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Salhab RQ, Ghazaleh ZI, Barbarawi W, Salah-Aldin R, Hour H, Sweity R, Bakri IA. An unusual occurrence of multiple primary malignant neoplasms: a case report and narrative review. Front Oncol 2024; 14:1381532. [PMID: 39087028 PMCID: PMC11288870 DOI: 10.3389/fonc.2024.1381532] [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: 02/03/2024] [Accepted: 06/26/2024] [Indexed: 08/02/2024] Open
Abstract
Introduction Multiple primary malignant neoplasms (MPMNs) are cancers presenting distinct pathological types that originate from different tissues or organs. They are categorized as either synchronous or metachronous. Nowadays, the incidence of MPMN is increasing. Patients and methods We present a case of a 71-year-old male patient with a medical history of hepatitis B and a family history of breast and endometrial cancers. The patient reported a nasal tip skin lesion with recurrent bleeding, and the history disclosed lower urinary tract symptoms. Further investigations revealed the coexistence of four primary cancers: basosquamous carcinoma of the nasal lesion, prostatic adenocarcinoma, hepatocellular carcinoma, and clear cell renal cell carcinoma. Results A multidisciplinary team cooperated to decide the proper diagnostic and therapeutic modules. Conclusion To the best of our knowledge, the synchronization of these four primary cancers has never been reported in the literature. Even so, multiple primary malignant neoplasms, in general, are no longer a rare entity and need proper explanations, a precise representation of definition and incidence, further work-up approaches, and treatment guidelines as well.
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Affiliation(s)
- Rawand Qasim Salhab
- Medical Research Club, Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Zeina Ihab Ghazaleh
- Medical Research Club, Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Wadee Barbarawi
- Department of Urology, Al-Makassed Islamic Charitable Hospital, Jerusalem, Palestine
| | - Riyad Salah-Aldin
- Department of Urology, Al-Makassed Islamic Charitable Hospital, Jerusalem, Palestine
| | - Hani Hour
- Department of Oncology, Beit Jala Hospital, Bethlehem, Palestine
| | - Raghad Sweity
- Medical Research Club, Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Izzeddin A. Bakri
- Department of Pathology, Al-Makassed Islamic Charitable Hospital, Jerusalem, Palestine
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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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Ediz C, Akan S, Huseyin Tavukcu H, Kayhan ME, Yilmaz O. Prognosis of primary or metachronous prostate cancer in multiple primary genitourinary cancers; a single center experience with long-term results. Aging Male 2021; 24:37-41. [PMID: 34338118 DOI: 10.1080/13685538.2020.1817368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE This study aims to analyze the challenges, approaches and long-term results of primary or metachronous prostate cancer (PCa) in cases with multiple primary genitourinary cancers. METHODOLOGY A total of 17 patients were included in the study. Patients with multiple primary genitourinary cancers were divided into two groups according to the diagnosis of primary or metachronous PCa as group 1 and group 2. RESULTS The median age of patients was similar in both groups. The median smoking status (pack-years) was higher in group 2 than group 1. The median prostate-specific antigen (PSA) level was higher in group 1 than group 2. The median follow-up time from primary to the metachronous tumour was higher in group 1 than group 2. The rate of recurrence in PCa was higher in group 1 than group 2. No statistically significant difference was observed in terms of patients' age, smoking status, PSA levels at diagnosis of PCa and biochemical recurrence or metastasis between the two groups (p > 0.05). CONCLUSION Primary PCa cases may progress more aggressively than metachronous PCa cases. Biochemical recurrence and metastasis may be less threatening in metachronous PCa cases than primary cases. Therefore, aggressive treatment can be avoided for metachronous PCa cases.
