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Collatuzzo G, Ferrante M, Ippolito A, Di Prima A, Colarossi C, Scarpulla S, Boffetta P, Sciacca S. Second Primary Cancers following Colorectal Cancer in Sicily, Italy. Cancers (Basel) 2022; 14:cancers14215204. [PMID: 36358623 PMCID: PMC9657763 DOI: 10.3390/cancers14215204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/19/2022] [Accepted: 10/20/2022] [Indexed: 11/26/2022] Open
Abstract
Simple Summary This study addressed the under-investigated issue of second primary cancer occurring in colorectal cancer survivors. Our aim was to explore whether patients recovered from a first colorectal cancer were at higher risk of developing a subsequent primary cancer. The hypothesis was that exposure to cancer treatment, enhanced health surveillance and shared risk factors may lead to an excess risk of second primary cancer in this population. The number of cases of second primary cancer exceeded the expected in this population, mainly driven by female genital cancers, and especially observed in the first years after colorectal cancer diagnosis. Our findings are overall consistent with previous studies, providing valuable information to better characterize and predict mortality from second primary cancer in subjects who suffered from first colorectal cancer. Abstract Background: Cancer survivors are at risk of developing second primary cancers (SPC). We investigated the risk of SPC in colorectal cancer (CRC) survivors in Sicily, Southern Italy. Methods: We analyzed data from the Eastern Sicily cancer registry covering 2.5 million people diagnosed and followed up between 2003 and 2017. We calculated the standardized incidence ratio (SIR) and 95% confidence interval (CI) of SPC overall and by cancer type, using the general Sicily population rates as reference. Results: A total of 19,040 cases of CRC and 1453 cases of SPC were included in the analysis. Mean age of occurrence of SPC was 68.1. The SIR for any SPC was 1.11 (95% CI 1.05–1.17); it was higher in women (1.18; 95% CI 1.08–1.29) than in men (1.07; 95% CI 0.97–1.14, p-value of difference 0.07). The SIR was increased for SPC from the ovary (SIR 2.01; 95% CI 1.33–2.95), kidney (SIR 2.00; 95% CI 1.54–2.56), endometrium (SIR 1.94; 95% CI 1.45–2.54), bladder (SIR 1.22, 95% CI 1.04–1.43) and stomach (1.29; 95% CI 0.98–1.66). The SIR for CRC as SPC was 0.84 (95% CI 0.70–1.01). No increased incidence was found for lung, prostate, breast, thyroid and liver cancer. The SIR for SPC overall and several cancers decreased with time of follow-up. Conclusions: In this population, CRC survivors have an 11% higher risk of developing a SPC than the general population, particularly cancers of the ovary, kidney, endometrium, bladder and stomach. Follow-up for SPC is required, especially during the first 5 years from CRC diagnosis.
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Affiliation(s)
- Giulia Collatuzzo
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
| | - Margherita Ferrante
- Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, Via Santa Sofia 87, 95123 Catania, Italy
- Cancer Registry of Catania, Messina, Syracuse and Enna, Via Santa Sofia 87, 95123 Catania, Italy
| | - Antonella Ippolito
- Cancer Registry of Catania, Messina, Syracuse and Enna, Via Santa Sofia 87, 95123 Catania, Italy
| | - Alessia Di Prima
- Cancer Registry of Catania, Messina, Syracuse and Enna, Via Santa Sofia 87, 95123 Catania, Italy
| | - Cristina Colarossi
- Mediterranean Institute of Oncology (IOM), Viagrande, 95029 Catania, Italy
| | | | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY 11794, USA
- Correspondence:
| | - Salvatore Sciacca
- Mediterranean Institute of Oncology (IOM), Viagrande, 95029 Catania, Italy
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Song L, Xu C, Zhang T, Chen S, Shi Z, Hu S, Cheng B, Tong H, Wei G, Li X. Development and validation of a competing risk model for second primary pancreatic ductal adenocarcinoma: A population-based study. Front Surg 2022; 9:934148. [PMID: 36111234 PMCID: PMC9468218 DOI: 10.3389/fsurg.2022.934148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 07/22/2022] [Indexed: 11/29/2022] Open
Abstract
Background With advances in early diagnosis and treatment, the number of cancer survivors continues to grow, and more and more cancer survivors face the threat of second primary cancer (SPM). Second primary pancreatic ductal adenocarcinoma (spPDAC) is an important subclass of SPM, but its prognostic characteristics are poorly understood. Methods A total of 5,439 spPDAC samples and 67,262 primary pancreatic ductal adenocarcinoma (pPDAC) samples were extracted from the SEER database for this study. Survival differences between spPDAC and pPDAC samples were compared using Kaplan–Meier curves and log-rank tests. The Fine and Gray proportional subdistributed hazard method was used to analyze potential associations between clinical variables and pancreatic ductal adenocarcinoma-specific death (PDACSD) and death from other causes. After that, the clinical variables significantly related to PDACSD were screened out to construct a competing risk nomogram, which was used to evaluate the probability of the occurrence of PDACSD. The C-index was used to evaluate the discriminative ability of the model. The area under the curve (AUC) was used to verify the discrimination of the model. The calibration curve was used to verify the calibration of the model. Decision curve analysis (DCA) was used to validate the clinical utility of the model. Results Compared with patients with spPDAC, the pPDAC sample had a better prognosis (p = 0.0017). Across all spPDAC samples, the three most common sites of first-present cancer were the prostate, breast, and digestive system. Age (p < 0.001), race (p = 0.006), interval (p = 0.016), location (p < 0.001), T stage (p = 0.003), M stage (p < 0.001), chemotherapy (p < 0.001), and radiotherapy (p = 0.006) were the clinical variables associated with PDACSD screened by multivariate competing risks analysis. The concordance index values for the training and validation sets were 0.665 (95% CI, 0.655, 0.675) and 0.666 (95% CI, 0.650, 0.682), respectively. AUC, calibration curve, and DCA indicated that the model we constructed had good discrimination, calibration, and clinical utility. Conclusions In conclusion, we first analyzed the impact of previous cancer history on prognosis. We then constructed a competing risk model that can predict the probability of developing PDACSD in spPDAC. This model has good discriminative ability, calibration, and clinical practicability and has certain guiding value for clinical decision-making.
