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Schwieger L, Postlewait LM, Liu Y, Jou S, Yi S, Peng L, Li X. Changes in expression of breast cancer tumor biomarkers between primary tumors and corresponding metastatic sites: common patterns and relationships with survival. Breast Cancer Res Treat 2024; 207:373-382. [PMID: 38780889 DOI: 10.1007/s10549-024-07368-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 04/25/2024] [Indexed: 05/25/2024]
Abstract
PURPOSE In metastatic breast cancer, differences in expression patterns of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER2) between the primary tumor (PT) and metastatic site (MET) have been reported. However, there is limited understanding of the relationship of tumor subtype discordance and overall survival (OS). We evaluated patterns of ER/PR/HER2 in PTs and corresponding METs and assessed the relationship between these patterns and OS. METHODS Patients diagnosed at our center with metastatic breast cancer (2011-2020) were included. ER/PR were stratified as < 1%/1-10%/ > 10% by immunohistochemistry and HER2 as positive/negative by immunohistochemistry/FISH. Tumor subtypes were classified as ER or PR + /HER2-, HER2+ , or triple-negative. Biomarker discordance data from PTs to METs were analyzed for expression patterns. OS was assessed. RESULTS Of 254 patients, 41 (16.1%) had synchronous and 213 (83.9%) had metachronous METs. Category change of ER/PR/HER2 expression was observed in 56 (22.0%), 117 (40.5%), and 30 (11.8%) patients, respectively. Tumor subtype changed in 56 (22.0%) patients. We identified a difference between PT and MET from ER > 10% to ER < 1% (n = 28,16.2% p < 0.01); PR > 10% to PR < 1% (n = 54,48.2%, p < 0.001); PR > 10% to PR 1-10% (n = 18,16.1%, p < 0.001), and ER or PR+/HER2- to triple-negative (n = 19,13.0%, p = 0.03). In log-rank analysis, change from an ER or PR+/HER2- (5-year OS 88.6%) PT to a HER2+(67.5%) or triple-negative (54.6%) MET was associated with decreased survival (p < 0.01); however, in multivariate analysis, discordant biomarker expression was not associated with decreased survival (p > 0.05). CONCLUSION Tumor expression of ER/PR/HER2 can differ between the PT and MET. Loss of ER/PR expression is common and may be related to worse survival. Routine assessment of MET tumor markers could inform prognosis and therapeutic decision-making.
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Affiliation(s)
- Lara Schwieger
- Division of Surgical Oncology, Department of Surgery, Grady Memorial Hospital, Emory University, Atlanta, GA, USA
| | - Lauren M Postlewait
- Division of Surgical Oncology, Department of Surgery, Grady Memorial Hospital, Emory University, Atlanta, GA, USA.
| | - Yi Liu
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, USA
| | - Stephanie Jou
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA
| | - Sha Yi
- Department of Pathology and Laboratory Medicine, East Carolina University, Greenville, NC, USA
| | - Limin Peng
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, USA
| | - Xiaoxian Li
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA.
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Ando S, Futami S, Azuma K, Nishimatsu K, Shirasaka T, Minami S. Synchronous Double Primary Lung Adenocarcinomas With EGFR L858R Point Mutation and MET Exon 14 Skipping Mutation. J Med Cases 2024; 15:153-158. [PMID: 39091578 PMCID: PMC11287901 DOI: 10.14740/jmc4210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Accepted: 06/11/2024] [Indexed: 08/04/2024] Open
Abstract
Various driver mutations and the corresponding molecular-targeted drugs have been detected and developed in non-small cell lung cancer. There were many cases in which surgical specimens had happened to find double primary cancers. However, to our knowledge, our case was the first report of synchronous double primary lung adenocarcinomas harboring epidermal growth factor receptor (EGFR) L858R and mesenchymal-to-epithelial transition (MET) exon 14 skipping mutations. A 75-year-old Japanese woman with chronic heart and renal failures was referred to our department because of a growing nodule in the right upper lung field on chest X-ray films. Chest computed tomography (CT) detected a nodule in the right S1 and another nodule in the left S1+2. Bronchoscopic biopsy diagnosed the right S1 nodule as moderately differentiated adenocarcinoma. Oncomine Dx Target Test Multi-CDx system of the right S1 adenocarcinoma detected EGFR L858R mutation. The 18F-fluorodeoxyglucose positron emission tomography/CT showed abnormal uptakes both in the right S1 and the left S1+2 nodules, and in the bilateral inferior paratracheal lymph nodes. We made a diagnosis of c-stage IIIA (cT1bN2M0) of adenocarcinoma in the right S1 and suspected another primary lung cancer in the left S1+2. Considering her general conditions, comorbidities and wishes, we started osimertinib. The right S1 cancer achieved partial response (PR), while the left S1+2 nodule and lymph nodes enlarged. Aspiration cytology from the left supraclavicular lymph node showed adenocarcinoma. The FoundationOne® Liquid CDx tumor profiling test detected not only EGFR L858R, but also MET exon 14 skipping mutation. We made a diagnosis of another primary adenocarcinoma from the left S1+2 nodule (cT1bN3M0, c-stage IIIB) with MET mutation, and changed osimertinib to capmatinib. Although the left S1+2 cancer achieved and maintained PR by capmatinib, the right S1 cancer increased, and several new metastases appeared. The subsequent switch from capmatinib to osimertinib could not control cancers. In this case, we tried to switch monotherapies from osimertinib to capmatinib for double primary adenocarcinomas harboring different two driver mutations, according to each cancer progression. The temporal and spatial heterogeneity reinforces the need for primary tissue biopsy if dual primaries are suspected. Temporally distinct liquid biopsies, not standard at present, may be considered.
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Affiliation(s)
- Seijitsu Ando
- Department of Respiratory Medicine, NHO Osaka National Hospital, Osaka City, Osaka 540-0006, Japan
| | - Shinji Futami
- Department of Respiratory Medicine, NHO Osaka National Hospital, Osaka City, Osaka 540-0006, Japan
| | - Koji Azuma
- Department of Respiratory Medicine, NHO Osaka National Hospital, Osaka City, Osaka 540-0006, Japan
| | - Kanako Nishimatsu
- Department of Respiratory Medicine, NHO Osaka National Hospital, Osaka City, Osaka 540-0006, Japan
| | - Takuma Shirasaka
- AIDS Medical Center, NHO Osaka National Hospital, Osaka City, Osaka 540-0006, Japan
| | - Seigo Minami
- Department of Respiratory Medicine, NHO Osaka National Hospital, Osaka City, Osaka 540-0006, Japan
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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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Sanli AN, Tekcan Sanli DE, Altundag MK, Aydogan F. Prognostic Factors Affecting Survival of Patients With Single Primary Breast Cancer vs Patients With Multiple Primary Cancers in Lifetime, One of Which is Breast Cancer. Am Surg 2024:31348241248695. [PMID: 38676386 DOI: 10.1177/00031348241248695] [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: 04/28/2024]
Abstract
PURPOSE The aim of this study was to investigate the demographic and molecular characteristics, overall survival (OS), cancer-specific survival (CSS), and prognostic factors affecting the survival of patients with single primary breast cancer (SPBC) and patients with multiple primary cancers in their life time in which one of them is breast cancer (MPC). METHODS Using data from SEER 17 Research Plus, patients with breast cancer diagnosed between 2010 and 2019 were included in this study. Race, marital status, laterality, tumor size, molecular subtype, grade, stage, radiotherapy-chemotherapy treatment, and surgery data were analyzed in the data obtained after excluding patients with missing values. Kaplan-Meier survival analysis was used for survival analysis, and Cox regression analysis was used to evaluate the prognostic factors. RESULTS 573175 patients were included in the study. The mean age of MPC patients was significantly higher than SPBC patients (65.99 ± 12.68, 60.33 ± 13.47, P < .001, respectively). Patients with SPBC had significantly more hormone receptor (HR)-positive/Her2 positive, HR-negative/Her2-negative, and HR-negative/Her2-positive molecular subtypes; patients with MPC had more HR-positive/Her2-negative subtypes (P < .001). Grade 3 tumor status, locoregional spread, and distant metastasis were significantly higher in SPBC patients (P < .001). Overall survival and CSS rates were significantly higher in SPBC patients (P < .001). In MPC patients, overall hazard ratio was 1.631 times higher than SPBC, and the cancer-specific hazard ratio was 1.096 times higher (95% CI [1.606-1.656], 95% CI [1.071-1.121], respectively). CONCLUSION Although patients with SPBC have worse prognostic tumor characteristics, OS and CSS rates are better than patients with MPC.