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Affiliation(s)
- Caner Ediz
- Department of Urology, Sultan Abdulhamid Han Education and Research Hospital, Istanbul, Turkey
| | - Serkan Akan
- Department of Urology, Sultan Abdulhamid Han Education and Research Hospital, Istanbul, Turkey
| | - Hasan Huseyin Tavukcu
- Department of Urology, Sultan Abdulhamid Han Education and Research Hospital, Istanbul, Turkey
| | - Muhammed Esad Kayhan
- Department of Urology, Sultan Abdulhamid Han Education and Research Hospital, Istanbul, Turkey
| | - Omer Yilmaz
- Department of Urology, Sultan Abdulhamid Han Education and Research Hospital, Istanbul, Turkey
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Chatterjee T, Singh K, Ahuja A, Pradeep V, S Gahlot GP. A rare presentation of dual malignancy (Transitional carcinoma urinary bladder and adenocarcinoma of biliary origin) in a 65 year old patient: An interesting autopsy finding. INDIAN J PATHOL MICR 2021; 64:610-612. [PMID: 34341290 DOI: 10.4103/ijpm.ijpm_138_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Tathagat Chatterjee
- Department of Laboratory Sciences and Molecular Medicine, Army Hospital (R& R), Delhi Cantt, India
| | - Kanwaljeet Singh
- Department of Laboratory Sciences and Molecular Medicine, Army Hospital (R& R), Delhi Cantt, India
| | - Ankur Ahuja
- Department of Laboratory Sciences and Molecular Medicine, Army Hospital (R& R), Delhi Cantt, India
| | - V Pradeep
- Department of Laboratory Sciences and Molecular Medicine, Army Hospital (R& R), Delhi Cantt, India
| | - G P S Gahlot
- Department of Laboratory Sciences and Molecular Medicine, Army Hospital (R& R), Delhi Cantt, India
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Ma Y, Cao JQ, Yin Y, Yao LT, Han X, Wang QM, Zhao Y. Rare case of uterine neoplasm: cervical sarcoma with endometrial carcinoma. J Int Med Res 2019; 48:300060519876792. [PMID: 31840528 PMCID: PMC7607216 DOI: 10.1177/0300060519876792] [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] [Indexed: 11/30/2022] Open
Abstract
Multiple primary malignant tumors (MPMTs) refer to two or more primary malignant
neoplasms that simultaneously or successively occur in one or more organs in the same
individual. Cervical sarcoma concomitant with endometrial carcinoma is rare. A 46-year-old
woman was admitted because of increased menstrual volume for 4 years and irregular vaginal
bleeding with discharge for 6 months. The diagnosis of endometrial carcinoma at stage II
was made on the basis of results of ultrasound, pelvic magnetic resonance imaging, and
hysteroscopic curettage. Extensive total abdominal hysterectomy + bilateral
adnexectomy + bilateral ovarian arteriovenous high ligation + pelvic adhesion
separation + pelvic lymphadenectomy +abdominal aortic lymphadenectomy via the abdomen were
performed. Postoperative diagnosis of cervical sarcomas with endometrial carcinoma in
stage IIIC1 was made according to the results of pathology and immunohistochemistry. Six
cycles of cisplatin-epirubicin-isocyclophosphamide treatment were provided after the
operation. Most clinical manifestations of cervical sarcomas are abnormal vaginal
bleeding. Use of preoperative imaging and hysteroscopy is difficult for diagnosing
cervical sarcomas, and postoperative pathological examinations and immunohistochemical
diagnosis are mainly used instead. The possibility of MPMTs should be considered for
endometrial carcinoma, especially if the cervical lesion is larger than that of the
uterine cavity.
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Affiliation(s)
- Ying Ma
- Department of Gynecology, The First Hospital of Shanxi Medical University, Taiyuan, China
| | - Jie-Qiong Cao
- First Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Yan Yin
- Department of Pathology, The First Hospital of Shanxi Medical University, Taiyuan, China
| | - Li-Ting Yao
- First Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Xiao Han
- First Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Qiu-Man Wang
- First Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Ye Zhao
- Department of Gynecology, The First Hospital of Shanxi Medical University, Taiyuan, China
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6
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Bisht N, Singh S, Sarin A, Gupta S, Singh HP, Kapoor A, Mulajker D, Joshi R, Purkayastha A, Mishra PS, Shelly D. The Conundrum of Dual Primary Malignancies: Four Years’ Experience of a Single Tertiary Care Institute in India. Indian J Med Paediatr Oncol 2019. [DOI: 10.4103/ijmpo.ijmpo_69_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Abstract
Background: Encountering more than one malignancy in a cancer patient is no longer uncommon; this increasing incidence is mostly attributable to the improvements in life expectancy, awareness, and diagnostic facilities. This article aims to highlight this institute’s experience in diagnosis and treatment of patients of multiple primary malignancies and a comprehensive review of literature. Materials and Methods: This is a descriptive study of retrospectively collected data of a single institution over 4 years from 2013 to 2016. Known cases of cancer who were diagnosed with a second primary malignancy were included in the study. Various details such as age, sex, site of disease, temporal relation of two cancers (synchronous or metachronous), family history, tobacco use, treatment given, and survival at 1 year were recorded, organized in a tabular form, analyzed, and described. Results: A total of 29 cases of dual malignancies comprising 0.74% of a total of 3879 patients of cancer were encountered. Seventy-two percent of the cases were metachronous and 5 years was the mean time interval between tumors. There was a female preponderance, and the average age was 56 years. Breast was the most common site of malignancy. At 1 year from diagnosis of second primary, 69% of the patients were alive and 27% were disease-free. Conclusion: Second primary in a patient of cancer is becoming increasingly common and the suspicion of the same should always be borne in mind during follow-up. Prognosis as well as intent of treatment depends on respective stages of the two malignancies.