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Li JL, Li H, Wu Q, Zhou H, Li Y, Li YH, Li J. Analysis of prognosis and treatment decisions for patients with second primary lung cancer following esophageal cancer. Front Oncol 2022; 12:777934. [PMID: 36052233 PMCID: PMC9425047 DOI: 10.3389/fonc.2022.777934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 07/18/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction As the long-term prognosis of esophageal cancer (EC) is improving, concerns of a second primary malignancy (SPM) have increased. However, research on lung cancer as the SPM after EC is limited. Therefore, we aimed to explore the prognostic factors and clinical treatment decisions of patients with second primary lung cancer following esophageal cancer (SPLC-EC). Materials and methods We identified the data of 715 patients with SPLC-EC from the Surveillance, Epidemiology, and End Results (SEER) database during 1975 to 2016. We established a nomogram through Cox regression modelling to predict the prognosis of patients with SPLC-EC. We determined the association between factors and cancer-specific mortality using the Fine-Gray competing risk model. Then, we performed survival analysis to evaluate the benefits of different treatment methods for overall survival (OS). Results The multivariate analysis indicated that sex, insurance recode, age, surgery and chemotherapy 0for first primary malignancy (FPM), primary site, stage, and surgery for SPM were independent prognostic factors for OS. Using concordance indices for OS, the nomogram of our cohort showed a higher value than the SEER historic-stage nomogram (0.8805 versus 0.7370). The Fine-Gray competing risk model indicated that surgery for FPM and SPM was the independent prognostic factor for EC-specific mortality (P=0.016, hazard ratio [HR] = 0.532) and LC-specific mortality (p=0.016, HR=0.457), respectively (p<0.001). Compared to the patient group having distant metastasis, patients with localized and regional metastasis benefitted from undergoing surgery for SPM (P<0.001, P<0.001, respectively). For patients without surgery for SPM, radiotherapy (P<0.001) and chemotherapy (P<0.001) could improve OS. Conclusions Surgery remains the mainstay for managing SPLC-EC, especially for localized and regional tumors. However, chemotherapy and radiotherapy are recommended for patients who cannot undergo surgery. These findings can have implications in the treatment decision-making for patients with SPLC-EC.
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Affiliation(s)
- Jin-luan Li
- Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China
| | - Hui Li
- Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China
| | - Qian Wu
- Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China
| | - Han Zhou
- Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China
| | - Yi Li
- Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China
| | - Yong-heng Li
- Department of Radiation Oncology, Key Laboratory of Carcinogenesis Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institution, Beijing, China
| | - Jiancheng Li
- Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China
- *Correspondence: Jiancheng Li,
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Ye J, Hu S, Zhang W, Zhang D, Zhang Y, Yu D, Peng J, Xu J, Wei Y. Better Prognosis and Survival in Esophageal Cancer Survivors After Comorbid Second Primary Malignancies: A SEER Database-Based Study. Front Surg 2022; 9:893429. [PMID: 35769151 PMCID: PMC9235858 DOI: 10.3389/fsurg.2022.893429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 04/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background With the development of surgical techniques and advances in systemic treatments, the survival time of esophageal cancer survivors has increased; however, the chance of developing a second primary malignancy (SPM) has also increased. These patients’ prognosis and treatment plans remain inconclusive. Objectives We aimed to evaluate and predict the survival of patients with esophageal cancer with second primary tumors, to provide insights and the latest data on whether to pursue more aggressive treatment. Materials and Methods We selected esophageal cancer cases from the latest available data from the SEER database on April 15, 2021. We performed life table analysis, Kaplan–Meier analysis, and univariate and multivariate Cox proportional hazards analysis to assess the patient data. We conducted multiple Cox regression equation analyses under multiple covariate adjustment models, and performed a stratified analysis of multiple Cox regression equation analysis based on different covariates. To describe our study population more simply and clearly, we defined the group of patients with esophageal cancer combined with a second primary malignant tumor (the first of two or more primaries) as the EC-SPM group. Results Our analysis of 73,456 patients with esophageal cancer found the median survival time of the EC-SPM group was 47.00 months (95% confidence interval (CI), 43.87–50.13), and the mean survival time was 74.67 months (95% CI, 72.12–77.22). Kaplan–Meier curves of different esophageal cancer survivors showed that the survival of the EC-SPM group was significantly better than that of the other groups (p < 0.01). Univariate Cox regression analysis showed that compared with only one malignancy only group, the hazard ratio (HR) of the EC-SPM group was 0.95 (95% CI, 0.92–0.99; p < 0.05). In the multivariate Cox regression analysis under different adjustment models, the EC-SPM group had a reduced risk of death compared with the one primary malignancy only group (HR < 1, p < 0.05). Conclusion Survivors of esophageal cancer with a second primary malignant cancer have a better prognosis, but require more aggressive treatment. This study provided new evidence and new ideas for future research on the pathophysiological mechanism and treatment concepts of esophageal cancer combined with SPM.
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Biesma NC, Te Riele WW, Van Santvoort HC, Molenaar IQ. Pancreatoduodenectomy for distal cholangiocarcinoma 13 years after oesophagectomy with gastric tube reconstruction: report of a case. BMJ Case Rep 2022; 15:e246852. [PMID: 35135799 PMCID: PMC8830154 DOI: 10.1136/bcr-2021-246852] [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] [Accepted: 12/30/2021] [Indexed: 11/03/2022] Open
Abstract
Advancements in cancer management have led to improved survival in patients with oesophageal cancer. This has resulted in an increased incidence of second primary malignancies with the pancreas as a common secondary cancer site. Resectable pancreatic and periampullary cancers are treated by pancreatoduodenectomy, including resection of the gastroduodenal artery which provides the blood supply to the gastric conduit in patients who underwent oesophagectomy. A 77-year-old man with a history of distal oesophageal cancer, for which an oesophagectomy with gastric tube reconstruction was performed, presented in the emergency department. Extensive workup showed a lesion suspected for a distal cholangiocarcinoma. Pancreatoduodenectomy was deemed feasible after arterial angiography revealed that the gastric conduit was dominantly vascularised by the right gastric artery. Adequate imaging of the blood supply is essential to determine eligibility for pancreatoduodenectomy in patients with a second primary malignancy in the pancreas or periampullary region after oesophagectomy with gastric tube reconstruction.
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Affiliation(s)
- Nanske C Biesma
- Department of Surgery, Regional Academic Cancer Center Utrecht, University Medical Center Utrecht Cancer Center & St. Antonius Hospital Nieuwegein, The Netherlands, Utrecht, The Netherlands
| | - Wouter W Te Riele
- Department of Surgery, Regional Academic Cancer Center Utrecht, University Medical Center Utrecht Cancer Center & St. Antonius Hospital Nieuwegein, The Netherlands, Utrecht, The Netherlands
| | - Hjalmar C Van Santvoort
- Department of Surgery, Regional Academic Cancer Center Utrecht, University Medical Center Utrecht Cancer Center & St. Antonius Hospital Nieuwegein, The Netherlands, Utrecht, The Netherlands
| | - I Quintus Molenaar
- Department of Surgery, Regional Academic Cancer Center Utrecht, University Medical Center Utrecht Cancer Center & St. Antonius Hospital Nieuwegein, The Netherlands, Utrecht, The Netherlands
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Gao Y, Qiu J, Gu L, Yang Y, Kang H, Zhang Y, Zhang S, Zhang Y, Wang H, Zhang Y, Qian J. Secondary primary lung cancer after esophageal cancer: a population-based study of 44,172 patients. Scand J Gastroenterol 2022; 57:222-231. [PMID: 34726133 DOI: 10.1080/00365521.2021.1994639] [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] [Indexed: 02/04/2023]
Abstract
BACKGROUND The present study aimed to assess the survival, incidence, and characteristics of secondary primary lung cancer (SPLC) after esophageal cancer (EC-LC). METHODS The patients with esophageal cancer (EC) who developed SPLC and patients with first primary lung cancer (LC-1) were retrospectively reviewed in the Surveillance, Epidemiology, and End Results 18 registries covering 2000-2016. Overall survival and characteristics were compared between patients with EC-LC and patients with LC-1. The independent relation between a history of EC and death was evaluated by calculating hazard ratios in multivariate Cox regression analysis propensity score-matching analysis, and multiple imputation for cases with missing information. RESULTS In comparison with the general population, the patients with EC had a higher risk for developing secondary primary lung cancer (SIR =1.86, 95% confidence interval (CI): 1.69-2.05). A history of EC was found to be an independent risk factor of death for lung squamous carcinoma (LUSC) and lung adenocarcinoma (LUAD) patients in localized stage based on multivariate Cox regression analysis, propensity score-matching analysis and multiple imputation. CONCLUSIONS There is a significantly increased risk of secondary primary lung cancer in EC survivors and a history of EC adversely affects overall survival in individuals who subsequently develop localized LUSC and LUAD. Clinicians should moderately strengthen lung tissue protection during the management of EC patients.
