fine-Gray multivariable regression model was used to evaluate predictive factors for SNUC. Cumulative incidence of mortality (CIM) was estimated with modified Kaplan-Meier analysis. RESULTS The median follow-up time for the 693 patients who underwent RC was 3.7 years (interquartile range [IQR] 1.9-5.9 years). SNUC developed in 85 (12.3%) patients at a median 3.0 years post-RC (IQR 1.2-5.5 years). On multivariable analysis, the only significant predictor for developing SNUC was freedom from BC recurrence or metastasis (HR 1.54, 95% CI 1.12-1.76, P = 0.019). The most common SNUCs were primary lung cancer (24, 3.2% of cohort) and colon cancer (9, 1.3% of cohort). BC surveillance imaging diagnosed SNUC in 35/52 (67.3%) patients with solid-organ visceral primaries. The overall mortality rate for any SNUC was 38.8%, with the 3 most lethal cancer types being pancreatic, lung, and colon (62.5%, 54.2%, and 44.4% mortality, respectively). The incidence of SNUC uniformly increased postoperatively, with a cumulative incidence of 22.1% (95% CI, 16.8-27.9%) at 12-years post-RC. 163 patients (23.5%) died from BC, 33 patients (4.8%) died from SNUC, and 94 patients (13.6%) died from other causes. While the CIM for BC plateaued around 5-years post-RC at 24%, the incidence of other-cause mortality uniformly rose throughout the postoperative period. By post-RC year 9 there was no significant difference in CIM between BC (CIM 27.2%, 95% CI, 23.5-31.1%) and other-causes (CIM 20.0%, 95% CI, 15.8-24.6%). CONCLUSIONS The cumulative incidence of SNUC at 12-years post-RC was 22%, with the majority identified on BC surveillance imaging. While BC mortality plateaued around 5-years post-RC, mortality related to SNUC or other causes rose steadily in the postoperative period. These data have clinical significance with regards to patient counseling, survivorship and oncologic surveillance in the highly comorbid muscle-invasive BC population.
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Affiliation(s)
- Patrick J Hensley
- Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Zhigang Duan
- Department of Health Services Research, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Kelly Bree
- Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Akshay Sood
- Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Hui Zhao
- Department of Health Services Research, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Niyati Lobo
- Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Roberto Contieri
- Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Matthew T Campbell
- Department of Genitourinary Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Charles C Guo
- Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Neema Navai
- Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Stephen B Williams
- Division of Urology, Department of Surgery, University of Texas Medical Branch, Galveston, TX
| | - Colin P Dinney
- Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Ashish M Kamat
- Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX.
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Chen M, Pan X, Wang H, Yao D. The risk and latency evaluation of secondary primary malignancies of cervical cancer patients who received radiotherapy: A study based on the SEER database. Front Oncol 2023; 12:1054436. [PMID: 36741727 PMCID: PMC9894156 DOI: 10.3389/fonc.2022.1054436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 12/01/2022] [Indexed: 01/20/2023] Open
Abstract
Objectives To study the risk factors for the onset of secondary primary malignancies (SPM) and the latency between SPM and cervical cancer after radiotherapy. Methods We selected patients with cervical cancer who underwent radiotherapy between 2000 and 2019 from the Surveillance, Epidemiology, and End Results (SEER) database. And the data of patients with cervical cancer who underwent radiotherapy in Guangxi Medical University Cancer Hospital during January 1,1997 to December 31,2016 were collected and analyzed. The factors associated with SPM onset and latency were then estimated by nomograms based on logistic regression and a complete risk model. Dynamic risk plots were performed by Poisson regression. Results A total of 32,313 cases of cervical cancer who underwent radiotherapy were downloaded from the SEER database; of these, 19,439 cases had a complete dataset and were included in the final analysis. In total, 561 cases suffered from SPM; the remaining 18,878 did not. And a total of 1486 cases of cervical cancer who underwent radiotherapy from Guangxi Medical University Cancer Hospital were analyzed, 27 cases caught SPM and the rest of 1459 cases did not. Patients with SPM were older than those without SPM(p=0.000); significant associations were also identified between SPM and white race(p=0.000), localized stage (p=0.000), squamous carcinoma (SCC)(p=0.003), surgery(p=0.000), and combination radiotherapy (p=0.026). A logistic regression nomogram showed that older age (HR:1.015, 95%CI:1.009-1.021, p=0.000), localized stage (HR:4.056, 95%CI: 2.625-6.269, p=0.000) and regional stage (HR: 3.181, 95%CI:2.094-4.834, p=0.000), white (HR: 1.722, 95%CI:1.145-2.590, p=0.000) and black race (HR: 1.889, 95%CI:1.327-2.689, p=0.000), and the receipt of surgery (HR: 1.381, 95%CI:1.151-1.657, p=0.000) were all independent risk factors for the onset of SPM. The largest proportion of cases involved SPM in the female reproductive system. A dynamic risk plot showed that age, race, stage, and surgery had impacts on the latency of SPM onset. A competing risk regression analysis nomogram showed that age (HR: 1.564, 95%CI: 1.272-1.920, p=0.000), surgery (HR: 1.415, 95%CI: 1.140-1.760, p=0.002), localized stage (HR: 8.035, 95%CI: 4.502-14.340, p=0.000) and regional stage (HR: 4.904, 95%CI: 2.790-8.620, p=0.000), and black race (HR: 1.786, 95%CI: 1.161-2.750, p=0.008) all had significant impacts on the cumulative incidence and latency of SPM. Conclusions Advanced age, the receipt of surgery, earlier stages, and white and black race were identified as risk factors for SPM onset and influenced latency in patients with cervical cancer after radiotherapy.