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Affiliation(s)
- Niharika Bisht
- Malignant Disease Treatment Centre, Command Hospital (SC), Pune, Maharashtra, India
| | - Sankalp Singh
- Malignant Disease Treatment Centre, Command Hospital (SC), Pune, Maharashtra, India
| | - Arti Sarin
- Malignant Disease Treatment Centre, Command Hospital (SC), Pune, Maharashtra, India
| | - Samir Gupta
- Malignant Disease Treatment Centre, Command Hospital (SC), Pune, Maharashtra, India
| | - Harinder Pal Singh
- Malignant Disease Treatment Centre, Command Hospital (SC), Pune, Maharashtra, India
| | - Amul Kapoor
- Malignant Disease Treatment Centre, Command Hospital (SC), Pune, Maharashtra, India
| | - Deepak Mulajker
- Malignant Disease Treatment Centre, Command Hospital (SC), Pune, Maharashtra, India
| | - Richa Joshi
- Malignant Disease Treatment Centre, Command Hospital (SC), Pune, Maharashtra, India
| | - Abhishek Purkayastha
- Malignant Disease Treatment Centre, Command Hospital (SC), Pune, Maharashtra, India
| | | | - Divya Shelly
- Department of Pathology, Armed Forces Medical College, Pune, Maharashtra, India
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Yang X, Qin D, Zhang Y, Li X, Liu N, Zhou Y, Feng M, Wang Y. An elderly female patient with ROS1 rearrangement primary lung adenocarcinoma and breast carcinoma: a rare case report and review of the literature. PRECISION CLINICAL MEDICINE 2019; 2:197-203. [PMID: 35694436 PMCID: PMC8982593 DOI: 10.1093/pcmedi/pbz013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 06/14/2019] [Accepted: 07/17/2019] [Indexed: 02/05/2023] Open
Abstract
We report the case of a 90-year-old female patient who was suffering from c-ros oncogene
1 (ros-1) rearrangement adenocarcinoma and breast cancer. After about
14 months of a reduced dose of crizotinib treatment, she had a stable disease according to
the Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1). This patient’s
case demonstrates that ros-1 rearrangements are not limited to patients
of young age. In addition, this case indicates that crizotinib, as second-line, or even
first-line, treatment may be effective and manageable in elderly patients. Furthermore,
for elderly patients carrying a ros1 fusion, a reduced dose of crizotinib
may be efficacious rather than a resistance factor. Based on our findings, we recommend
that elderly patients with advanced lung adenocarcinoma should be considered for inclusion
in molecular screening for ros-1 translocation, especially for
never-smokers negative for epidermal growth factor receptor (egfr)
mutation and the fusion between echinoderm microtubule associated protein-like 4 (EML4)
and anaplastic lymphoma kinase (ALK). This deserves attention because the population is
aging, with increasing incidence and morbidity of multiple primary malignant tumors.
Neglect of breast nodules at the onset is one of the limitations of our case, as
combination of primary lung cancer with breast cancer is common. Above all, use of
antiestrogens before and after the diagnosis of non-small-cell lung cancer is related to a
reduced risk of lung cancer mortality. Therefore, careful attention should always be paid
to these cases.
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Affiliation(s)
- Xiaojuan Yang
- Department of Thoracic Oncology, Cancer Center, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China
| | - Diyuan Qin
- State Key Laboratory of Biotherapy, Sichuan University, No. 17, Section 3, Renmin South Road, Chengdu 610041, China
| | - Yu Zhang
- Department of Pathology, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China
| | - Xue Li
- Department of Thoracic Oncology, Cancer Center, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China
| | - Ning Liu
- Department of Thoracic Oncology, Cancer Center, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China
| | - Ying Zhou
- Department of Thoracic Oncology, Cancer Center, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China
| | - Ming Feng
- Department of Pathology, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China
| | - Yongsheng Wang
- Department of Thoracic Oncology, Cancer Center, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, China
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Babu G, Asati V, Lakshmaiah KC, Lokanatha D, Jacob LA, Babu S, Lokesh KN, Rudresh AH, Rajeev LK, Saldanha S, Chethan R, Koppaka D, Premalata CS. Every distant deposit is not a metastasis: Synchronous primaries do exist. Indian J Cancer 2019; 56:70-73. [PMID: 30950449 DOI: 10.4103/ijc.ijc_637_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Synchronous occurrence of two malignant tumors is a rare event. With increasing use of sophisticated imaging modalities for staging, synchronous multiple tumors are more commonly detected now. Assuming the second primary malignancy as metastasis will change the intent of treatment from curative to palliative, greater awareness among oncologists is of paramount importance. This study is an example where thorough clinical examination and proper judgment resulted in correct diagnosis and appropriate treatment. MATERIALS AND METHODS This is a prospective descriptive study. Patients diagnosed with synchronous primary tumors from January 2016 to November 2017 at our center were reviewed. RESULTS Ten cases of synchronous primary malignancies were detected during this period. A total of 20 primary tumors were diagnosed. Lung carcinoma and gastrointestinal malignancies were the most common (five patients each). The median age was 59.5 years. Seven patients were male. Second primary tumor was suspected in four patients during clinical examination, while in six patients it was suspected on imaging. Even in the presence of two primary tumors, three patients were treated with curative intent. CONCLUSION Possibility of synchronous second primary malignancy should always be kept whenever a distant deposit is detected at an unusual site. Histopathological evaluation of the lesion before assuming a metastasis will lead to accurate diagnosis, staging, and appropriate treatment.