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Affiliation(s)
- Yadong Gao
- Department of Gastroenterology, Affiliated Hospital 2 of Nantong University, Nantong, Jiangsu, China.,Department of Gastroenterology, the First People's Hospital of Nantong, Nantong, Jiangsu, China.,Medical Research Center, Affiliated Hospital 2 of Nantong University, Nantong, Jiangsu, China.,Nantong Clinical College of Kangda College, Nanjing Medical University, Nantong, Jiangsu, China
| | - Jianwei Qiu
- Department of Gastroenterology, Affiliated Hospital 2 of Nantong University, Nantong, Jiangsu, China.,Department of Gastroenterology, the First People's Hospital of Nantong, Nantong, Jiangsu, China.,Medical Research Center, Affiliated Hospital 2 of Nantong University, Nantong, Jiangsu, China
| | - Liugen Gu
- Department of Gastroenterology, Affiliated Hospital 2 of Nantong University, Nantong, Jiangsu, China.,Department of Gastroenterology, the First People's Hospital of Nantong, Nantong, Jiangsu, China
| | - Yanmei Yang
- Department of Gastroenterology, Affiliated Hospital 2 of Nantong University, Nantong, Jiangsu, China.,Department of Gastroenterology, the First People's Hospital of Nantong, Nantong, Jiangsu, China.,Medical Research Center, Affiliated Hospital 2 of Nantong University, Nantong, Jiangsu, China
| | - Haifeng Kang
- Department of Gastroenterology, Affiliated Hospital 2 of Nantong University, Nantong, Jiangsu, China.,Department of Gastroenterology, the First People's Hospital of Nantong, Nantong, Jiangsu, China
| | - Yong Zhang
- Medical Research Center, Affiliated Hospital 2 of Nantong University, Nantong, Jiangsu, China
| | - Shenglai Zhang
- Department of Gastroenterology, Affiliated Hospital 2 of Nantong University, Nantong, Jiangsu, China.,Department of Gastroenterology, the First People's Hospital of Nantong, Nantong, Jiangsu, China
| | - Yan Zhang
- Department of Gastroenterology, Affiliated Hospital 2 of Nantong University, Nantong, Jiangsu, China.,Department of Gastroenterology, the First People's Hospital of Nantong, Nantong, Jiangsu, China.,Medical Research Center, Affiliated Hospital 2 of Nantong University, Nantong, Jiangsu, China
| | - Huimin Wang
- Department of Cardiovasology, Affiliated Hospital 2 of Nantong University, Nantong, Jiangsu, China
| | - Yi Zhang
- Department of Neurosurgery, Affiliated Hospital 2 of Nantong University, Nantong, Jiangsu, China
| | - Junbo Qian
- Department of Gastroenterology, Affiliated Hospital 2 of Nantong University, Nantong, Jiangsu, China.,Department of Gastroenterology, the First People's Hospital of Nantong, Nantong, Jiangsu, China.,Medical Research Center, Affiliated Hospital 2 of Nantong University, Nantong, Jiangsu, China
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Characteristics and Prognostic Factors of Metachronous Second Primary Upper Gastrointestinal Cancer. J Surg Res 2020; 258:254-264. [PMID: 33038603 DOI: 10.1016/j.jss.2020.08.075] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 08/20/2020] [Accepted: 08/26/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND Patients with metachronous malignancies before carcinomas of the upper gastrointestinal tract were analyzed regarding clinical parameters, oncological outcome, and prognosis. METHODS We analyzed the data of 1583 patients with gastroesophageal cancer who underwent oncological resections between 2002 and 2018. Of 1583 patients, 172 had a malignant tumor before the upper gastrointestinal cancer (second primary carcinomas) and 1411 without preceding malignancies served as the control group. The analyses were performed between both groups and within the subgroup of second primary carcinomas. RESULTS Patients with second primary carcinomas were older (P < 0.0001), had more comorbidities (P < 0.0001), and underwent longer surgical resections (P = 0.0024). They had lower (y)pT-categories (P = 0.0427) and had longer stays in intensive care unit (P = 0.0002) and hospital (P = 0.0018). R0-resection was more frequent (P = 0.0275) while having more surgical complications (P = 0.0378). The median survival was 39.5 mo (primary carcinoma) versus 32.9 mo for (second primary carcinoma) and was not significantly different (P = 0.5359).In the subgroup analysis of second primaries, there were no significant survival differences depending on primary tumor entity (P = 0.4989). pT status (P = 0.0062), pN status (P < 0.0001), pM status (P < 0.0001), and R-status (P < 0.0001) were significant prognostic factors. A time period >9 y after the primary cancer could be identified as a novel and beneficial survival factor (P = 0.0496). Most patients with primary colorectal, prostate, hematogenous, or breast cancer had adenocarcinoma, whereas patients with initial otolaryngologic cancers mainly had squamous cell carcinoma. CONCLUSIONS Second primary carcinomas of the upper gastrointestinal tract show distinct clinical and oncological characteristics. Common prognostic factors are applicable, and oncologic resection is recommended.
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Zhang G, Wu B, Wang X, Li J. Second primary malignancy in patients with esophageal adenocarcinoma and squamous cell carcinoma. Medicine (Baltimore) 2019; 98:e17083. [PMID: 31490413 PMCID: PMC6738979 DOI: 10.1097/md.0000000000017083] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
There have been no studies on implementing effective screening models for esophageal adenocarcinoma and squamous cell carcinoma survivors. We used a proportional subdistribution hazards model to estimate second primary malignancy risks among patients with esophageal adenocarcinoma and squamous cell carcinoma. We validated models using a bootstrap cross-validation method and performed decision curve analysis to evaluate their clinical utility. Age group and SEER historic stage were significantly associated with second primary malignancy risk after diagnosis of esophageal adenocarcinoma and squamous cell carcinoma. Saving positive lymph nodes and distant metastasis were significant factors in the adenocarcinoma group, and marital status, tumor location, and chemotherapy were significant factors in the squamous cell carcinoma group. Calibration plots show good concordance between predicted and actual outcomes except in high-probability areas for the risk of a second primary malignancy in patients with esophageal squamous cell carcinoma. Discrimination performances of the Fine-Gray models were evaluated using c-indices, which were 0.691 and 0.662 for second primary malignancies in patients with esophageal adenocarcinoma and squamous cell carcinoma, respectively. Decision curve analysis yielded a range of threshold probabilities (0.020-0.177 and 0.021-0.133 for patients with esophageal adenocarcinoma and squamous cell carcinoma, respectively) at which the clinical net benefit of the risk model was larger than those of hypothetical all-screening and no-screening scenarios. Our nomograms enable selection of patient populations at high risk for a second primary malignancy and thus will facilitate the design of prevention trials for affected populations.