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Affiliation(s)
- Ahmet Necati Sanli
- Department General Surgery, Abdulkadir Yuksel State Hospital, Gaziantep, Turkey
| | | | | | - Fatih Aydogan
- Breast Health Center, Memorial Bahcelievler Hospital, Istanbul, Turkey
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Maji S, Ghosh SK, Jha JK, Chaturvedi V. A prospective observational study to assess the epidemiological profile of multiple primary cancers in Eastern India. J Cancer Res Ther 2024; 20:888-892. [PMID: 39023596 DOI: 10.4103/jcrt.jcrt_1603_20] [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: 10/30/2020] [Accepted: 07/29/2022] [Indexed: 07/20/2024]
Abstract
BACKGROUND Multiple primary cancers once thought to be rare have become increasingly common as the lifespan of cancer survivors has increased with availability of better and more effective cancer treatment. However, their exact incidence is not known and data on their epidemiological characteristics are not available. AIM The aim of this study is to study the epidemiologic characteristics of multiple primary cancers in the eastern region of India. MATERIALS AND METHOD The study was conducted in the Department of Surgical Oncology, Medical College, Kolkata, from 2017 to 2020 over a period of 3 years. All patients with a diagnosis of second primary as per International Agency for Research on Cancer (IARC) definition or those developing a second primary within the study period were included for analysis. Data were recorded in form of preformed questionnaires. All the cases were followed up for at least 12 months. RESULT Fifty cases of multiple primary tumors were identified, out of which 21 were synchronous while rest 29 were metachronous type. The male-female ratio was 1:1.2. The median age at presentation for index malignancy was 50 years. The most common malignancy in the synchronous group was a combination of variety of GI cancers (six cases). In the metachronous category, a combination of reproductive cancers (breast, ovary, cervix, and endometrium) along with Gastrointestinal cancer (GI) cancers (colon, rectum) was most frequently found (eight cases). Definite risk factors for multiple primary tumors were identifiable in 10 cases: arsenic exposure in 5 cases, hereditary in 4 cases, and immunosuppression in 1, while in 8 cases, risk factors were only speculative (radiation 5 cases, chemotherapy 3). At the time of the last follow-up, 36 subjects were alive and 3 dead while the status of 11 subjects was unknown. CONCLUSION This is the first comprehensive study on multiple primary cancers and the largest so far in India. Our study overcomes the shortcoming of previous case series from our subcontinent. The merits of our study include the use of the most accepted IARC definition, updated staging guidelines with long follow-up, and reliable survival data. Additionally, we could identify risk factors in 50% of our subjects. And our study shows various new combinations of cancers not reported before. Clustering of cases in the young adolescent group (25-49) years is also a new finding. We also highlight the existing ambiguity in the way this entity is defined. Demerits include the loss of follow-up data in a significant number of patients.
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Affiliation(s)
- Suvendu Maji
- Department of Surgical Oncology, Medical College, Kolkata, West Bengal, India
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Tian Y, He L, Zhang B, Deng L, Wang J. A Competing Risk Nomogram for Prediction of Prognosis in Patients With Primary Squamous Cell Thyroid Carcinoma. Technol Cancer Res Treat 2024; 23:15330338241254059. [PMID: 38725285 PMCID: PMC11085001 DOI: 10.1177/15330338241254059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 04/09/2024] [Accepted: 04/22/2024] [Indexed: 05/12/2024] Open
Abstract
Objective: Primary squamous cell thyroid carcinoma (PSCTC) is an extremely rare carcinoma, accounting for less than 1% of all thyroid carcinomas. However, the factors contributing to PSCTC outcomes remain unclear. This study aimed to identify the prognostic factors and develop a prognostic predictive model for patients with PSCTC. Methods: The analysis included patients diagnosed with thyroid carcinoma between 1975 and 2016 from the Surveillance, Epidemiology, and End Results database. Prognostic differences among the 5 pathological types of thyroid carcinomas were analyzed. To determine prognostic factors in PSCTC patients, the Cox regression model and Fine-Gray competing risk model were utilized. Based on the Fine-Gray competing risk model, a nomogram was established for predicting the prognosis of patients with PSCTC. Results: A total of 198,757 thyroid carcinoma patients, including 218 PSCTC patients, were identified. We found that PSCTC and anaplastic thyroid cancer had the worst prognosis among the 5 pathological types of thyroid carcinoma (P < .001). According to univariate and multivariate Cox regression analyses, age (71-95 years) was an independent risk factor for poorer overall survival and disease-specific survival in PSCTC patients. Using Fine-Gray regression analysis, the total number of in situ/malignant tumors for patient (Number 1) (≥2) was identified as an independent protective factor for prognosis of PSCTC. The area under the curve, the concordance index (C-index), calibration curves and decision curve analysis revealed that the nomogram was capable of predicting the prognosis of PSCTC patients accurately. Conclusion: The competing risk nomogram is highly accurate in predicting prognosis for patients with PSCTC, which may help clinicians to optimize individualized treatment decisions.
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Affiliation(s)
- Ye Tian
- Department of Thyroid and Breast Surgery, Wuhan No. 1 Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lei He
- Department of Blood Transfusion, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bin Zhang
- Department of Blood Transfusion, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Linfeng Deng
- Department of Blood Transfusion, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Juan Wang
- Department of Blood Transfusion, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Sancheti S, Goel AK, Singla A, Chauhan KS, Arora K, Chaudhary D, Dora T, Tahlan S, Kadam P, Joshi P, Sali A, Brar RS, Budukh A, Gulia A, Divatia JV, Badwe R. Deciphering the Patterns of Dual Primary Cases Registered at the Hospital-Based Cancer Registry: First Experience from Rural Cancer Center in North India. J Lab Physicians 2023; 15:524-532. [PMID: 37780887 PMCID: PMC10539055 DOI: 10.1055/s-0043-1768631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 03/13/2023] [Indexed: 10/03/2023] Open
Abstract
Objectives The objective is to present the patterns of dual primary malignancies diagnosed at the Pathology Laboratory of Cancer Hospital with the support from hospital-based cancer registry (HBCR), Sangrur, Punjab, India for the years 2018 and 2019. Methods HBCR abstracts data from electronic medical records. Trained cancer registry staff abstracts cases in standard pro forma. Dual primary was coded as per the International Agency for Research on Cancer rule and was rechecked by the pathologist. Statistical Analysis Data about multiple primary was entered and documented in an Excel sheet. Time interval was calculated by subtracting the date of diagnosis for second primary and first primary. Results A total of 6,933 cases were registered, 45 cases are dual primary (26 females, 19 males) of which 64.4% are synchronous and 35.6% metachronous cases. Seventy-nine percent received cancer-directed treatment for synchronous and 87% for metachronous. The most common sites of the primary tumor were breast (33%), head and neck (22.2%), gynecological sites (11%), prostate (9%), esophagus (4%), and remaining other tumors (20.8%). Most common sites for second malignancies were gastrointestinal (GI) tract (31%), gynecological sites (18%), head and neck (16%), hematological malignancies (7%), soft tissue sarcoma (4%), breast (2%), and other sites (22%). Conclusion More than 70% of cases of primary tumors were in breast, head and neck, gynecological, and prostate. Of these, more than 60% of the second malignancy was found in the GI tract, gynecological, and head and neck sites. Around two-thirds of dual tumors are synchronous. Breast cancer cases have higher incidence of second malignancy. Regular follow-up is necessary to assess the survival of the second primary.