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Affiliation(s)
- Govind Babu
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - Vikas Asati
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - K C Lakshmaiah
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - D Lokanatha
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - Linu Abraham Jacob
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - Suresh Babu
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - K N Lokesh
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - A H Rudresh
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - L K Rajeev
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - Smitha Saldanha
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - R Chethan
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - Deepak Koppaka
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - C S Premalata
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
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Hu Z, Zhang M, Wang Z, Song J, Jiang W, Li L, Hu X. An observational study on the clinical features of esophageal cancer followed by multiple primary cancers. Future Oncol 2018; 15:601-610. [PMID: 30477336 DOI: 10.2217/fon-2018-0621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM To investigate the nature of multiple primary cancers initiated by esophageal cancer-multiple primary cancers (EC-MPC). PATIENTS & METHODS SEER data about patients'/tumor characteristics, and survival were analyzed and compared. RESULTS & CONCLUSION 1727 of 29,733 registered EC patients have EC-MPC. Individuals diagnosed at 60-79 years old, earlier stage and/or moderately differentiated EC were more likely to get EC-MPC. Fewer patients in the EC-MPC group suffered from metastases. Patients in the EC-MPC group showed a longer survival rate and lower EC-specific deaths. Other factors like age, sex, race, tumor differentiation and Tumor, Node, Metastasis stage also affected survival. Radiation can improve survival. EC-MPC patients have some distinct features compared with solitary EC.
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Affiliation(s)
- Zhipeng Hu
- Department of Cardiovascular Surgery, Renmin hospital of Wuhan University, 238 Jiefang Road, Wuhan City of Hubei Provice, PR China
| | - Min Zhang
- Department of Cardiovascular Surgery, Renmin hospital of Wuhan University, 238 Jiefang Road, Wuhan City of Hubei Provice, PR China
| | - Zhiwei Wang
- Department of Cardiovascular Surgery, Renmin hospital of Wuhan University, 238 Jiefang Road, Wuhan City of Hubei Provice, PR China
| | - Junlong Song
- Department of Breast & Thyroid Surgery, Renmin hospital of Wuhan University, 238 Jiefang Road, Wuhan City of Hubei Provice, PR China
| | - Wanli Jiang
- Department of Cardiovascular Surgery, Renmin hospital of Wuhan University, 238 Jiefang Road, Wuhan City of Hubei Provice, PR China
| | - Luocheng Li
- Department of Cardiovascular Surgery, Renmin hospital of Wuhan University, 238 Jiefang Road, Wuhan City of Hubei Provice, PR China
| | - Xiaoping Hu
- Department of Cardiovascular Surgery, Renmin hospital of Wuhan University, 238 Jiefang Road, Wuhan City of Hubei Provice, PR China
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Kim BK, Oh SJ, Song JY, Lee HB, Park MH, Jung Y, Park WC, Lee J, Sun WY. Clinical Characteristics and Prognosis Associated with Multiple Primary Cancers in Breast Cancer Patients. J Breast Cancer 2018; 21:62-69. [PMID: 29628985 PMCID: PMC5880967 DOI: 10.4048/jbc.2018.21.1.62] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 01/15/2018] [Indexed: 12/20/2022] Open
Abstract
Purpose Breast cancer is one of the most common malignancies worldwide and the second most common cancer among Korean women. The prognosis of breast cancer is poor in patients with other primary cancers. However, there have been few clinical studies regarding this issue. Therefore, we analyzed the characteristics and prognosis of patients with breast cancer with multiple primary cancers (MPCs). Methods Data from the Korean Breast Cancer Society Registry were analyzed. Data from enrolled patients who underwent surgery for breast cancer were analyzed for differences in prognosis dependent on the presence of MPCs, and which MPC characteristics affected their prognosis. Results Among the 41,841 patients analyzed, 913 patients were found to have MPCs, accounting for 950 total MPCs. There was a significant difference in survival rates between the breast cancer only group and the MPC group. The 5-year survival rates were 93.6% and 86.7% and the 10-year survival rates were 87.5% and 70.4%, respectively. Among the 913 patients with MPCs, patients with two or more MPCs had significantly worse prognoses than patients with a single MPC. With respect to the time interval between breast cancer and MPC occurrence, patients with a 5-year or greater interval had significantly better prognoses than patients with less than 1 year between occurrences. Among MPCs, thyroid cancer was the most common primary cancer. However, this type was not related to the prognosis of breast cancer. Gynecologic cancer, colorectal cancer, upper gastrointestinal cancer, and lung cancer were related to breast cancer prognosis. Conclusion MPCs were a poor prognostic factor for patients with breast cancer. Two or more MPCs and a shorter time interval between occurrences were worse prognostic factors. Although MPCs were a poor prognostic factor, thyroid cancer did not affect the prognosis of patients with breast cancer.