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Chang CC, Bi KW, Lin HJ, Su YC, Wang WL, Lin CY, Ting CF, Sun MF, Huang ST. Conventional Western Treatment Associated With Chinese Herbal Medicine Ameliorates the Incidence of Head and Neck Cancer Among Patients With Esophageal Cancer. Integr Cancer Ther 2019; 18:1534735419834353. [PMID: 30866690 PMCID: PMC6419260 DOI: 10.1177/1534735419834353] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Because of advances in medical treatment, the survival of cancer patients is prolonged. In line with the prolonged survival time of cancer the incidence of second primary cancer has increased. There is currently no effective way to prevent the occurrence of secondary primary cancer (SPC). OBJECTIVES The aim of this study is to evaluate whether Chinese Herbal Medicine (CHM) is correlated with reduced occurrence of second primary cancer (SPC) of head and neck (H&N) in patients with esophageal cancer (EC). METHOD We identified 15,546 patients who were diagnosed with esophageal cancer between Jan 1, 2000, and Dec 31, 2010. The patients with H&N cancer before receiving CHM were excluded. After the selection and matching process, both CHM and non-CHM cohorts each contained 850 individuals. We compared the cumulative incidence of SPC of H&N with or without CHM treatment in patients with EC by the Kaplan-Meier method. NodeXL is used to run a network analysis of CHM to examine the association between herbs and formulas. RESULTS Compared with non-CHM users, CHM-users showed a reduced incidence rate of SPC of H&N among the patients with EC. Reduced cumulative incidence of SPC of H&N among patients with EC was noted in the CHM cohort compared to the non-CHM cohort. The most commonly used single herbs and formulas were associated with reducing SPC occurrence. CONCLUSION We propose that CHM as an adjuvant therapy may prevent the occurrence of SPC of H&N in patients with EC.
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Affiliation(s)
| | - Kuo-Wei Bi
- 2 Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung, China
| | - Hung-Jen Lin
- 1 China Medical University Hospital, Taichung, China.,3 China Medical University, Taichung, China
| | - Yuan-Chih Su
- 1 China Medical University Hospital, Taichung, China.,3 China Medical University, Taichung, China
| | - Wen-Ling Wang
- 1 China Medical University Hospital, Taichung, China.,3 China Medical University, Taichung, China
| | - Chen-Yuan Lin
- 1 China Medical University Hospital, Taichung, China.,3 China Medical University, Taichung, China
| | - Chun-Fu Ting
- 1 China Medical University Hospital, Taichung, China.,3 China Medical University, Taichung, China
| | - Mao-Feng Sun
- 1 China Medical University Hospital, Taichung, China.,3 China Medical University, Taichung, China
| | - Sheng-Teng Huang
- 1 China Medical University Hospital, Taichung, China.,3 China Medical University, Taichung, China.,4 China Medical University, Tainan, China
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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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Kawachi H, Fujimoto D, Morimoto T, Ito M, Teraoka S, Sato Y, Nagata K, Nakagawa A, Otsuka K, Tomii K. Clinical Characteristics and Prognosis of Patients With Advanced Non–Small-cell Lung Cancer Who Are Ineligible for Clinical Trials. Clin Lung Cancer 2018; 19:e721-e734. [DOI: 10.1016/j.cllc.2018.05.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 05/08/2018] [Accepted: 05/17/2018] [Indexed: 11/27/2022]
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Type of second primary malignancy after achieving complete response by definitive chemoradiation therapy in patients with esophageal squamous cell carcinoma. Int J Clin Oncol 2018. [PMID: 29520523 DOI: 10.1007/s10147-018-1258-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND While the standard treatment for stage II-III (non-T4) esophageal squamous cell carcinoma (ESCC) is neoadjuvant therapy followed by esophagectomy, definitive chemoradiation therapy (dCRT) is an option to treat ESCC patients who reject or may not tolerate surgical treatment. Second primary malignancy (SPM) is a problem for long-term survivors after achieving complete response (CR) by dCRT. METHODS The source of the subjects in this study was the patients with stage II/III (excluding T4 disease) ESCC (UICC6th) who underwent dCRT from 2000 to 2011 at the National Cancer Center Hospital, Japan. SPM, defined as malignancy newly detected at different site from the initial disease, was checked in patients who achieved CR by the initial dCRT. RESULTS Among the 285 patients with stage II/III (excluding T4 disease) ESCC who underwent dCRT, 185 patients achieved CR. SPM was detected in 49 patients (median time to developing SPM, 41.5 months), accounting for 19.3% (95% CI 0.137-0.257) as the 5-year cumulative risk of SPM. SPMs were head and neck cancer (n = 12), gastric cancer (n = 12), esophageal cancer (n = 7), lung cancer (n = 5), colon cancer (n = 4), diffuse large B-cell lymphoma (n = 3), bladder cancer (n = 2), small intestinal cancer (n = 1), cholangiocarcinoma (n = 1), malignant melanoma (n = 1), and breast cancer (n = 1). There were no significant differences in baseline characteristics between the patients who developed SPM (n = 49) and others (n = 136). CONCLUSIONS Because second primary malignancy developed often after achieving CR by dCRT for ESCC, it should be followed carefully.
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Zhao XK, Mao YM, Meng H, Song X, Hu SJ, Lv S, Cheng R, Zhang TJ, Han XN, Ren JL, Qi YJ, Wang LD. Shared susceptibility loci at 2q33 region for lung and esophageal cancers in high-incidence areas of esophageal cancer in northern China. PLoS One 2017; 12:e0177504. [PMID: 28542283 PMCID: PMC5436667 DOI: 10.1371/journal.pone.0177504] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 04/30/2017] [Indexed: 11/19/2022] Open
Abstract
Background Cancers from lung and esophagus are the leading causes of cancer-related deaths in China and share many similarities in terms of histological type, risk factors and genetic variants. Recent genome-wide association studies (GWAS) in Chinese esophageal cancer patients have demonstrated six high-risk candidate single nucleotide polymorphisms (SNPs). Thus, the present study aimed to determine the risk of these SNPs predisposing to lung cancer in Chinese population. Methods A total of 1170 lung cancer patients and 1530 normal subjects were enrolled in this study from high-incidence areas for esophageal cancer in Henan, northern China. Five milliliters of blood were collected from all subjects for genotyping. Genotyping of 20 high-risk SNP loci identified from genome-wide association studies (GWAS) on esophageal, lung and gastric cancers was performed using TaqMan allelic discrimination assays. Polymorphisms were examined for deviation from Hardy-Weinberg equilibrium (HWE) using Х2 test. Bonferroni correction was performed to correct the statistical significance of 20 SNPs with the risk of lung cancer. The Pearson’s Х2 test was used to compare the distributions of gender, TNM stage, histopathological type, smoking and family history by lung susceptibility genotypes. Kaplan-Meier and Cox regression analyses were carried out to evaluate the associations between genetic variants and overall survival. Results Four of the 20 SNPs identified as high-risk SNPs in Chinese esophageal cancer showed increased risk for Chinese lung cancer, which included rs3769823 (OR = 1.26; 95% CI = 1.107–1.509; P = 0.02), rs10931936 (OR = 1.283; 95% CI = 1.100–1.495; P = 0.04), rs2244438 (OR = 1.294; 95% CI = 1.098–1.525; P = 0.04) and rs13016963 (OR = 1.268; 95% CI = 1.089–1.447; P = 0.04). All these SNPs were located at 2q33 region harboringgenes of CASP8, ALS2CR12 and TRAK2. However, none of these susceptibility SNPs was observed to be significantly associated with gender, TNM stage, histopathological type, smoking, family history and overall survival. Conclusions The present study identified four high-risk SNPs at 2q33 locus for Chinese lung cancer and demonstrated the shared susceptibility loci at 2q33 region for Chinese lung and esophageal cancers.