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Affiliation(s)
- Mengjie Chen
- The Department of Gynecological Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, China
| | - Xinbin Pan
- The Department of Gynecological Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, China,The Department of Radiotherapy, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, China
| | - He Wang
- The Department of Gynecological Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, China
| | - Desheng Yao
- The Department of Gynecological Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, China,*Correspondence: Desheng Yao,
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van der Straten L, Levin MD, Dinnessen MAW, Visser O, Posthuma EFM, Doorduijn JK, Langerak AW, Kater AP, Dinmohamed AG. Risk of second primary malignancies in patients with chronic lymphocytic leukemia: a population-based study in the Netherlands, 1989-2019. Blood Cancer J 2023; 13:15. [PMID: 36635262 PMCID: PMC9837130 DOI: 10.1038/s41408-023-00784-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 12/23/2022] [Accepted: 01/05/2023] [Indexed: 01/14/2023] Open
Abstract
The longevity of patients with chronic lymphocytic leukemia (CLL) has improved progressively over the past decades, making it essential to understand long-term health outcomes, such as second primary malignancies (SPMs). Therefore, this nationwide, population-based study assessed the risk of SPM development in CLL patients diagnosed during 1989-2019 in the Netherlands compared to the expected number of malignancies in an age-, sex-, and period-matched group from the general Dutch population. In 24,815 CLL patients followed for 162,698.49 person-years, 4369 SPMs were diagnosed with a standardized incidence ratio (SIR) of 1.63 (95% confidence interval [CI] 1.59-1.68). This elevated risk was observed for solid (SIR, 1.67; 95% CI, 1.65-1.75) and hematological SPMs (SIR 1.42; 95% CI, 1.24-1.62). The highest risk for SPMs was noted beyond five years post-diagnosis (SIR, 1.70; 95% CI, 1.62-1.77), for male individuals (SIR, 1.70; 95% CI, 1.64-1.77), and patients aged 18-69 years (SIR, 1.92; 95% CI, 1.79-2.05). The risk of SPMs was higher in CLL patients who received anti-neoplastic therapy (SIR, 2.12; 95% CI, 1.96-2.28), as compared with those who did not (SIR, 1.58; 95% CI, 1.53-1.63). Routine surveillance activities and tailored interventions to counteract the increased morbidity and excess mortality associated with SPMs are essential for improving long-term outcomes in CLL patients.
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Affiliation(s)
- Lina van der Straten
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands. .,Department of Internal Medicine, Albert Schweitzer Hospital, Dordrecht, The Netherlands. .,Department of Immunology, Erasmus MC, Rotterdam, The Netherlands.