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Affiliation(s)
- Bong Kyun Kim
- Department of Surgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea
| | - Se Jeong Oh
- Department of Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Jeong-Yoon Song
- Department of Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
| | - Han-Byoel Lee
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Min Ho Park
- Department of Surgery, Chonnam National University Medical School, Gwangju, Korea
| | - Yongsik Jung
- Department of Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Woo-Chan Park
- Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jina Lee
- Department of Surgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea
| | - Woo Young Sun
- Department of Surgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea
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Abstract
Nowadays, the risk of developing second primary cancers among women diagnosed with prior breast cancer represents a public health issue worldwide.Twenty-eight cases of the primary breast cancer with the multiple primary cancers (MPC) between 2008 and 2015 at our hospital were retrospectively analyzed in regards to age of patients, family history, interval time of the 2 cancers, and survival time of these patients.A total 28 cases were analyzed, at the mean age of 44.57 years at the diagnosis of the first primary cancer. The most common primary cancer in these breast cancer patients was contralateral breast cancer. Of 28 patients with breast cancer, 16 developed a second malignant tumor of the opposite breast, there were no significant difference both median age at first breast cancer and second breast cancer (P > .05). The difference of interval time of 2 cancers also had no statistical significance. There was no statistically significant difference in overall survival between the bilateral primary breast cancers (BPBC) group and the group of breast cancer patients who diagnosed with another cancer (P > .05). If we grouped patients age of diagnosed with the first cancer (<45, ≥45 years), no statistical different between 2 groups (P > .05). However, the survival time with positive-node patients was lower than in patients with node-negative, the difference had a notable significant difference (P < .01). And there are 3 cases had a positive family history for malignant tumor in the form of first-degree relative.Multiple primary carcinoma in patients with prior breast cancer is not the influencing factor of prognosis. It is crucial to detect, diagnose, and treat cancers at their early stage for improving the cure rate of cancer and the survival rate of patients.
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Affiliation(s)
- YiHui Liu
- Department of Oncology, The First Affiliated Hospital of Xi’an JiaoTong University, Xi’an, Shaanxi
| | - ChunHui Dong
- Department of Oncology, The First Affiliated Hospital of Xi’an JiaoTong University, Xi’an, Shaanxi
- Department of Oncology, The Ninth Hospital of Xi’an, Xi’an, P.R. China
| | - Ling Chen
- Department of Oncology, The First Affiliated Hospital of Xi’an JiaoTong University, Xi’an, Shaanxi
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12
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Şahin AF, Altok M, Akdeniz F, Yıldız G, Divrik RT. Second primary cancers in patients with urothelial cancers. Investig Clin Urol 2016; 57:330-5. [PMID: 27617314 PMCID: PMC5017561 DOI: 10.4111/icu.2016.57.5.330] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 07/20/2016] [Indexed: 12/04/2022] Open
Abstract
Purpose To investigate the second primary cancers (SPCs) in patients with urothelial cancer (UC). Materials and Methods The records of 2,339 patients whose UC was diagnosed between January 1974 and December 2012 were reviewed. All data about characteristics of patients, of UC and, of SPC was, recorded digitally. We investigated the prevalence and the type of second or higher order cancers, and the factors associated with SPC. Results Total 260 patients (11.1%) had SPC, 14 had a third primary cancer and one had a fourth primary cancer. The most common SPC with UC was lung cancer (29.6%). Of all 260 with SPC, 64 (24.6%) had synchronous (within the 6 months) SPC, 120 (46.2%) had subsequent SPC and, 76 (29.2%) had antecedent SPC. The mean duration of SPC was 56 months in patients with subsequent SPC and 75.8 months in patients with antecedent SPC. The mean age at the time of diagnosis of UC was higher in patients with SPC. The ratio of male gender, body mass index, blood type, status of smoking and, occupational risk was similar in both groups. Total amount of smoking and the mean follow-up were higher in patients with SPC. Conclusions The majority of the patients with UC have long life expectancy. In patients with UC, the risk of having another cancer is quite higher than normal population. The physicians managing patients with UC should look for SPC.