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Affiliation(s)
- Xue Ke Zhao
- Henan Key Laboratory for Esophageal Cancer Research, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yi Min Mao
- Henan Key Laboratory for Esophageal Cancer Research, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Hui Meng
- Henan Key Laboratory for Esophageal Cancer Research, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Xin Song
- Henan Key Laboratory for Esophageal Cancer Research, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Shou Jia Hu
- Henan Key Laboratory for Esophageal Cancer Research, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Shuang Lv
- Henan Key Laboratory for Esophageal Cancer Research, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Rang Cheng
- Henan Key Laboratory for Esophageal Cancer Research, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Tang Juan Zhang
- Henan Key Laboratory for Esophageal Cancer Research, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Xue Na Han
- Henan Key Laboratory for Esophageal Cancer Research, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Jing Li Ren
- Henan Key Laboratory for Esophageal Cancer Research, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yi Jun Qi
- Henan Key Laboratory of Cancer Epigenetic, Cancer Institute, The First Affiliated Hospital, College of Clinical Medicine, Henan University of Science and Technology, Luoyang, Henan, China
| | - Li Dong Wang
- Henan Key Laboratory for Esophageal Cancer Research, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- * E-mail:
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Dasanu CA, Hyams DM, Senatore FJ. Adenocarcinoma of the appendix occurring in a patient treated with paclitaxel for locally advanced esophageal cancer. J Oncol Pharm Pract 2017; 24:150-152. [PMID: 28436298 DOI: 10.1177/1078155217689947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Paclitaxel has been linked with a number of immunosuppressive effects such as decreased numbers and activity of dendritic cells, NK-cells and monocytes, which may in turn lead to defective T-cell activation. In addition, this agent was shown to cause mitotic arrest resembling high-grade dysplasia throughout the gastrointestinal tract, including the appendix. We have previously documented a series of lung cancer patients who developed pre-malignant colonic polyps and/or colon cancer either during or weeks following chemotherapy with paclitaxel, suggesting a potential role of this agent in their pathogenesis. We describe herein a patient who developed adenocarcinoma of the appendix five months after paclitaxel therapy for a locally advanced lower esophageal cancer. Although the cancer of the appendix was in early stage, it was poorly differentiated and showed lymphovascular invasion. The context, timeline and existing experience suggest that this second cancer was triggered by a pre-existing insult, conceivably delivered by paclitaxel.
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Affiliation(s)
- Constantin A Dasanu
- 1 Eisenhower Medical Center, University of California San Diego/Lucy Curci Cancer Center, Rancho Mirage, CA, USA
| | - David M Hyams
- 2 Department of Surgery, Eisenhower Medical Center, Rancho Mirage, CA, USA
| | - Frank J Senatore
- 3 Department of Medicine, University of Connecticut Health Center, Farmington, CT, USA
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Saqib A, Ibrahim U, Maroun R. Primary Pulmonary Lymphoma and Synchronous Cecal Adenocarcinoma: A Rare Occurrence. Cureus 2016; 8:e944. [PMID: 28133582 PMCID: PMC5268376 DOI: 10.7759/cureus.944] [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] [Indexed: 11/13/2022] Open
Abstract
In the era of extensive imaging and increasing indications for performing PET-CT scans, the recognition of synchronous tumors may be greater than before. However, the majority of these tumors are seen to occur in the same organ system, likely because of sharing similar pathogenic mechanisms. Synchronous lung cancers of similar or differing histologies have been reported. Primary pulmonary lymphoma, which is a rare form of non-Hodgkin’s lymphoma, has also been seen with a synchronous primary lung cancer. However, we report a case of a 56-year-old male diagnosed with primary pulmonary lymphoma and on PET-CT imaging, found to have a cecal lesion, the biopsy of which showed adenocarcinoma. We discuss the incidence of the co-existence of multiple tumors, the pathogenic mechanisms involved, and approaches to the management of these rare clinical scenarios.
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Affiliation(s)
- Amina Saqib
- Pulmonary/Critical Care, Staten Island University Hospital
| | - Uroosa Ibrahim
- Department of Hematology/Oncology, Staten Island University Hospital
| | - Rabih Maroun
- Pulmonary/Critical Care, Staten Island University Hospital
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Management and Reconstruction of a Gastroesophageal Junction Adenocarcinoma Patient Three Years after Pancreaticoduodenectomy: A Surgical Puzzle. Case Rep Surg 2016; 2016:5650382. [PMID: 27635275 PMCID: PMC5007305 DOI: 10.1155/2016/5650382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Accepted: 08/03/2016] [Indexed: 01/17/2023] Open
Abstract
Introduction. With the improving survival of cancer patients, the development of a secondary primary cancer is an increasingly common phenomenon. Extensive surgery during initial treatment may pose significant challenges to surgeons managing the second primary cancer. Case Presentation. A 69-year-old male, who had a pancreaticoduodenectomy three years ago for pancreatic head adenocarcinoma, underwent an uneventful extended total gastrectomy for gastroesophageal junctional adenocarcinoma. The reconstruction controversies and considerations are highlighted. Discussion. Genetic, environmental, and lifestyle factors are common for several gastrointestinal malignancies. However, the occurrence of a second unfavorable cancer such as gastroesophageal adenocarcinoma after pancreatic head cancer treatment is extremely uncommon. This clinical scenario possesses numerous difficulties for the surgeon, since surgical resection is the mainstay of treatment for both malignancies. Gastrointestinal reconstruction becomes challenging and requires careful planning and meticulous surgical technique along with sound intraoperative judgement.
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Jang BI, Hwang MJ. Do Esophageal Squamous Cell Carcinoma Patients Have an Increased Risk of Coexisting Colorectal Neoplasms? Gut Liver 2016; 10:6-7. [PMID: 26696025 PMCID: PMC4694727 DOI: 10.5009/gnl15564] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- Byung Ik Jang
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Moon Joo Hwang
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
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Tominaga K, Doyama H, Nakanishi H, Yoshida N, Takeda Y, Ota R, Tsuji K, Matsunaga K, Tsuji S, Takemura K, Yamada S, Katayanagi K, Kurumaya H. Importance of colonoscopy in patients undergoing endoscopic resection for superficial esophageal squamous cell carcinoma. Ann Gastroenterol 2016; 29:318-24. [PMID: 27366032 PMCID: PMC4923817 DOI: 10.20524/aog.2016.0025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Accepted: 02/09/2016] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The aim of the study was to clarify the frequency of colorectal neoplasm (CRN) complicating superficial esophageal squamous cell carcinoma (ESCC) and the need for colonoscopy. METHODS We retrospectively reviewed 101 patients who had undergone initial endoscopic resection (ER) for superficial ESCC. Control group participants were age- and sex-matched asymptomatic subjects screened at our hospital over the same period of time. Advanced adenoma was defined as an adenoma ≥10 mm, with villous features, or high-grade dysplasia. Advanced CRN referred to advanced adenoma or cancer. We measured the incidence of advanced CRN in superficial ESCC and controls, and we compared the characteristics of superficial ESCC patients with and without advanced CRN. RESULTS In the superficial ESCC group, advanced CRNs were found in 17 patients (16.8%). A history of smoking alone was found to be a significant risk factor of advanced CRN [odds ratio 6.02 (95% CI 1.30-27.8), P=0.005]. CONCLUSION The frequency of synchronous advanced CRN is high in superficial ESCC patients subjected to ER. Colonoscopy should be highly considered for most patients who undergo ER for superficial ESCC with a history of smoking, and is recommended even in superficial ESCC patients.