| | - Mark-David Levin
- grid.413972.a0000 0004 0396 792XDepartment of Internal Medicine, Albert Schweitzer Hospital, Dordrecht, The Netherlands
| | - Manette A. W. Dinnessen
- grid.470266.10000 0004 0501 9982Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands ,Amsterdam UMC, University of Amsterdam, Department of Hematology, Cancer Center Amsterdam, Lymphoma and Myeloma Center Amsterdam, Amsterdam, The Netherlands
| | - Otto Visser
- grid.470266.10000 0004 0501 9982Department of Registration, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Eduardus F. M. Posthuma
- grid.415868.60000 0004 0624 5690Department of Internal Medicine, Reinier The Graaf Hospital, Delft, The Netherlands ,grid.10419.3d0000000089452978Department of Hematology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jeanette K. Doorduijn
- grid.5645.2000000040459992XErasmus MC Cancer Institute, Department of Hematology, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Anton W. Langerak
- grid.5645.2000000040459992XDepartment of Immunology, Erasmus MC, Rotterdam, The Netherlands
| | - Arnon P. Kater
- Amsterdam UMC, University of Amsterdam, Department of Hematology, Cancer Center Amsterdam, Lymphoma and Myeloma Center Amsterdam, Amsterdam, The Netherlands
| | - Avinash G. Dinmohamed
- grid.470266.10000 0004 0501 9982Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands ,Amsterdam UMC, University of Amsterdam, Department of Hematology, Cancer Center Amsterdam, Lymphoma and Myeloma Center Amsterdam, Amsterdam, The Netherlands ,grid.5645.2000000040459992XErasmus MC, Department of Public Health, University Medical Center Rotterdam, Rotterdam, The Netherlands ,grid.12380.380000 0004 1754 9227Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Hematology, Cancer Center Amsterdam, Amsterdam, The Netherlands
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Prognosis of male lung cancer patients with urinary cancer: a study from a national population-based analysis. Sci Rep 2023; 13:283. [PMID: 36609573 PMCID: PMC9822891 DOI: 10.1038/s41598-023-27566-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 01/04/2023] [Indexed: 01/09/2023] Open
Abstract
Lung cancer accounts for the most cancer-related deaths in the world. Our previous study suggested the improved survival of lung cancer patients, mainly female patients, with subsequent metachronous primary breast cancer. However, whether the survival advantages of the two primaries are associated with patients' sex and the specific breast cancer is unclear. Whether male lung cancer patients with another primary may encounter the same survival advantage as female patients is also uncertain. The uncertainty hinders these patients from the potential benefit of lung cancer clinical trial. A total of 343 male lung adenocarcinoma patients with subsequent bladder papillary transitional cell carcinoma (LCBC), 1539 lung adenocarcinoma patients with prior bladder papillary transitional cell carcinoma (BCLC), 1181 lung adenocarcinoma patients with subsequent prostate adenocarcinoma (LCPC), 7426 lung adenocarcinoma patients with prior prostate adenocarcinoma (PCLC), and patients with single bladder/prostate/lung (SLC) cancer were identified from the Surveillance, Epidemiology, and End Results. Patients were classified into simultaneous two primary cancer (sTPC), metachronous two primary cancer 1 (mTPC1), or mTPC2 groups when interval time between two cancers was within 6 months, between 7 and 60 months, or over 60 months, respectively. Propensity matching score program was executed to match the two primary cancers with single primary. Cox regression and competing risk regression were performed to identify confounders associated with all-cause and cancer-specific survival, respectively. The major cancer-related and non-cancer-related death in the two primaries were lung cancer and heart disease, respectively. Median overall survival times since lung primary of LCBC and SLC were 97 and 17 months, respectively, and incidence of all-cause and cancer-specific death in LCBC since lung malignancy was significantly lower (Coef. - 1.24, 95% CI - 1.49 to 0.99; SHR 0.42, 95% CI 0.33-0.53). Among the categorized groups, prognosis values of sTPC and mTPC2 groups were not statically different from that of the matched single lung cancer, whereas increased overall survival time and decreased incidence of all-cause and cancer-specific death relative to the matched patients were observed in mTPC1 group (H.R 0.28, 95% CI 0.19-0.41; SHR 0.33, 95% CI 0.23-0.47). Similar prognosis of LCPC relative to SLC was also observed. Furthermore, a generally improved survival relative to SLC was observed in PCLC (median survival times of PCLC and SLC were 17 and 12 months, respectively; Coef. - 0.32, 95% CI - 0.43 to 0.22; SHR 0.77, 95% CI 0.69-0.85), whereas prognosis of BCLC was similar to the matched ones. These results hinted that survival of lung cancer patients might vary with prior cancer history. Further analysis among groups with the two primaries suggested that advanced bladder cancer was not associated with prognosis of patients with LCBC and BCLC. On the contrary, advanced prostate cancer was associated with all-cause and cancer-specific death in patients with PCLC but not in patients with LCPC. Compared with patients with single lung cancer, male lung cancer patients with subsequent bladder/prostate primary over 6 months experienced generally improved survival. These results were similar to our previous study regarding female lung cancer patients with another breast primary. On the contrary, male lung cancer patients with prior primary malignancy encountered varied prognosis: improved survival relative to single lung primary was observed in lung cancer with prior prostate cancer, whereas prognosis of lung cancer with prior bladder cancer was not different. Therefore, great attention was required to characterize prognosis of lung cancer patients with another primary in advance, which was essential to eliminate the potential bias when these patients were included into the clinical trials.