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Affiliation(s)
| | - Muammer Altok
- Department of Urology, Süleyman Demirel University Medicine School, Isparta, Turkey
| | - Fırat Akdeniz
- Department of Urology, MH Tepecik Research and Education Hospital, İzmir, Turkey
| | - Güner Yıldız
- Department of Urology, MH Tepecik Research and Education Hospital, İzmir, Turkey
| | - Rauf Taner Divrik
- Department of Urology, Şifa University Medicine School, İzmir, Turkey
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13
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Chang CC, Chung YH, Liou CB, Lee YC, Weng WL, Yu YC, Yen TH, Wu JM. Influence of residential environment and lifestyle on multiple primary malignancies in Taiwan. Asian Pac J Cancer Prev 2016; 16:3533-8. [PMID: 25921174 DOI: 10.7314/apjcp.2015.16.8.3533] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Multiple primary malignancies (MPM) have become increasingly prevalent worldwide. This investigation was aimed at establishing the clinicopathological characteristics of MPM patients and evaluating the impact of the living environment on MPM in the Taiwanese population. MATERIALS AND METHODS From January 2009 to December 2013, a total of 8,268 cancer patients were identified in our institutional center. Of these, 125 were diagnosed as MPM and thus enrolled. Data for clinicopathological features and treatment approaches for these MPM patients living in urban or suburb zone were obtained. Findings for the air pollution status in Taiwan were also collected. RESULTS The most common cancer match of MPM was esophageal cancer with hypopharyngeal cancer (12.8%), followed by colorectal cancer with gastric cancer (6.4%) and colorectal cancer with breast cancer (5.6%). The air quality was significantly worse in the urban than in the suburban zone and there was a remarkably higher portion of MPM patients in the urban zone suffering from grade III and IV post-chemotherapeutic neutropenia (30.8% vs 15.1%, P=0.036). CONCLUSIONS The tumor frequency and site distribution should be taken into the clinical evaluation because there is a relatively high risk of developing MPM. This study also highlighted the potential influence of environmental factors on post-chemotherapeutic neutropenia for patients with MPM.
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Affiliation(s)
- Chih-Chun Chang
- Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei City, Taiwan E-mail :
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14
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Li F, Zhong WZ, Niu FY, Zhao N, Yang JJ, Yan HH, Wu YL. Multiple primary malignancies involving lung cancer. BMC Cancer 2015; 15:696. [PMID: 26466785 PMCID: PMC4606552 DOI: 10.1186/s12885-015-1733-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 10/08/2015] [Indexed: 12/14/2022] Open
Abstract
Background The incidence of multiple primary malignancies (MPM) has increased sharply in recent decades. However, the clinical characteristics and prognosis of MPM patients involving lung cancer were not fully elucidated. This retrospective study was designed to explore the clinical characteristics and prognosis of MPM patients involving lung cancer in the People’s Republic of China. Methods Of 5405 lung cancer cases diagnosed at the Guangdong Lung Cancer Institute between 2005 and 2013, we analyzed 185 patients (3.4 %) with MPM involving lung cancer. Results Among 185 patients with MPM involving lung cancer, 10 (5.4 %)had three malignancies and 175 (94.6 %) had two malignancies. 10 patients with three malignancies were excluded from the analysis to avoid misunderstanding. Of 175 accompanying malignancies, 64 (36.6 %) were synchronous MPM patients and 111 (63.4 %) were metachronous MPM patients; 49 (28.0 %) were lung cancer first MPM patients and 126 (72.0 %) were other cancer first MPM patients. The most frequent accompanying malignancy was colon cancer (25/175), followed by rectal cancer (18/175), esophageal cancer (17/175), and thyroid cancer (13/175). Metachronous MPM patients showed significantly better overall survival (OS) than synchronous MPM, with a median OS of 72.8 (range 12.2–391.0) and 12.9 (range 0.8–86.3)months, respectively (P < 0.001). Cox regression analysis revealed that time of occurrence and stage were independent factors for OS. Conclusions Colorectal cancer, esophageal cancer, and thyroid cancer were the tumors that most frequently accompanying lung cancer. Metachronous MPM patients showed significantly better OS compared with synchronous MPM patients.
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Affiliation(s)
- Feng Li
- Southern Medical University, 510515, Guangzhou, Guangdong, People's Republic of China. .,Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Sciences, 510080, Guangzhou, Guangdong, People's Republic of China.
| | - Wen-Zhao Zhong
- Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Sciences, 510080, Guangzhou, Guangdong, People's Republic of China.
| | - Fei-Yu Niu
- Southern Medical University, 510515, Guangzhou, Guangdong, People's Republic of China. .,Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Sciences, 510080, Guangzhou, Guangdong, People's Republic of China.
| | - Ning Zhao
- Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Sciences, 510080, Guangzhou, Guangdong, People's Republic of China.
| | - Jin-Ji Yang
- Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Sciences, 510080, Guangzhou, Guangdong, People's Republic of China.
| | - Hong-Hong Yan
- Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Sciences, 510080, Guangzhou, Guangdong, People's Republic of China.
| | - Yi-Long Wu
- Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Sciences, 510080, Guangzhou, Guangdong, People's Republic of China.