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Affiliation(s)
- Sankalp Sancheti
- Department of Pathology, Homi Bhabha Cancer Hospital (Unit of Tata Memorial Centre), Sangrur, Punjab, India
| | - Alok Kumar Goel
- Department of Medical Oncology, Homi Bhabha Cancer Hospital (Unit of Tata Memorial Centre), Sangrur, Punjab, India
| | - Anshul Singla
- Department of Surgical Oncology, Homi Bhabha Cancer Hospital (Unit of Tata Memorial Centre), Sangrur, Punjab, India
| | - Kuldeep Singh Chauhan
- Hospital-Based Cancer Registry, Homi Bhabha Cancer Hospital (Unit of Tata Memorial Centre), Sangrur, Punjab, India
| | - Kiran Arora
- Hospital-Based Cancer Registry, Homi Bhabha Cancer Hospital (Unit of Tata Memorial Centre), Sangrur, Punjab, India
| | - Debashish Chaudhary
- Department of Surgical Oncology, Homi Bhabha Cancer Hospital (Unit of Tata Memorial Centre), Sangrur, Punjab, India
| | - Tapas Dora
- Department of Radiation Oncology, Homi Bhabha Cancer Hospital, Sangrur, Punjab, India
| | - Shweta Tahlan
- Department of Surgical Oncology, Homi Bhabha Cancer Hospital (Unit of Tata Memorial Centre), Sangrur, Punjab, India
| | - Prithviraj Kadam
- Division of Medical Records and Cancer Registries, Centre for Cancer Epidemiology, ACTREC, Navi Mumbai, Maharashtra, India
| | - Prachi Joshi
- Division of Medical Records and Cancer Registries, Centre for Cancer Epidemiology, ACTREC, Navi Mumbai, Maharashtra, India
| | - Akash Sali
- Department of Pathology, Homi Bhabha Cancer Hospital (Unit of Tata Memorial Centre), Sangrur, Punjab, India
| | - Rahatdeep Singh Brar
- Department of Radiodiagnosis, Homi Bhabha Cancer Hospital (Unit of Tata Memorial Centre), Sangrur, Punjab, India
| | - Atul Budukh
- Division of Medical Records and Cancer Registries, Centre for Cancer Epidemiology, ACTREC, Navi Mumbai, Maharashtra, India
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India
| | - Ashish Gulia
- Department of Surgical Oncology, Homi Bhabha Cancer Hospital (Unit of Tata Memorial Centre), Sangrur, Punjab, India
| | - Jigeeshu Vasishtha Divatia
- Department of Anaesthesia Critical Care and Pain Management, Homi Bhabha Cancer Hospital (Unit of Tata Memorial Centre), Sangrur, Punjab, India
| | - Rajendra Badwe
- Department of Surgical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India
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Ibrahim MA, Dashuki N, Mohd Noor N, Rusli SM. Multiple primary malignant tumours of lung and colorectal adenocarcinoma: A case report. PROCEEDINGS OF SINGAPORE HEALTHCARE 2023. [DOI: 10.1177/20101058231163408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023] Open
Abstract
Multiple primary malignant tumors of lung and colorectal incidence were extremely rare and in most cases, diagnosed incidentally. Due to its rarity, most physicians consider pulmonary lesions found in patients with a history of colorectal cancer as lung metastasis. To avoid misdiagnosis and treatment delays, it is critical to properly screen and explore for possible metastasis or the occurrence of a second primary tumor after a primary cancer has been diagnosed. We describe a 72-year-old woman who presented with rectal bleeding associated with altered bowel movement. Rectal biopsy revealed colon adenocarcinoma and subsequent CT scan showed sigmoid colon mass and right lower lobe lung mass with multiple mediastinal lymphadenopathies. Biopsies of the mediastinal lymph nodes also showed adenocarcinoma. PET/CT scans showed different SUVmax of lesions in the sigmoid colon and right lower lobe, which raised the possibility of separate colonic and lung primary tumors as opposed to colonic primary with lung metastasis. Further immunohistology studies confirmed separate primary lung tumor. These diagnoses facilitate the clinical approach and define treatment options for the patient.
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Affiliation(s)
- Muhammad Amin Ibrahim
- Department of Internal Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Malaysia
| | - Nuruliman Dashuki
- Department of Internal Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Malaysia
| | - Norizal Mohd Noor
- Department of Pathology, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Malaysia
| | - Siti Mayuha Rusli
- Department of Surgery, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Malaysia
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Oey O, Tiong SS, Wong SL, Navadgi S, Khan Y. Triple synchronous malignancies of the stomach, bladder and thyroid in a previously treated prostate cancer patient: A Case Report. Folia Med (Plovdiv) 2023; 65:693-698. [PMID: 37655393 DOI: 10.3897/folmed.65.e96012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 11/24/2022] [Indexed: 09/02/2023] Open
Abstract
Cancers that develop within six months of the first primary cancer are referred to as synchronous malignancies. These malignancies are difficult to diagnose and treat, with treatment primarily based on case reports.
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Affiliation(s)
- Oliver Oey
- St John of God Midland Public and Private Hospital, Perth, Australia
| | | | - Sze Ling Wong
- St John of God Midland Public and Private Hospital, Perth, Australia
| | | | - Yasir Khan
- St John of God Midland Public and Private Hospital, Perth, Australia
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Mei L, Feng J, Zhao L, Zheng X, Li X. Nomogram for predicting survival of patients with gastric cancer and multiple primary malignancies: a real-world retrospective analysis using the Surveillance, Epidemiology and End Results database. J Int Med Res 2023; 51:3000605231187944. [PMID: 37572023 PMCID: PMC10423457 DOI: 10.1177/03000605231187944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 06/12/2023] [Indexed: 08/14/2023] Open
Abstract
OBJECTIVES Gastric cancer combined with multiple primary malignancies (GCM) is increasingly common. This study investigated GCM clinical features and survival time. METHODS Patients with GCM and GC only (GCO) were selected from the Surveillance, Epidemiology and End Results (SEER) database. Survival was compared between GCM and GCO groups using propensity score matching. Then, the GCM group was divided into a training cohort and a validation cohort. These cohorts were used to establish a nomogram for survival prediction in patients with GCM. RESULTS Survival time was significantly longer in the GCM group than in the GCO group. All-subsets regression was used to identify four variables for nomogram establishment: age, gastric cancer sequence, N stage, and surgery. The concordance index and time-dependent receiver operating characteristic curve indicated that the nomogram had favorable discriminative ability. Calibration plots of predicted and actual probabilities showed good consistency in both the training and validation cohorts. Decision curve analysis and risk stratification showed that the nomogram was clinically useful; it had favorable discriminative ability to recognize patients with different levels of risk. CONCLUSIONS Compared with GCO, GCM is a relatively indolent malignancy. The nomogram developed in this study can help clinicians to assess GCM prognosis.