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Affiliation(s)
- Kei Tominaga
- Department of Gastroenterology (Kei Tominaga, Hisashi Doyama, Hiroyoshi Nakanishi, Naohiro Yoshida, Yasuhito Takeda, Ryosuke Ota, Kunihiro Tsuji, Kazuhiro Matsunaga, Shigetsugu Tsuji, Kenichi Takemura, Shinya Yamada)
| | - Hisashi Doyama
- Department of Gastroenterology (Kei Tominaga, Hisashi Doyama, Hiroyoshi Nakanishi, Naohiro Yoshida, Yasuhito Takeda, Ryosuke Ota, Kunihiro Tsuji, Kazuhiro Matsunaga, Shigetsugu Tsuji, Kenichi Takemura, Shinya Yamada)
| | - Hiroyoshi Nakanishi
- Department of Gastroenterology (Kei Tominaga, Hisashi Doyama, Hiroyoshi Nakanishi, Naohiro Yoshida, Yasuhito Takeda, Ryosuke Ota, Kunihiro Tsuji, Kazuhiro Matsunaga, Shigetsugu Tsuji, Kenichi Takemura, Shinya Yamada)
| | - Naohiro Yoshida
- Department of Gastroenterology (Kei Tominaga, Hisashi Doyama, Hiroyoshi Nakanishi, Naohiro Yoshida, Yasuhito Takeda, Ryosuke Ota, Kunihiro Tsuji, Kazuhiro Matsunaga, Shigetsugu Tsuji, Kenichi Takemura, Shinya Yamada)
| | - Yasuhito Takeda
- Department of Gastroenterology (Kei Tominaga, Hisashi Doyama, Hiroyoshi Nakanishi, Naohiro Yoshida, Yasuhito Takeda, Ryosuke Ota, Kunihiro Tsuji, Kazuhiro Matsunaga, Shigetsugu Tsuji, Kenichi Takemura, Shinya Yamada)
| | - Ryosuke Ota
- Department of Gastroenterology (Kei Tominaga, Hisashi Doyama, Hiroyoshi Nakanishi, Naohiro Yoshida, Yasuhito Takeda, Ryosuke Ota, Kunihiro Tsuji, Kazuhiro Matsunaga, Shigetsugu Tsuji, Kenichi Takemura, Shinya Yamada)
| | - Kunihiro Tsuji
- Department of Gastroenterology (Kei Tominaga, Hisashi Doyama, Hiroyoshi Nakanishi, Naohiro Yoshida, Yasuhito Takeda, Ryosuke Ota, Kunihiro Tsuji, Kazuhiro Matsunaga, Shigetsugu Tsuji, Kenichi Takemura, Shinya Yamada)
| | - Kazuhiro Matsunaga
- Department of Gastroenterology (Kei Tominaga, Hisashi Doyama, Hiroyoshi Nakanishi, Naohiro Yoshida, Yasuhito Takeda, Ryosuke Ota, Kunihiro Tsuji, Kazuhiro Matsunaga, Shigetsugu Tsuji, Kenichi Takemura, Shinya Yamada)
| | - Shigetsugu Tsuji
- Department of Gastroenterology (Kei Tominaga, Hisashi Doyama, Hiroyoshi Nakanishi, Naohiro Yoshida, Yasuhito Takeda, Ryosuke Ota, Kunihiro Tsuji, Kazuhiro Matsunaga, Shigetsugu Tsuji, Kenichi Takemura, Shinya Yamada)
| | - Kenichi Takemura
- Department of Gastroenterology (Kei Tominaga, Hisashi Doyama, Hiroyoshi Nakanishi, Naohiro Yoshida, Yasuhito Takeda, Ryosuke Ota, Kunihiro Tsuji, Kazuhiro Matsunaga, Shigetsugu Tsuji, Kenichi Takemura, Shinya Yamada)
| | - Shinya Yamada
- Department of Gastroenterology (Kei Tominaga, Hisashi Doyama, Hiroyoshi Nakanishi, Naohiro Yoshida, Yasuhito Takeda, Ryosuke Ota, Kunihiro Tsuji, Kazuhiro Matsunaga, Shigetsugu Tsuji, Kenichi Takemura, Shinya Yamada)
| | - Kazuyoshi Katayanagi
- Department of Diagnostic Pathology (Kazuyoshi Katayanagi, Hiroshi Kurumaya), Ishikawa Prefectural Central Hospital, Kanazawa, Japan
| | - Hiroshi Kurumaya
- Department of Diagnostic Pathology (Kazuyoshi Katayanagi, Hiroshi Kurumaya), Ishikawa Prefectural Central Hospital, Kanazawa, Japan
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Incidence and risk factors of synchronous colorectal cancer in patients with esophageal cancer: an analysis of 480 consecutive colonoscopies before surgery. Int J Clin Oncol 2016; 21:1079-1084. [PMID: 27368336 DOI: 10.1007/s10147-016-1015-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 06/23/2016] [Indexed: 12/16/2022]
Abstract
BACKGROUND The precise incidence rates of multiple primary colorectal cancers in esophageal cancer patients are unknown. METHODS In total, 480 consecutive patients with esophageal cancers surgically resected in the Kumamoto University Hospital received preoperative total colonoscopy for the assessment of colorectal disease between April 2005 and February 2016. We retrospectively investigated the occurrence of synchronous colorectal cancer with esophageal cancer. In addition, we examined the risk factors for the incidence of multiple primary colorectal cancers. RESULTS Of the 480 patients, 14 (2.9 %) had synchronous colorectal cancers, 13 had well-differentiated tubular adenocarcinomas, and 1 had papillary adenocarcinoma. Other 14 patients had metachronous colorectal cancer. The current incidence rates of synchronous and total (both synchronous and metachronous) colorectal cancers outnumbered those in normal healthy population and those in esophageal cancer patients which previously reported by The Japan Esophageal Society. The age ≥70 years (hazard ratio 4.82, 95 % confidence interval 1.473-15.78; p = 0.009) and Brinkman index ≥800 (hazard ratio 3.47, 95 % confidence interval 1.056-11.37; p = 0.040) were the independent risk factors for the incidence of synchronous colorectal cancer. They were also the independent risk factors for the incidence of total colorectal cancer. CONCLUSIONS The results of the present study suggested that pretreatment screening with total colonoscopy is meaningful for patients with esophageal cancer, because the frequency of synchronous colorectal cancer was not negligible. Particularly, in patients >70 years and with history of heavy smoking, pretreatment colonoscopy might be necessary.