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15
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Tsai HW, Chang CC, Sun JT, Liou CB, Lin HC, Lin IH, Yu YC, Weng WL, Leong KI, Yen TH, Wu JM. Clinical features of patients with esophageal and second primary cancers. Asian Pac J Cancer Prev 2015; 15:9831-4. [PMID: 25520113 DOI: 10.7314/apjcp.2014.15.22.9831] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The prevalence of esophageal cancer (EC) with second primary cancers (SPC) is increasing worldwide. This study was aimed to understand the clinical features of EC patients with SPC in the Taiwanese population. MATERIALS AND METHODS Clinical and laboratory data for 180 EC patients with or without SPC were collected between January 2009 and December 2013. Information on treatment approaches, location of SPCs and ABO blood type were also collected and stratified. RESULTS The most common SPC in EC patients was hypopharyngeal cancer, followed by laryngeal cancer and hepatocellular carcinoma in our study. Malignancies of colon, prostate and lung were also found. There was a significant higher portion of blood type A in the EC patients with SPC compared with those without (42.4% vs 19.5%, P=0.006). CONCLUSIONS The frequency and SPC site distribution and blood type A should be considered in clinical evaluation of EC patients with a high risk of developing SPC in the Taiwanese population.
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Affiliation(s)
- Huang-Wen Tsai
- Department of General Surgery, Far Eastern Memorial Hospital, New Taipei, Taiwan E-mail :
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16
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Gu HL, Zeng SX, Chang YB, Lin Z, Zheng QJ, Zheng XQ, Peng ZW, Zhan SQ. Multidisciplinary treatment based on surgery leading to long-term survival of a patient with multiple asynchronous rare primary malignant neoplasms: A case report and literature review. Oncol Lett 2014; 9:1135-1141. [PMID: 25663869 PMCID: PMC4315099 DOI: 10.3892/ol.2014.2833] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 12/03/2014] [Indexed: 11/17/2022] Open
Abstract
Patients that present with multiple primary malignant neoplasms are increasingly encountered, but the treatment of such patients presents specific challenges and long-term survival is rare. The present study reports the case of a 45-year-old female diagnosed with three rare, distinct primary malignant neoplasms, including epithelioid hemangioendothelioma (EHE) of the brain, Ewing’s sarcoma of the lumbar 2 vertebra and a malignant solitary fibrous tumour (SFT) of the liver, at different time points. The patient underwent multidisciplinary treatment according to the diagnoses, including radial resection of all primary lesions, chemotherapy (consisting of vincristine, dactinomycin, cyclophosphamide and adriamycin) and radiotherapy, to treat Ewing’s sarcoma and metastases of EHE and malignant SFT. Following these treatments, the patient survived for >14 years. Multidisciplinary treatment regimens based on surgery can lead to long-term survival of patients with multiple asynchronous rare primary malignant neoplasms. The present study reported that multidisciplinary treatment regimens based on surgery can lead to the long-term survival of patients with multiple asynchronous rare primary malignant neoplasms.
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Affiliation(s)
- Hong-Lin Gu
- Department of Othopedics, Guangdong Academy of Medical Science, Guangdong General Hospital, Guangdong 510080, P.R. China
| | - Shi-Xing Zeng
- Department of Othopedics, Guangdong Academy of Medical Science, Guangdong General Hospital, Guangdong 510080, P.R. China
| | - Yun-Bing Chang
- Department of Othopedics, Guangdong Academy of Medical Science, Guangdong General Hospital, Guangdong 510080, P.R. China
| | - Zhen Lin
- Department of Othopedics, Guangdong Academy of Medical Science, Guangdong General Hospital, Guangdong 510080, P.R. China
| | - Qiu-Jian Zheng
- Department of Othopedics, Guangdong Academy of Medical Science, Guangdong General Hospital, Guangdong 510080, P.R. China
| | - Xiao-Qing Zheng
- Department of Othopedics, Guangdong Academy of Medical Science, Guangdong General Hospital, Guangdong 510080, P.R. China
| | - Zhen-Wei Peng
- Department of Oncology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, P.R. China
| | - Shi-Qiang Zhan
- Department of Othopedics, Guangdong Academy of Medical Science, Guangdong General Hospital, Guangdong 510080, P.R. China
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17
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Jiao F, Yao LJ, Zhou J, Hu H, Wang LW. Clinical features of multiple primary malignancies: a retrospective analysis of 72 Chinese patients. Asian Pac J Cancer Prev 2014; 15:331-4. [PMID: 24528052 DOI: 10.7314/apjcp.2014.15.1.331] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
There is a scarcity of reports addressing patients with multiple primary malignancies (MPM), especially for Chinese cses. The aim of this study was to present a detailed analysis of Chinese patients presenting with at least two primary malignancies. Particularly, the clinical characteristics and survival between synchronous and metachronous MPM were compared. Out of 6,545 cases, 72 patients (1.1%) including 39 males (54.2%) and 33 females (45.8%) were diagnosed as MPM, giving a male: female sex ratio of 1.2:1. Of these, there were 16 (22.2%) cases of synchronous MPM (7 males, 9 females), 55(76.4%) metachronous (31 males, 24 females), and 1 "mixed form". For first tumor diagnosis time, synchronous MPM patients generally presented later than the metachronous cases. The top three sites for malignancies with metachronous MPM were colorectum, head and neck, and lung, while for synchronous they were lung, colorectum and breast. Among MPM patients, the median survival time was 15.7 years and the 5-year survival was 56%, and there was statistical difference in MPM categories (P < 0.05). The median survival time was 17.3 years and 3.8 years for metachronous and synchronous MPM patients, respectively. In comparison with synchronous MPM patients, those metachronous had a longer survival. This studies increase understanding of the clinical features of Chinese MPM patients and suggest that those presenting with metachronous cancers have a higher incidence and a better prognosis.