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Wang C, Wang D, Pan C, Zhang J, Cheng C, Zhai Y, Yu M, Wang Z, Li G, Zhang W. Clinical characteristics and survival of glioblastoma complicated with non-central nervous system tumors. Chin Neurosurg J 2022; 8:43. [PMID: 36575552 PMCID: PMC9793540 DOI: 10.1186/s41016-022-00312-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 12/07/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Diagnosis and treatment of patients with glioblastoma (GBM) who are also diagnosed with primary non-central nervous system (CNS) tumors remain a challenge, yet little is known about the clinical characteristics and prognosis of these patients. The data presented here compared the clinical and pathological features between glioblastoma patients with or without primary non-CNS tumors, trying to further explore this complex situation. METHODS Statistical analysis was based on the clinical and pathological data of 45 patients who were diagnosed with isocitrate dehydrogenase (IDH) wild-type glioblastoma accompanied by non-CNS tumors between January 2019 and February 2022 in Beijing Tiantan Hospital. Univariate COX proportional hazard regression model was used to determine risk factors for overall survival. RESULTS It turned out to be no significant difference in the overall survival (OS) of the 45 patients with IDH-wild-type GBM plus non-CNS tumors, compared with the 112 patients who were only diagnosed with IDH-wild-type GBM. However, there was a significant difference in OS of GBM patients with benign tumors compared to those with malignant tumors. CONCLUSIONS Implications for the non-central nervous system tumors on survival of glioblastomas were not found in this research. However, glioblastomas complicated with other malignant tumors still showed worse clinical outcomes.
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Affiliation(s)
- Chen Wang
- grid.411617.40000 0004 0642 1244Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No. 119 South Fourth Ring Western Road, Fengtai District, Beijing, China
| | - Di Wang
- grid.411617.40000 0004 0642 1244Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No. 119 South Fourth Ring Western Road, Fengtai District, Beijing, China
| | - Changqing Pan
- grid.411617.40000 0004 0642 1244Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No. 119 South Fourth Ring Western Road, Fengtai District, Beijing, China
| | - Jiazheng Zhang
- grid.411617.40000 0004 0642 1244Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No. 119 South Fourth Ring Western Road, Fengtai District, Beijing, China
| | - Cheng Cheng
- grid.411617.40000 0004 0642 1244Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No. 119 South Fourth Ring Western Road, Fengtai District, Beijing, China
| | - You Zhai
- grid.411617.40000 0004 0642 1244Beijing Neurosurgical Institute, Capital Medical University, No. 119 South Fourth Ring Western Road, Fengtai District, Beijing, China
| | - Mingchen Yu
- grid.411617.40000 0004 0642 1244Beijing Neurosurgical Institute, Capital Medical University, No. 119 South Fourth Ring Western Road, Fengtai District, Beijing, China
| | - Zhiliang Wang
- grid.411617.40000 0004 0642 1244Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No. 119 South Fourth Ring Western Road, Fengtai District, Beijing, China
| | - Guanzhang Li
- grid.411617.40000 0004 0642 1244Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No. 119 South Fourth Ring Western Road, Fengtai District, Beijing, China ,grid.411617.40000 0004 0642 1244Beijing Neurosurgical Institute, Capital Medical University, No. 119 South Fourth Ring Western Road, Fengtai District, Beijing, China ,Chinese Glioma Genome Atlas (CGGA), Beijing, China
| | - Wei Zhang
- grid.411617.40000 0004 0642 1244Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No. 119 South Fourth Ring Western Road, Fengtai District, Beijing, China ,grid.411617.40000 0004 0642 1244Beijing Neurosurgical Institute, Capital Medical University, No. 119 South Fourth Ring Western Road, Fengtai District, Beijing, China ,grid.24696.3f0000 0004 0369 153XCenter of Brain Tumor, Beijing Institute for Brain Disorders, Beijing, China ,grid.411617.40000 0004 0642 1244China National Clinical Research Center for Neurological Diseases, Beijing, China ,Chinese Glioma Genome Atlas (CGGA), Beijing, China
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Tillu N, Kulkarni J. Multi-quadrant Robotic-Assisted Surgery for Synchronous Tumours Involving the Genitourinary System - Our Experience. Indian J Surg Oncol 2022; 13:842-847. [PMID: 36687229 PMCID: PMC9845482 DOI: 10.1007/s13193-022-01584-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 07/07/2022] [Indexed: 02/07/2023] Open
Affiliation(s)
- Neeraja Tillu
- Asian Cancer Institute, 93, ACI Hospital, 95, August Kranti Rd, Kemps Corner, Cumballa Hill, Mumbai, Maharashtra 400036 India
| | - Jagdeesh Kulkarni