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Park SJ, Yi B, Lee HS, Oh WY, Na HK, Lee M, Yang M. To quit or not: Vulnerability of women to smoking tobacco. JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH. PART C, ENVIRONMENTAL CARCINOGENESIS & ECOTOXICOLOGY REVIEWS 2016; 34:33-56. [PMID: 26669465 DOI: 10.1080/10590501.2015.1131539] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Tobacco smoking is currently on the rise among women, and can pose a greater health risk. In order to understand the nature of the increase in smoking prevalence among women, we focused on the vulnerability of women to smoking behaviors--smoking cessation or tobacco addiction--and performed a systematic review of the socioeconomic and intrinsic factors as well as tobacco ingredients that affect women's susceptibility to smoking tobacco. We observed that nicotine and other tobacco components including cocoa-relatives, licorice products, and menthol aggravate tobacco addiction in women rather than in men. Various genetic and epigenetic alterations in dopamine pathway and the pharmaco-kinetics and -dynamic factors of nicotine also showed potential evidences for high susceptibility to tobacco addiction in women. Therefore, we suggest systemic approaches to prevent tobacco smoking-related health risks, considering gene-environment-gender interaction.
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Affiliation(s)
- Se-Jung Park
- a Research Center for Cell Fate Control, College of Pharmacy, Sookmyung Women's University , Seoul , Republic of Korea
| | - Bitna Yi
- b Department of Neurosurgery , Stanford University School of Medicine , Stanford , California , USA
| | - Ho-Sun Lee
- a Research Center for Cell Fate Control, College of Pharmacy, Sookmyung Women's University , Seoul , Republic of Korea
| | - Woo-Yeon Oh
- a Research Center for Cell Fate Control, College of Pharmacy, Sookmyung Women's University , Seoul , Republic of Korea
| | - Hyun-Kyung Na
- a Research Center for Cell Fate Control, College of Pharmacy, Sookmyung Women's University , Seoul , Republic of Korea
| | - Minjeong Lee
- a Research Center for Cell Fate Control, College of Pharmacy, Sookmyung Women's University , Seoul , Republic of Korea
| | - Mihi Yang
- a Research Center for Cell Fate Control, College of Pharmacy, Sookmyung Women's University , Seoul , Republic of Korea
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Jensen LF, Pedersen AF, Andersen B, Vestergaard M, Vedsted P. Non-participation in breast cancer screening for women with chronic diseases and multimorbidity: a population-based cohort study. BMC Cancer 2015; 15:798. [PMID: 26502879 PMCID: PMC4623919 DOI: 10.1186/s12885-015-1829-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2015] [Accepted: 10/18/2015] [Indexed: 11/14/2022] Open
Abstract
Background Chronic diseases and multimorbidity are common in western countries and associated with increased breast cancer mortality. This study aims to investigate non-participation in breast cancer screening among women with chronic diseases and multimorbidity and the role of time in this association. Method This population-based cohort study used regional and national registries. Women who were invited to the first breast cancer screening round in the Central Denmark Region in 2008–09 were included (n = 149,234). Selected chronic diseases and multimorbidity were assessed up to 10 years before the screening date. Prevalence ratios (PR) were used as an association measure. Results The results indicated that women with at least one chronic condition were significantly more likely not to participate in breast cancer screening. In adjusted analysis, a significantly higher likelihood of non-participation was found for women with cancer (PR = 1.50, 95 % CI: 1.40–1.60), mental illness (PR = 1.51, 95 % CI: 1.42–1.60), chronic obstructive pulmonary disease (PR = 1.51, 95 % CI: 1.42–1.62), neurological disorders (PR = 1.24, 95 % CI: 1.12–1.37) and kidney disease (PR = 1.70, 95 % CI 1.49–1.94), whereas women with chronic bowel disease (PR = 0.75, 95 % CI 0.65–0.88) were more likely to participate than women without these disease. Multimorbidity was associated with increased non-participation likelihood. E.g. having 3 or more diseases was associated with 58 % increased non-participation likelihood (95 % CI: 27–96 %). Higher non-participation was also observed for women with severe multimorbidity (PR = 1.53, 95 % CI: 1.23–1.90) and mental-physical multimorbidity (PR = 1.54, 95 % CI: 1.36–1.75). Conclusion In conclusion, we found a strong association between non-participation in breast cancer screening for some chronic diseases and for multimorbidity. The highest propensity not to participate was observed for women with hospital contacts related to the chronic disease in the period closest to the screening date. Electronic supplementary material The online version of this article (doi:10.1186/s12885-015-1829-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- L F Jensen
- Department of Public Health, The Research Unit for General Practice, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark. .,Department of Public Health, Section for General Practice, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark. .,Department of Public Health, The Research Centre for Cancer Diagnosis in Primary Care (CaP), Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark. .,Department for Public Health Programs, Regional Hospital of Randers, Skovlyvej 1, 8930, Randers, Denmark.
| | - A F Pedersen
- Department of Public Health, The Research Unit for General Practice, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark. .,Department of Public Health, The Research Centre for Cancer Diagnosis in Primary Care (CaP), Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark.
| | - B Andersen
- Department for Public Health Programs, Regional Hospital of Randers, Skovlyvej 1, 8930, Randers, Denmark.
| | - M Vestergaard
- Department of Public Health, The Research Unit for General Practice, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark. .,Department of Public Health, Section for General Practice, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark.
| | - P Vedsted
- Department of Public Health, The Research Unit for General Practice, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark. .,Department of Public Health, The Research Centre for Cancer Diagnosis in Primary Care (CaP), Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark.
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Baeg MK, Choi MG, Jung YD, Ko SH, Lim CH, Kim HH, Kim JS, Cho YK, Park JM, Lee IS, Kim SW. Esophageal Squamous Cell Carcinoma Patients Have an Increased Risk of Coexisting Colorectal Neoplasms. Gut Liver 2015; 10:76-82. [PMID: 25963088 PMCID: PMC4694738 DOI: 10.5009/gnl14381] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background/Aims Esophageal squamous cell carcinoma (ESCC) and colorectal neoplasms (CRNs) share risk factors. We aimed to investigate whether the CRN risk is increased in ESCC patients. Methods ESCC patients who underwent a colonoscopy within 1 year of diagnosis were retrospectively analyzed. Patients were matched 1:3 by age, gender, and body mass index to asymptomatic controls. CRN was defined as the histological confirmation of adenoma or adenocarcinoma. Advanced CRN was defined as any of the following: ≥3 adenomas, high-grade dysplasia, villous features, tumor ≥1 cm, or adenocarcinoma. The risk factors for both CRN and advanced CRN were evaluated by univariate and multivariate analyses. Results Sixty ESCC patients were compared with 180 controls. The ESCC group had significantly higher numbers of CRNs (odds ratio [OR], 2.311; 95% confidence interval [CI], 1.265 to 4.220; p=0.006) and advanced CRNs (OR, 2.317; 95% CI, 1.185 to 4.530; p=0.013). Significant risk factors for both CRN and advanced CRN by multivariate analysis included ESCC (OR, 2.157, 95% CI, 1.106 to 4.070, p=0.024; and OR, 2.157, 95% CI, 1.045 to 4.454, p=0.038, respectively) and older age (OR, 1.068, 95% CI, 1.032 to 1.106, p<0.001; and OR, 1.065, 95% CI, 1.024 to 1.109, p=0.002, respectively). Conclusions The rates of CRN and advanced CRN are significantly increased in ESCC. Colonos-copy should be considered at ESCC diagnosis.