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Affiliation(s)
- Feng Jiao
- Department of Oncology, Shanghai Jiao Tong University Affiliated First People's Hospital, Shanghai, China E-mail :
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18
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Abstract
Background Multiple primary neoplasms in surviving cancer patients are relatively common, with an increasing incidence. Their impact on survival has not been clearly defined. Methods This was a retrospective review of clinical data for all consecutive patients with histologically confirmed cancer, with emphasis on single versus multiple primary neoplasms. Second primaries discovered at the workup of the index (first) primary were termed simultaneous, if discovered within 6 months of the index primary were called synchronous, and if discovered after 6 months were termed metachronous. Results Between 2005 and 2012, of 1,873 cancer patients, 322 developed second malignancies; these included two primaries (n=284), and three or more primaries (n=38). Forty-seven patients had synchronous primaries and 275 had metachronous primaries. Patients with multiple primaries were predominantly of Caucasian ancestry (91.0%), with a tendency to develop thrombosis (20.2%), had a strong family history of similar cancer (22.3%), and usually presented with earlier stage 0 through stage II disease (78.9%). When compared with 1,551 patients with a single primary, these figures were 8.9%, 15.6%, 18.3%, and 50.9%, respectively (P≤0.001). Five-year survival rates were higher for metachronous cancers (95%) than for synchronous primaries (59%) and single primaries (59%). The worst survival rate was for simultaneous concomitant multiple primaries, being a median of 1.9 years. The best survival was for patients with three or more primaries (median 10.9 years) and was similar to the expected survival for the age-matched and sex-matched general population (P=0.06991). Conclusion Patients with multiple primaries are usually of Caucasian ancestry, have less aggressive malignancies, present at earlier stages, frequently have a strong family history of similar cancer, and their cancers tend to have indolent clinical behavior with longer survival rates, possibly related to genetic predisposition.
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Affiliation(s)
- Magid H Amer
- Department of Medicine, St Rita's Medical Center, Lima, OH, USA
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19
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Flego V, Ristić S, Dević Pavlić S, Matanić Lender D, Bulat-Kardum L, Kapović M, Radojčić Badovinac A. Tumor necrosis factor-alpha gene promoter -308 and -238 polymorphisms in patients with lung cancer as a second primary tumor. Med Sci Monit 2013; 19:846-51. [PMID: 24113849 PMCID: PMC3808239 DOI: 10.12659/msm.889554] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background Lung cancer is the most common second primary cancer. We investigated whether the TNF-α-308 and TNF-α-238 polymorphisms were associated with the susceptibility and severity of lung cancer as the second primary cancer (LC2). Material/Methods This study included 104 patients from the group LC2. The control subjects included 2 groups. The first control group (LC1) comprised 201 unrelated patients with lung cancer as a first primary cancer. The second control group (HC) comprised 230 healthy blood donors, matched for sex and age to the study group. Results The frequencies of the TNF-α-238 polymorphism GG genotype and the G allele were higher in the LC2 group than in the LC1 group, but the differences did not reach significance (p=0.054 and p=0.057, respectively). Similar differences were found in the TNF-α-238 polymorphism GG genotype and G allele between the LC2 group and the HC group (p=0.054 and p=0.057, respectively). In terms of the different types of lung cancer, patients with a second primary NSCLC (non-small cell lung cancer) more frequently had TNF-α-238 polymorphism GG genotypes and G alleles than patients with a first primary NSCLC (the differences approached statistical significance: p=0.060, p=0.064, respectively). All (100%) patients of group LC2 (n=104) had the GG genotype and the G allele. GG genotype was exclusive and no A allele was found in group LC2. Conclusions TNF-α-238 polymorphism GG genotype and the G allele could have a promotional effect on the development of NSCLC in the group of patients with LC2.
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Affiliation(s)
- Veljko Flego
- Department of Pulmonology, Clinical Hospital Centre Rijeka, Rijeka, Croatia
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20
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Hulikal N, Ray S, Thomas J, Fernandes DJ. Second Primary Malignant Neoplasms: A Clinicopathological Analysis from a Cancer Centre in India. Asian Pac J Cancer Prev 2012; 13:6087-91. [DOI: 10.7314/apjcp.2012.13.12.6087] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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