- Asian Cancer Institute, 93, ACI Hospital, 95, August Kranti Rd, Kemps Corner, Cumballa Hill, Mumbai, Maharashtra 400036 India
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He D, Wu P, Li G, Zhu S, Wang Q, Shao Q, Chang H. Association between a prior cancer history and prognosis in adult patients with high‑grade glioma. J Clin Neurosci 2022; 106:20-26. [DOI: 10.1016/j.jocn.2022.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 09/02/2022] [Accepted: 09/20/2022] [Indexed: 11/15/2022]
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Joshi U, Bhattarai A, Gaire S, Gill S, Agrawal V, Yadav SK, Low SK, Dhakal P, Bhatt VR, Kouides PA. Risk of second primary malignancy in patients with primary myelofibrosis: a SEER database study. Leuk Lymphoma 2022; 63:3456-3461. [PMID: 36120968 DOI: 10.1080/10428194.2022.2123227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Prior studies report a greater incidence of second primary malignancy (SPM) among patients with myeloproliferative neoplasms, although the true risk in primary myelofibrosis (PMF) has not been elucidated. We utilized the Surveillance, Epidemiology, and End Results database to evaluate the risk of SPM in PMF patients and analyzed the effects of sociodemographic factors on the risk of SPM. Out of 5273 patients, 385 patients (7.30%) developed SPM. SPM occurred at SIR of 1.95 (95% CI 1.76-2.15) and AER of 149.01 per 10,000 population. A significantly higher incidence of melanoma (SIR 1.76, 95% CI 1.01-2.86), lymphoma (SIR 3.38, 95% CI 2.28-4.83), and leukemia (SIR 27.19, 95% CI 23.09-31.81) was observed. The risk was significantly higher in patients ≤60 years, males, chemotherapy recipients, within 5 years of PMF diagnosis, and for PMF diagnosed after 2009.
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Affiliation(s)
- Utsav Joshi
- Department of Internal Medicine, Rochester General Hospital, Rochester, NY, USA
| | - Adheesh Bhattarai
- Department of Internal Medicine, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | - Suman Gaire
- Department of Internal Medicine, Mount Sinai Hospital, Chicago, IL, USA
| | - Simrat Gill
- Department of Internal Medicine, Rochester General Hospital, Rochester, NY, USA
| | - Vishakha Agrawal
- Department of Internal Medicine, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | - Sumeet Kumar Yadav
- Department of Hospital Internal Medicine, Mayo Clinic Health System, Mankato, MN, USA
| | - Soon Khai Low
- Department of Internal Medicine, Rochester General Hospital, Rochester, NY, USA
| | - Prajwal Dhakal
- Department of Internal Medicine, Division of Hematology, Oncology, and Blood & Marrow Transplantation, University of Iowa, Iowa City, IA, USA
| | - Vijaya Raj Bhatt
- Department of Internal Medicine, Division of Oncology and Hematology, University of Nebraska Medical Center, Omaha, NE, USA.,Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, USA
| | - Peter A Kouides
- Division of Hematology and Clinical Oncology, Rochester General Hospital, Rochester, NY, USA.,University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
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Othmane B, Yi Z, Zhang C, Chen J, Zu X, Fan B. Filling the gaps in the research about second primary malignancies after bladder cancer: Focus on race and histology. Front Public Health 2022; 10:1036722. [PMID: 36466542 PMCID: PMC9713240 DOI: 10.3389/fpubh.2022.1036722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 10/19/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose Previous research has shown that bladder cancer has one of the highest incidences of developing a second primary malignancy. So, we designed this study to further examine this risk in light of race and histology. Patients and methods Using the surveillance, epidemiology, and end results (SEER) 18 registry, we retrospectively screened patients who had been diagnosed with bladder cancer between 2000 and 2018. We then tracked these survivors until a second primary cancer diagnosis, the conclusion of the trial, or their deaths. In addition to doing a competing risk analysis, we derived standardized incidence ratios (SIRs) and incidence rate ratios (IRRs) for SPMs by race and histology. Results A total of 162,335 patients with bladder cancer were included, and during follow-ups, a second primary cancer diagnosis was made in 31,746 of these patients. When the data were stratified by race, SIRs and IRRs for SPMs showed a significant difference: Asian/Pacific Islanders (APIs) had a more pronounced increase in SPMs (SIR: 2.15; p 0.05) than White and Black individuals who had an SIRs of 1.69 and 1.94, respectively; p 0.05. In terms of histology, the epithelial type was associated with an increase in SPMs across all three races, but more so in APIs (IRR: 3.51; 95% CI: 2.11-5.85; p 0.001). Conclusion We found that race had an impact on both the type and risk of SPMs. Additionally, the likelihood of an SPM increases with the length of time between the two malignancies and the stage of the index malignancy.