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Affiliation(s)
- Linhang Mei
- Department of Surgical Oncology, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China
| | - Jie Feng
- Department of Traumatic Orthopedics, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China
| | - Lingdan Zhao
- Department of General Practice, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China
| | - Xiaokang Zheng
- Emergency Department, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China
| | - Xiao Li
- Department of General Surgery, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China
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Chen N, Shi L, Ge J, Jia R, Jiang J. Risk and prediction of multiple primary malignancies after early gastric cancer. Front Oncol 2023; 13:1205358. [PMID: 37560468 PMCID: PMC10409482 DOI: 10.3389/fonc.2023.1205358] [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: 04/13/2023] [Accepted: 07/10/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Patients with early gastric cancer have increased risk of developing multiple primary malignancies (MPM) due to improved survival rates. The purpose of this study was to evaluate the clinicopathological features of MPM and to generate a useful tool for predicting the development of MPM after early gastric cancer. METHODS We selected 1025 early gastric cancer patients with complete medical records for a retrospective analysis. The Cox proportional risk regression model was used to analyze the independent risk factors for the development of MPM in early gastric cancer. RStudio software was used to compare the OS of early gastric cancer patients with and without MPM, and a nomogram was established to predict the probability of MPM 1-, 2-, 3-year after early gastric cancer. The predictive effectiveness of the nomogram was evaluated by the C-index and calibration curve. Decision curve analysis (DCA) measured the applicability of the nomogram to clinical practice. RESULTS Of the 1025 patients with early gastric cancer, 66 patients (6.4%) had 69 primary cancers other than early gastric cancer. They had a median follow-up of 41 months, and their cumulative incidence of MPM was 4.9%, 5.4% and 5.9% after 1-, 2-, and 3- year, respectively. Oesophageal cancer was the most frequently detected MPM, followed by lung and colorectal cancers. Male (p=0.038), age ≥65 years (p=0.003), smoking history (p=0.036), and lymph node metastasis (p=0.013) were independent risk factors for MPM in patients with early gastric cancer. Patients with early gastric cancer with MPM had a worse OS prognosis than patients with early gastric cancer without MPM (p<0.001). The internally validated nomogram predicted the probability of developing MPM after early gastric cancer (C index= 0.697). The calibration chart showed that the predicted probability of MPM in early gastric cancer was similar to the observed result, and the DCA showed strong clinical practicability. CONCLUSION After the diagnosis and treatment of early gastric cancer, we should be alert to the possibility of MPM and perform regular and careful monitoring.
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Affiliation(s)
| | | | | | | | - Junmei Jiang
- Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
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12
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Jiang W, Zhang G, Li H, Xu X, Jia L, Luo X, Cao Z. Synchronous triple primary gastrointestinal malignant tumors treated with laparoscopic surgery: A case report. Open Med (Wars) 2023; 18:20230742. [PMID: 37415609 PMCID: PMC10320567 DOI: 10.1515/med-2023-0742] [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: 03/23/2022] [Revised: 06/06/2023] [Accepted: 06/11/2023] [Indexed: 07/08/2023] Open
Abstract
Synchronous gastrointestinal multiple primary tumors including gastric, colonic, and rectal cancers are rare. Moreover, it was a challenge to find an appropriate procedure without negatively impacting the overall outcome. We described the case of a 63-year-old woman who presented with a 4 month history of upper abdominal pain, acid regurgitation, and anemia. Gastroscopy with biopsy suggested early cancer of gastric antrum. Abdominal contrast-enhanced computerized tomography and colonoscopy revealed ascending colon and rectum tumors. She had no family history of malignancy. Endoscopic submucosal dissection was performed for gastric cancer, and the pathological result presented that it was poorly differentiated and invaded into deep submucosa. The laparoscopy-assisted radical surgery combined with distal gastrectomy, right hemicolectomy, and anterior resection of rectum was performed for these three tumors via eight ports and a 7 cm midline upper-abdominal incision. No other perioperative complications were encountered except postoperative ileus. The patient was discharged on the 12th postoperative day. The pathological results revealed gastric cancer (T1N0M0), right colonic cancer (T3N1M0), and rectal cancer (T2N0M0), indicating complete surgical resection. We reported that our laparoscopic approach for synchronous triple primary gastrointestinal malignant tumors was feasible and minimally invasive.
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Affiliation(s)
- Wei Jiang
- Department of Gastrointestinal Surgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, 430000, Wuhan, China
| | - Genshan Zhang
- Department of Gastrointestinal Surgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, 430000, Wuhan, China
| | - Haijie Li
- Department of Gastrointestinal Surgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, 430000, Wuhan, China
| | - Xiangshang Xu
- Department of Gastrointestinal Surgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, 430000, Wuhan, China
| | - Lingwei Jia
- Department of Gastrointestinal Surgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, 430000, Wuhan, China
| | - Xuelai Luo
- Department of Gastrointestinal Surgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, 430000, Wuhan, China
| | - Zhixin Cao
- Department of Gastrointestinal Surgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, 430000, Wuhan, China
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13
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Gao R, Yang F, Yang C, Zhang Z, Liu M, Xiang C, Hu H, Luo X, Li J, Liu R. A case report and literature review of immune checkpoint inhibitor-associated pneumonia caused by penpulimab. Front Immunol 2023; 14:1114994. [PMID: 37426639 PMCID: PMC10323425 DOI: 10.3389/fimmu.2023.1114994] [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: 12/03/2022] [Accepted: 05/23/2023] [Indexed: 07/11/2023] Open
Abstract
Objective From the perspective of intensive care physicians, this paper reviews the diagnosis and treatment of CIP patients, analyzes and refines relevant literature on CIP. To summarize the characteristics of diagnosis and treatment of severe CIP provides the basis and reference for early identification, diagnosis and treatment. Methods A case of severe CIP caused by piamprilizumab and ICI was reviewed and the literature was reviewed. Results This was a patient with lung squamous cell carcinoma with lymphoma who had been treated with multiple chemoradiotherapy and immunotherapy with piamprizumab. The patient was admitted to the ICU with respiratory failure. The intensive care physician performs anti-infective, fluid management, hormonal anti-inflammatory, respiratory and nutritional support treatment, and relies on mNGS to exclude severe infection and CIP treatment, thus successfully saving the patient's life and improving discharge. Conclusions The incidence of CIP is very low, and its diagnosis should be combined with clinical manifestations and previous drug use. mNGS can provide certain value in the exclusion of severe infections, so as to provide basis and reference for the early identification, diagnosis and treatment of severe CIP.