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Affiliation(s)
- Myong Ki Baeg
- Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Myung-Gyu Choi
- Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Yun Duk Jung
- Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Sun-Hye Ko
- Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Chul-Hyun Lim
- Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Hyung Hun Kim
- Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Jin Su Kim
- Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Yu Kyung Cho
- Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Jae Myung Park
- Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - In Seok Lee
- Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Sang-Woo Kim
- Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
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Laccetti AL, Pruitt SL, Xuan L, Halm EA, Gerber DE. Effect of prior cancer on outcomes in advanced lung cancer: implications for clinical trial eligibility and accrual. J Natl Cancer Inst 2015; 107:djv002. [PMID: 25667420 DOI: 10.1093/jnci/djv002] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Prior cancer is a common exclusion criterion in lung cancer trials. This practice reflects concerns that prior cancer may affect trial conduct or outcomes. However, the impact of prior cancer on survival in lung cancer is not known. METHODS We identified patients older than age 65 years with stage IV lung cancer diagnosed between 1992 and 2009 in the Surveillance, Epidemiology, and End Results-Medicare linked registry. Prior cancer was characterized by type, stage, and timing. All-cause and lung cancer-specific survival were compared between patients with and without prior cancer using propensity score-adjusted Cox regression. RESULTS Overall, 102 929 patients with stage IV lung cancer were identified, of whom 14.7% had a history of prior cancer. More than two-thirds (76.0%) of prior cancers were localized or regional stage; most were diagnosed five or fewer years prior to the lung cancer diagnosis. In propensity score-adjusted analysis, patients with prior cancer had better all-cause (hazard ratio [HR] = 0.93, 95% confidence interval [CI] = 0.91 to 0.94) and lung cancer-specific (HR = 0.81, 95% CI = 0.79 to 0.82) survival. In a simulated clinical trial-eligible population (age <75 years, no comorbidity, treated with chemotherapy), similar trends were noted. In subset analyses according to stage, type, and timing of prior cancer, no group of patients with prior cancer had inferior survival compared with patients without prior cancer. CONCLUSION Among patients with stage IV lung cancer, prior cancer does not convey an adverse effect on clinical outcomes, regardless of prior cancer stage, type, or timing. Broader inclusion in clinical trials of advanced lung cancer patients with a history of prior cancer should be considered.
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Affiliation(s)
- Andrew L Laccetti
- Department of Internal Medicine (ALL, EAH, DEG), Department of Clinical Sciences (SLP, LX, EAH), Harold C. Simmons Cancer Center (SLP, EAH, DEG), University of Texas Southwestern Medical Center, Dallas, TX
| | - Sandi L Pruitt
- Department of Internal Medicine (ALL, EAH, DEG), Department of Clinical Sciences (SLP, LX, EAH), Harold C. Simmons Cancer Center (SLP, EAH, DEG), University of Texas Southwestern Medical Center, Dallas, TX
| | - Lei Xuan
- Department of Internal Medicine (ALL, EAH, DEG), Department of Clinical Sciences (SLP, LX, EAH), Harold C. Simmons Cancer Center (SLP, EAH, DEG), University of Texas Southwestern Medical Center, Dallas, TX
| | - Ethan A Halm
- Department of Internal Medicine (ALL, EAH, DEG), Department of Clinical Sciences (SLP, LX, EAH), Harold C. Simmons Cancer Center (SLP, EAH, DEG), University of Texas Southwestern Medical Center, Dallas, TX
| | - David E Gerber
- Department of Internal Medicine (ALL, EAH, DEG), Department of Clinical Sciences (SLP, LX, EAH), Harold C. Simmons Cancer Center (SLP, EAH, DEG), University of Texas Southwestern Medical Center, Dallas, TX.
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Abstract
Follow-up program in squamous cell carcinoma of head and neck district is crucial to detect locoregional recurrence and second primary tumors and to manage treatment toxicities. The choice of the appropriate frequency of visits and imaging modality can be troublesome. Details of timing surveillance and type of diagnostic procedure are still not well defined. This review highlights the problem from a clinician’s point of view.
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Ma J, Zhan C, Wang L, Jiang W, Zhang Y, Shi Y, Wang Q. The sweet approach is still worthwhile in modern esophagectomy. Ann Thorac Surg 2014; 97:1728-33. [PMID: 24650587 DOI: 10.1016/j.athoracsur.2014.01.034] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Revised: 01/14/2014] [Accepted: 01/17/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND The Ivor Lewis and Sweet approaches are the two most widely used open transthoracic esophagectomy techniques. We evaluated and compared the therapeutic efficacy of these two approaches to determine the appropriate method to treat middle or lower third esophageal carcinomas. METHODS We retrospectively reviewed patients who underwent esophagectomy with the Sweet (n=748) and Ivor Lewis (n=167) approaches at Zhongshan Hospital, Fudan University between January 2007 and December 2010. Patients with preoperatively identified superior mediastinal lymph node metastases, high-level lesions (above the carina), and benign tumors were excluded. Perioperative-related indicators and 5-year survival rates were compared between groups. RESULTS Compared with the Ivor Lewis approach, the Sweet approach has a shorter operative time (181±71 minutes versus 208±63 minutes; p<0.001), less blood loss (167±71 mL versus 179±87 mL; p=0.043), and a lower incidence of transfusion (8.7% versus 13.8%; p=0.044) and postoperative complications (12.3% versus 20.4%; p=0.002). The Ivor Lewis approach was more likely to result in wound infection (3.2% versus 7.8%; p=0.010) and delayed gastric emptying (1.7% versus 4.7%; p=0.046). There was no significant difference between groups with regard to the number of lymph nodes harvested or total number of patients with lymph node metastases. There was no significant difference in locoregional recurrence, distant recurrence, or 5-year survival between approaches. CONCLUSIONS The Sweet approach has many advantages for the treatment of middle or lower third esophageal carcinomas. It is a safe, effective, and worthwhile approach in modern thoracic surgery.
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Affiliation(s)
- Jun Ma
- Department of Thoracic Surgery, ZhongShan Hospital, Fudan University, Shanghai, China
| | - Cheng Zhan
- Department of Thoracic Surgery, ZhongShan Hospital, Fudan University, Shanghai, China
| | - Lin Wang
- Department of Thoracic Surgery, ZhongShan Hospital, Fudan University, Shanghai, China
| | - Wei Jiang
- Department of Thoracic Surgery, ZhongShan Hospital, Fudan University, Shanghai, China
| | - Yongxing Zhang
- Department of Thoracic Surgery, ZhongShan Hospital, Fudan University, Shanghai, China
| | - Yu Shi
- Department of Thoracic Surgery, ZhongShan Hospital, Fudan University, Shanghai, China
| | - Qun Wang
- Department of Thoracic Surgery, ZhongShan Hospital, Fudan University, Shanghai, China.
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