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Affiliation(s)
- Belaydi Othmane
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Zhenglin Yi
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Chunyu Zhang
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Jinbo Chen
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Xiongbing Zu
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Benyi Fan
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China,*Correspondence: Benyi Fan
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Yang W, Zhao Y, Ge Q, Wang X, Jing Y, Zhao J, Liu G, Huang H, Cheng F, Wang X, Ye Y, Song W, Liu X, Du J, Sheng J, Cao X. Genetic mutation and tumor microbiota determine heterogenicity of tumor immune signature: Evidence from gastric and colorectal synchronous cancers. Front Immunol 2022; 13:947080. [PMID: 36420271 PMCID: PMC9676241 DOI: 10.3389/fimmu.2022.947080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 09/23/2022] [Indexed: 01/11/2024] Open
Abstract
Both colorectal and gastric cancer are lethal solid-tumor malignancies, leading to the majority of cancer-associated deaths worldwide. Although colorectal cancer (CRC) and gastric cancer (GC) share many similarities, the prognosis and drug response of CRC and GC are different. However, determinants for such differences have not been elucidated. To avoid genetic background variance, we performed multi-omics analysis, including single-cell RNA sequencing, whole-exome sequencing, and microbiome sequencing, to dissect the tumor immune signature of synchronous primary tumors of GC and CRC. We found that cellular components of juxta-tumoral sites were quite similar, while tumoral cellular components were specific to the tumoral sites. In addition, the mutational landscape and microbiome contributed to the distinct TME cellular components. Overall, we found that different prognoses and drug responses of GC and CRC were mainly due to the distinct TME determined by mutational landscape and microbiome components.
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Affiliation(s)
- Weili Yang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yaxing Zhao
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Zhejiang Provincial Key Laboratory of Pancreatic Disease, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Zhejiang University Cancer Center, Zhejiang University, Hangzhou, China
| | - Qiongxiang Ge
- Department of Anorectal Surgery, The First Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang Provincial Hospital of Traditional Chinese Medicine (TCM), Hangzhou, China
| | - Xiaoli Wang
- Department of Hepato-Gastroenterology, Tianjin Medical University General Hospital, Tianjin Medical University, Tianjin, China
| | - Yang Jing
- Department of Hepato-Gastroenterology, Tianjin Medical University General Hospital, Tianjin Medical University, Tianjin, China
| | - Jingwen Zhao
- Department of Hepato-Gastroenterology, Tianjin Medical University General Hospital, Tianjin Medical University, Tianjin, China
| | - Gang Liu
- Department of Surgery, Tianjin Medical University General Hospital, Tianjin Medical University, Tianjin, China
| | - He Huang
- Frontiers Science Center for Synthetic Biology, School of Chemical Engineering and Technology, Tianjin University, Tianjin, China
| | - Fei Cheng
- Department of Pathology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaoxi Wang
- Department of Pathology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yulin Ye
- Department of Hepato-Gastroenterology, Tianjin Medical University General Hospital, Tianjin Medical University, Tianjin, China
| | - Wenjing Song
- Department of Pathology, Tianjin Medical University General Hospital, Tianjin Medical University, Tianjin, China
| | - Xinjuan Liu
- Department of Gastroenterology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Juan Du
- Department of Gastroenterology, First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Jianpeng Sheng
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Zhejiang Provincial Key Laboratory of Pancreatic Disease, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Zhejiang University Cancer Center, Zhejiang University, Hangzhou, China
| | - Xiaocang Cao
- Department of Hepato-Gastroenterology, Tianjin Medical University General Hospital, Tianjin Medical University, Tianjin, China
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