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Affiliation(s)
| | | | | | | | | | | | | | - Xiaoxiu Luo
- *Correspondence: Xiaoxiu Luo, ; Jiajia Li, ; Rongan Liu,
| | - Jiajia Li
- *Correspondence: Xiaoxiu Luo, ; Jiajia Li, ; Rongan Liu,
| | - Rongan Liu
- *Correspondence: Xiaoxiu Luo, ; Jiajia Li, ; Rongan Liu,
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14
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Na SK, Kang SH. The development of hepatocellular carcinoma during long-term treatment for recurrent non-small cell lung cancer: a case report. JOURNAL OF LIVER CANCER 2023; 23:230-234. [PMID: 37384034 PMCID: PMC10202240 DOI: 10.17998/jlc.2023.03.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 03/03/2023] [Accepted: 03/03/2023] [Indexed: 06/30/2023]
Abstract
Multiple primary malignancies (MPMs) are defined as the presence of two or more malignancies in different organs, without a subordinate relationship. Although rarely reported, hepatocellular carcinoma (HCC) occasionally presents with simultaneous or metachronous primary malignancies in other organs. In this report, we describe a patient with lung adenocarcinoma and lymph node and bone metastases, treated with five chemotherapeutic regimens for 24 months. Changing the chemotherapy regimen based on the suspicion of metastasis of a new liver mass did not lead to improvements. This prompted a liver biopsy and a revised diagnosis of HCC. Sixth-line treatment with the concurrent use of cisplatin-paclitaxel for lung cancer and sorafenib for HCC, stabilized the disease. The concurrent treatment was not tolerated and was discontinued owing to adverse events. Considering our findings, treatment with increased efficacy and lower toxicity for MPMs is warranted.
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Affiliation(s)
- Seong Kyun Na
- Department of Internal Medicine, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Seong Hee Kang
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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15
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Alhamadh MS, Alanazi RB, Alqirnas MQ, Alhabeeb AY, Chachar YS, Alkaiyat M, Sabatin F. The burden and predictors of venous thromboembolic diseases in patients with multiple primary malignancies. Cancer Rep (Hoboken) 2023; 6:e1742. [PMID: 36314077 PMCID: PMC10026306 DOI: 10.1002/cnr2.1742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 09/21/2022] [Accepted: 10/08/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Venous thromboembolism (VTE) represents a considerable burden on cancer patients' survival and quality of life, but this burden varies based on the patient's baseline characteristics and cancer-related factors. Although solid evidence on the predictors and effect of VTE in cancer patients exists. AIM To evaluate VTE rate, morbidity, and mortality to develop parameters that could predict VTEs and their associated mortality in patients with multiple primary malignancies (MPMs). METHOD AND RESULTS This was a retrospective cohort study that took place at King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia. Two hundred and forty-two patients with at least two biopsy-proven malignancies and had at least 3 months of follow-up after MPMs diagnosis were included. VTE was diagnosed in 14.5% of the cases, two-thirds of which were deep vein thrombosis. VTE was significantly associated with a higher mortality and worse survival. Predictors of VTE after MPMs diagnosis were a high ECOG performance status at MPMs diagnosis, a metastatic first primary malignancy, and ICU admission after MPMs diagnosis. Having a GI or hematological malignancy as the second primary malignancy, a high D-dimer at ICU admission, and palliative care referral were significantly associated with a higher mortality in patients who had VTE. CONCLUSION VTE was diagnosed in 14.5% of patients with MPMs and it significantly compromises their survival. We believe that these results might be of particular benefit since the phenomenon of MPMs is becoming more frequently encountered.
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Affiliation(s)
- Moustafa S Alhamadh
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of the National Guard-Health Affairs, Riyadh, Kingdom of Saudi Arabia
- King Abdullah International Medical Research Center, Ministry of the National Guard-Health Affairs, Riyadh, Kingdom of Saudi Arabia
| | - Rakan B Alanazi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of the National Guard-Health Affairs, Riyadh, Kingdom of Saudi Arabia
- King Abdullah International Medical Research Center, Ministry of the National Guard-Health Affairs, Riyadh, Kingdom of Saudi Arabia
| | - Muhannad Q Alqirnas
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of the National Guard-Health Affairs, Riyadh, Kingdom of Saudi Arabia
- King Abdullah International Medical Research Center, Ministry of the National Guard-Health Affairs, Riyadh, Kingdom of Saudi Arabia
| | - Abdulrahman Yousef Alhabeeb
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of the National Guard-Health Affairs, Riyadh, Kingdom of Saudi Arabia
- King Abdullah International Medical Research Center, Ministry of the National Guard-Health Affairs, Riyadh, Kingdom of Saudi Arabia
| | - Yusra Sajid Chachar
- College of Sciences and Health Professions at King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of the National Guard-Health Affairs, Riyadh, Kingdom of Saudi Arabia
| | - Mohammad Alkaiyat
- King Abdullah International Medical Research Center, Ministry of the National Guard-Health Affairs, Riyadh, Kingdom of Saudi Arabia
- Department of Medical Oncology, King Abdulaziz Medical City, Ministry of the National Guard-Health Affairs, Riyadh, Kingdom of Saudi Arabia
| | - Fouad Sabatin
- King Abdullah International Medical Research Center, Ministry of the National Guard-Health Affairs, Riyadh, Kingdom of Saudi Arabia
- Department of Medical Oncology, King Abdulaziz Medical City, Ministry of the National Guard-Health Affairs, Riyadh, Kingdom of Saudi Arabia
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16
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Park CL, Moria F, Saleh RR. Combination of Osimertinib with Concurrent Chemotherapy and Hormonal Therapy for Synchronous NSCLC, Hormone Receptor-Positive Breast Cancer, and Triple-Negative Breast Cancer: Case Report. Case Rep Oncol 2023; 16:1080-1086. [PMID: 37900833 PMCID: PMC10601812 DOI: 10.1159/000533783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 08/22/2023] [Indexed: 10/31/2023] Open
Abstract
Patients presenting with multiple primary malignancies remain a growing challenge for physicians due to a lack of data for generalizable guidelines. Identification of driver mutations in carcinogenesis leads to the development of targeted treatment of many different cancer types, but its combination with other anti-cancer therapy is not well understood. We report a case of a 66-year-old woman who presented with triple-negative breast cancer, multifocal hormone receptor-positive breast cancer, primary epidermal growth factor receptor-mutated lung adenocarcinoma, possible primary lung adenocarcinoma of unspecified mutational status in the contralateral lung, and a solitary metastatic lesion in the brain from one of her primary cancers. She was treated with stereotactic radiosurgery and osimertinib in combination with carboplatin/nab-paclitaxel, doxorubicin/cyclophosphamide, and letrozole, with excellent clinical and radiographical response. We did not observe synergistic toxicity or unexpected adverse events from the treatment. To the best of our knowledge, this is the first report of concurrent osimertinib with these chemotherapy and hormonal therapy agents. As large-scale studies are difficult to conduct for these rare cases requiring exceptional treatment, it is important for physicians to build on the community's shared experience via case reports to better predict efficacy and safety of combining targeted agents with other conventional systemic treatments.
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Affiliation(s)
- Changsu L Park
- Department of Medical Oncology, McGill University Health Center, McGill University, Montreal, QC, Canada
| | - Feras Moria
- Department of Medical Oncology, McGill University Health Center, McGill University, Montreal, QC, Canada
| | - Ramy R Saleh
- Department of Medical Oncology, McGill University Health Center, McGill University, Montreal, QC, Canada
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Naorem R, Ghogale KS, Waghmare CM. Multiple malignant primary tumors (non-head and neck): Contemplation needed. J Cancer Res Ther 2023; 19:S752-S757. [PMID: 38384051 DOI: 10.4103/jcrt.jcrt_155_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: 01/19/2022] [Accepted: 08/06/2022] [Indexed: 02/23/2024]
Abstract
BACKGROUND The incidence of multiple malignant primary tumors (MMPT) is increasing which needs attention. Hence, we undertook this study to analyze clinico-demographic details and treatment outcomes in patients with non-head and neck MMPT. MATERIALS AND METHODS Hospital case records of patients with histopathology proven MMPT registered in the radiation oncology department from January 1, 2008 to December 31, 2020 were retrospectively studied. Modified Warren-Gates criteria were used to define MMPT. Patients with MMPT of the head and neck (both an index and second primary as head-neck) were excluded from the study. Demographic and clinical details were recorded and analyzed. RESULTS Forty-two eligible cases of non-head and neck MMPT were studied. The median age at diagnosis of an index case was 55 years (minimum 21, maximum 85) with a male to a female sex ratio of 5:37. Twelve patients had synchronous (28.57%) and 30 had metachronous (71.42%) MMPT. The average period between metachronous tumors was 77.77 months (minimum 12, maximum 312). The most common site of an index and second primary tumor was the breast (26; 61.90% and 23; 54.76%, respectively). Seventeen (65.38%) out of 26 index breast cancer were bilateral breast cancer and nine were others. In six cases of MMPT, there was an association between the breast and cervix. CONCLUSION Breast cancer was the most common site for both an index and second primary malignancy followed by genital cancers. With cautious monitoring and patient education, second primary tumor could be detected earlier and managed better giving a good quality of life to patients.
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Affiliation(s)
- Raphel Naorem
- Department of Radiation Oncology, Dr. Balasaheb Vikhe Patil Rural Medical College and Dr. Vitthalrao Vikhe Patil Pravara Rural Hospital, PIMS-DU, Loni, Ahmadnagar, Maharashtra, India
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18
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Wang W, Liu X, Dang J, Li G. Survival and prognostic factors in patients with synchronous multiple primary esophageal squamous cell carcinoma receiving definitive radiotherapy: A propensity score-matched analysis. Front Oncol 2023; 13:1132423. [PMID: 37035207 PMCID: PMC10080148 DOI: 10.3389/fonc.2023.1132423] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 03/13/2023] [Indexed: 04/11/2023] Open
Abstract
Purpose To compare the lesion characteristics and radiotherapy efficacy of patients with single and multiple esophageal squamous cell carcinoma (ESCC), to evaluate the effect of multiple lesions on ESCC, and establish a nomogram survival prediction model for patients with synchronous multiple primary esophageal squamous cell carcinoma (SMPESCC) who received definitive radiotherapy. Materials and methods The study enrolled 1,034 patients with ESCC who underwent definitive radiotherapy between 2010 and 2020. The efficacy of radiotherapy was compared between 101 patients with SMPESCC and 933 patients with single ESCC. Propensity score matching was used to control for potential confounders. For patients with SMPESCC, a nomogram prediction model was established based on the Cox regression model. Results The median OS was 30.00 (95% CI = 25.08-34.92) months for the single lesion group and 19.00 (95% CI = 15.51-22.48) months for the multiple cancer group respectively. Multivariate COX regression analysis showed that multiple cancer was an independent prognostic factor for ESCC patients (HR=1.89, 95%CI=1.49-2.38, P<0.001). Cox multivariate analysis of SMPESCC patients showed that T stage (P =0.002), chemotherapy (P =0.006), and lesion spacing (P =0.004) were independent prognostic factors associated with OS. The nomogram was established by combining T stage, chemotherapy, and lesion spacing, and Harrell's C index was 0.711 after internal cross-validation. The calibration curve and decision curve analysis confirmed that the nomogram survival prediction model had a good predictive value for individual survival. Conclusions The survival rate of single esophageal cancer is significantly better than that of multiple lesions. Patients with SMPESCC exhibit worse survival than patients with single ESCC. Multiple lesions have a significant impact on the survival of patients with ESCC. The nomogram model established for SMPESCC patients can well predict the individual survival of patients.
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Affiliation(s)
- Wenyi Wang
- Department of Radiation Oncology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Xiaoxu Liu
- Department of Surgical Oncology and General Surgery, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Jun Dang
- Department of Radiation Oncology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Guang Li
- Department of Radiation Oncology, The First Affiliated Hospital of China Medical University, Shenyang, China
- *Correspondence: Guang Li,
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19
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Wang C, Wang D, Pan C, Zhang J, Cheng C, Zhai Y, Yu M, Wang Z, Li G, Zhang W. Clinical characteristics and survival of glioblastoma complicated with non-central nervous system tumors. Chin Neurosurg J 2022; 8:43. [PMID: 36575552 PMCID: PMC9793540 DOI: 10.1186/s41016-022-00312-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 12/07/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Diagnosis and treatment of patients with glioblastoma (GBM) who are also diagnosed with primary non-central nervous system (CNS) tumors remain a challenge, yet little is known about the clinical characteristics and prognosis of these patients. The data presented here compared the clinical and pathological features between glioblastoma patients with or without primary non-CNS tumors, trying to further explore this complex situation. METHODS Statistical analysis was based on the clinical and pathological data of 45 patients who were diagnosed with isocitrate dehydrogenase (IDH) wild-type glioblastoma accompanied by non-CNS tumors between January 2019 and February 2022 in Beijing Tiantan Hospital. Univariate COX proportional hazard regression model was used to determine risk factors for overall survival. RESULTS It turned out to be no significant difference in the overall survival (OS) of the 45 patients with IDH-wild-type GBM plus non-CNS tumors, compared with the 112 patients who were only diagnosed with IDH-wild-type GBM. However, there was a significant difference in OS of GBM patients with benign tumors compared to those with malignant tumors. CONCLUSIONS Implications for the non-central nervous system tumors on survival of glioblastomas were not found in this research. However, glioblastomas complicated with other malignant tumors still showed worse clinical outcomes.
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Affiliation(s)
- Chen Wang
- grid.411617.40000 0004 0642 1244Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No. 119 South Fourth Ring Western Road, Fengtai District, Beijing, China
| | - Di Wang
- grid.411617.40000 0004 0642 1244Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No. 119 South Fourth Ring Western Road, Fengtai District, Beijing, China
| | - Changqing Pan
- grid.411617.40000 0004 0642 1244Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No. 119 South Fourth Ring Western Road, Fengtai District, Beijing, China
| | - Jiazheng Zhang
- grid.411617.40000 0004 0642 1244Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No. 119 South Fourth Ring Western Road, Fengtai District, Beijing, China
| | - Cheng Cheng
- grid.411617.40000 0004 0642 1244Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No. 119 South Fourth Ring Western Road, Fengtai District, Beijing, China
| | - You Zhai
- grid.411617.40000 0004 0642 1244Beijing Neurosurgical Institute, Capital Medical University, No. 119 South Fourth Ring Western Road, Fengtai District, Beijing, China
| | - Mingchen Yu
- grid.411617.40000 0004 0642 1244Beijing Neurosurgical Institute, Capital Medical University, No. 119 South Fourth Ring Western Road, Fengtai District, Beijing, China
| | - Zhiliang Wang
- grid.411617.40000 0004 0642 1244Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No. 119 South Fourth Ring Western Road, Fengtai District, Beijing, China
| | - Guanzhang Li
- grid.411617.40000 0004 0642 1244Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No. 119 South Fourth Ring Western Road, Fengtai District, Beijing, China ,grid.411617.40000 0004 0642 1244Beijing Neurosurgical Institute, Capital Medical University, No. 119 South Fourth Ring Western Road, Fengtai District, Beijing, China ,Chinese Glioma Genome Atlas (CGGA), Beijing, China
| | - Wei Zhang
- grid.411617.40000 0004 0642 1244Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No. 119 South Fourth Ring Western Road, Fengtai District, Beijing, China ,grid.411617.40000 0004 0642 1244Beijing Neurosurgical Institute, Capital Medical University, No. 119 South Fourth Ring Western Road, Fengtai District, Beijing, China ,grid.24696.3f0000 0004 0369 153XCenter of Brain Tumor, Beijing Institute for Brain Disorders, Beijing, China ,grid.411617.40000 0004 0642 1244China National Clinical Research Center for Neurological Diseases, Beijing, China ,Chinese Glioma Genome Atlas (CGGA), Beijing, China
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Sambo M. Use of multikinase inhibitors/lenvatinib in patients with synchronous/metachronous cancers coinciding with radioactive-resistant differentiated thyroid cancer. Cancer Med 2022; 11 Suppl 1:26-32. [PMID: 36202607 PMCID: PMC9537058 DOI: 10.1002/cam4.5107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 07/22/2022] [Accepted: 07/24/2022] [Indexed: 11/13/2022] Open
Abstract
This review focuses on patients with differentiated thyroid carcinoma (DTC) associated with multiple primary malignant neoplasm (MPMN) treated by multikinase inhibitors (MKIs) as systemic treatment for advanced disease. Despite the increasing frequency of MPMNs (many at an advanced stage) and the usefulness of MKIs for multiple metastatic cancers, published data on the management of MPMN and MKI therapies in this scenario are scarce. There are infrequent descriptions of patients with advanced MPMN treated with MKIs, but only a few have described advanced DTC. The management of MPMNs, including DTC and its particular circumstances, is reviewed, focusing on the evidence for MKI therapies. Some considerations for MPMN patients with advanced DTC are discussed, with the intention of helping physicians make decisions in these challenging situations and improving treatment and patient outcomes.
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Affiliation(s)
- Marcel Sambo
- Endocrinology and Nutrition DepartmentGeneral University Hospital Gregorio MaranonMadridSpain
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21
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How to prioritize treatment in dual malignancy: A case report of patient with non-Hodgkin lymphoma and breast cancer. Ann Med Surg (Lond) 2022; 81:104300. [PMID: 36147133 PMCID: PMC9486382 DOI: 10.1016/j.amsu.2022.104300] [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: 06/09/2022] [Revised: 07/26/2022] [Accepted: 07/26/2022] [Indexed: 01/17/2023] Open
Abstract
Introduction Clinicians often encounter dilemma upon treating multiple primary malignancies. Case presentation We report a case of a female patient, 72, complained of a lump under her left eye since January 2019. Patient was diagnosed with infiltrating ductal carcinoma grade III of the right breast in June 2018 with ER+, PR+, and HER2-, treated with hormonal treatment. Histopathology examination of the lump revealed Non Hodgkin Lymphoma (NHL), B cell type, high grade. Patients received rituximab, cyclophosphamide, epirubicin, vincristin, and prednisone (RHCOP) for 6 cycles to overcome lymphoma then received hormonal therapy afterwards. Clinical discussion According to earlier published case reports, it's advised to start hormonal therapy after RHCOP. The survival time was 21 months (5.1–114.7 months) with 5-year overall survival 29% Conclusion Unfortunately, we could not have a follow-up on the patient after finishing 6 cycles of RHCOP due to the COVID-19 pandemic situation. A patient may experience multiple primary malignancies. Non-hodgkin lymphoma (NHL) as the secondary malignancy in BC is a rare case. In a BC patient with secondary NHL, we should consider to treat NHL first using anthracycline-based treatment and rituximab, in this case, RHCOP, if the CD20 turns out positive. Hormonal therapy would be the next agenda.
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Synchronous/Metachronous Multiple Primary Malignancies: Review of Associated Risk Factors. Diagnostics (Basel) 2022; 12:diagnostics12081940. [PMID: 36010291 PMCID: PMC9406460 DOI: 10.3390/diagnostics12081940] [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: 07/02/2022] [Revised: 08/03/2022] [Accepted: 08/09/2022] [Indexed: 11/23/2022] Open
Abstract
The incidence of secondary primary malignancy (SPM) has been reported to range from 1.33% to 5.8%, according to the location of the primary cancer and the follow-up duration. The highest occurrence rate of SPM, of 36.6% within 6 months, has been reported in lung cancer. Genitourinary malignancies were reported to be the third-most-common SPM in several reports. However, the incidence of genitourinary malignancy as the first primary cancer associated with SPM has not been reported. Several risk factors are related to the occurrence of SPM, including viral infection chemotherapy, radiation, genetics, smoking, betel quid chewing, and environmental factors. An early survey for SPM is indicated in first primary malignancy patients with these associated factors. In this study, we summarize several risk factors related to the occurrence of SPMs and preventive tests, which may help in their early detection and, consequently, better survival.
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Shi J, Li Y, Song W, Wang M, Zhang L, Lian H, He Z, Wei N, Zheng Z, Wen J. Risk of colon cancer-related death in people who had cancer in the past. Int J Colorectal Dis 2022; 37:1785-1797. [PMID: 35796872 DOI: 10.1007/s00384-022-04202-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/10/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND The rate of second primary malignancies (SPM) is gradually increasing. Yet, the risk of death from primary cancer vs. SPM is still not well understood. In this study, we investigated the survival of patients with colorectal cancer (as SPM) who had cancer in the past (prior cancer) and the risk factors of SPM death in this population. MATERIALS AND METHODS Based on the Surveillance, Epidemiology, and End Results (SEER) database, we identified 1866 colon cancer patients with prior cancer in our main cohort and 43,959 colon cancer patients, including 37,440 patients with colon cancer as only malignancy and 6519 patients with colon cancer as subsequent colon cancer (SCC), in a second cohort and 3429 colon cancer patients, including 2371 patients with prior colon cancer (PCC) and 1058 patients with colon cancer as SPM, in a third cohort. After propensity score matching, 6519 pairs of subjects were identified in second cohort. RESULTS Patients with prior prostate and breast cancer had a higher risk of developing colon cancer compared to those with gastrointestinal cancer. Also, colon cancer patients with different prior cancer had different survival rates. Furthermore, except for prior lung cancer (52.78 vs. 25.93%), most subjects died due to colon cancer complications. The ratio of colon cancer deaths to prior cancer deaths in patients with a low stage and high stage was 1.51 and 6.64, respectively. In addition, colon cancer-specific survival (CSS) and OS rates were significantly lower in subjects with colon cancer as the SPM than in those with PCC. Also, compared with PCC, SPM was associated with OS and CSS with HR 1.59 (95 CI 1.43-1.78) and HR 2.00 (95% CI 1.70-2.36). Furthermore, compared with only colon cancer, SCC was associated with OS and CSS with HR 1.23 (95 CI 1.17-1.29) and HR 1.13 (95% CI 1.06-1.21). CONCLUSIONS Prior cancer was found to have an adverse impact on OS in patients with colon cancer (secondary cancer), most of whom died due to colon cancer as secondary cancer itself rather than prior cancer. Early detection and treatment strategies should be investigated in this population.
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Affiliation(s)
- Jing Shi
- Mega Data Application Center of Department of Information Management, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, Guangdong, People's Republic of China
| | - Yingmei Li
- Department of Pharmacy, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, Guangdong, People's Republic of China
| | - Wei Song
- Mega Data Application Center of Department of Information Management, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, Guangdong, People's Republic of China
| | - Mingxue Wang
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, People's Republic of China
| | - Linyu Zhang
- Mega Data Application Center of Department of Information Management, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, Guangdong, People's Republic of China
| | - Haobin Lian
- Mega Data Application Center of Department of Information Management, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, Guangdong, People's Republic of China
| | - Zhi He
- Mega Data Application Center of Department of Information Management, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, Guangdong, People's Republic of China
| | - Nijun Wei
- Mega Data Application Center of Department of Information Management, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, Guangdong, People's Republic of China
| | - Zilong Zheng
- Mega Data Application Center of Department of Information Management, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, Guangdong, People's Republic of China.
| | - Juan Wen
- Department of Dermatovenereology, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, Guangdong, People's Republic of China.
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Effects of Tobacco Smoking on the Survivability of Patients with Multiple Cancers and Single Lung Cancer. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159179. [PMID: 35954530 PMCID: PMC9368588 DOI: 10.3390/ijerph19159179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/12/2022] [Accepted: 07/24/2022] [Indexed: 12/24/2022]
Abstract
Lung cancer is the leading cause of death worldwide among men and women. Tobacco smoking is the number one risk factor for lung cancer. The aim of our study was to evaluate the survivability of patients with single lung cancer in relation to the survival time in patients with multiple neoplasms whose last neoplasm was a lung cancer. A retrospective analysis was con-ducted of data from medical histories of patients hospitalized at the Pulmonary Hospital in Olsztyn (Poland) from 2012 to 2017, with a lung cancer diagnosis as the first or subsequent cancer. The total longevity of women with diagnosed multiple cancers was found to be shorter than that of men: 67.60 years (SD: 7.77) and 69.91 years (SD: 7.97), respectively. Among the ex-smokers, the longevity of men (68.93 years) was longer than that of women (66.18 years). Survival time, counted from the diagnosis of both the first and subsequent cancer, was longer among patients with multiple cancers than among patients with single lung cancer (p = 0.000). Women’s survivability was worse than men’s in the case of multiple cancers and in the group of people who quit smoking (p = 0.037; p = 0.000). To conclude, smoking tobacco affects the survival of patients with lung cancer. Smoking cessation improves overall survival.
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Alhamadh MS, Alanazi RB, Algarni ST, Alhuntushi AAR, Alshehri MQ, Chachar YS, Alkaiyat M, Sabatin F. A Descriptive Study of the Types and Survival Patterns of Saudi Patients with Multiple Primary Solid Malignancies: A 30-Year Tertiary Care Center Experience. Curr Oncol 2022; 29:4941-4955. [PMID: 35877253 PMCID: PMC9315520 DOI: 10.3390/curroncol29070393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/30/2022] [Accepted: 07/07/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Objective: Cancer survival has improved significantly, which reflects the achievements in screening, diagnosis, and treatment. As a consequence, multiple primary malignancies are diagnosed more frequently, with an incidence ranging from 0.52–11.7%. The types of malignancy that coexist and survival patterns vary notably in different countries and geographical areas. Due to the limited literature in Saudi Arabia, a baseline of prevalent malignancy combinations and their survival patterns would support early detection and disease management. Method: This was a retrospective descriptive study conducted from 1993–2022 at King Abdulaziz Medical City, Department of Medical Oncology, Riyadh, Saudi Arabia. Patients with at least two biopsy-proven solid malignancies were included. Patients with hematological malignancies, missing data, or an uncertain or indecisive pathology report were excluded. Result: In total, 321 patients were analyzed. More than half (57.3%) of the patients were female. A third (33%) of the cases were synchronous, and 67% were metachronous. The most frequent site of the first primary malignancy was breast cancer, followed by colorectal, skin, and thyroid cancers. The most frequent site of the second primary malignancy was colorectal cancer, followed by thyroid, breast, and liver cancers. Only 4% of the cases had a third primary malignancy, with colorectal and appendiceal cancers being the most frequent. The most frequently observed histopathology in the synchronous and metachronous malignancies was adenocarcinoma. Breast–colorectal, breast–thyroid, and kidney–colorectal were the most frequently observed malignancy combinations. Conclusion: The current study offers a baseline of multiple primary malignancies in Saudi Arabia and provides supporting evidence that the pattern of multiple primary malignancies varies among different countries and ethnicities. The possibility of developing another primary malignancy should be considered when treating and monitoring cancer patients.
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Affiliation(s)
- Moustafa S. Alhamadh
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of the National Guard—Health Affairs, Riyadh 14611, Saudi Arabia; (R.B.A.); (S.T.A.); (A.A.R.A.); (M.Q.A.)
- King Abdullah International Medical Research Center, Ministry of the National Guard—Health Affairs, Riyadh 11481, Saudi Arabia; (Y.S.C.); (M.A.); (F.S.)
- Correspondence: ; Tel.: +96-656-333-4984
| | - Rakan B. Alanazi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of the National Guard—Health Affairs, Riyadh 14611, Saudi Arabia; (R.B.A.); (S.T.A.); (A.A.R.A.); (M.Q.A.)
- King Abdullah International Medical Research Center, Ministry of the National Guard—Health Affairs, Riyadh 11481, Saudi Arabia; (Y.S.C.); (M.A.); (F.S.)
| | - Sultan T. Algarni
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of the National Guard—Health Affairs, Riyadh 14611, Saudi Arabia; (R.B.A.); (S.T.A.); (A.A.R.A.); (M.Q.A.)
- King Abdullah International Medical Research Center, Ministry of the National Guard—Health Affairs, Riyadh 11481, Saudi Arabia; (Y.S.C.); (M.A.); (F.S.)
| | - Ahmed Abdullah R. Alhuntushi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of the National Guard—Health Affairs, Riyadh 14611, Saudi Arabia; (R.B.A.); (S.T.A.); (A.A.R.A.); (M.Q.A.)
- King Abdullah International Medical Research Center, Ministry of the National Guard—Health Affairs, Riyadh 11481, Saudi Arabia; (Y.S.C.); (M.A.); (F.S.)
| | - Mohammed Qasim Alshehri
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of the National Guard—Health Affairs, Riyadh 14611, Saudi Arabia; (R.B.A.); (S.T.A.); (A.A.R.A.); (M.Q.A.)
- King Abdullah International Medical Research Center, Ministry of the National Guard—Health Affairs, Riyadh 11481, Saudi Arabia; (Y.S.C.); (M.A.); (F.S.)
| | - Yusra Sajid Chachar
- King Abdullah International Medical Research Center, Ministry of the National Guard—Health Affairs, Riyadh 11481, Saudi Arabia; (Y.S.C.); (M.A.); (F.S.)
- College of Sciences and Health Professions, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of the National Guard—Health Affairs, Riyadh 14611, Saudi Arabia
| | - Mohammad Alkaiyat
- King Abdullah International Medical Research Center, Ministry of the National Guard—Health Affairs, Riyadh 11481, Saudi Arabia; (Y.S.C.); (M.A.); (F.S.)
- Department of Medical Oncology, King Abdulaziz Medical City, Ministry of the National Guard—Health Affairs, Riyadh 12713, Saudi Arabia
| | - Fouad Sabatin
- King Abdullah International Medical Research Center, Ministry of the National Guard—Health Affairs, Riyadh 11481, Saudi Arabia; (Y.S.C.); (M.A.); (F.S.)
- Department of Medical Oncology, King Abdulaziz Medical City, Ministry of the National Guard—Health Affairs, Riyadh 12713, Saudi Arabia
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Romano C, Di Gregorio S, Pennisi MS, Tirrò E, Broggi G, Caltabiano R, Manzella L, Ruggieri M, Vigneri P, Di Cataldo A. Multiple primary malignances managed with surgical excision: a case report with next generation sequencing analysis. Mol Biol Rep 2022; 49:9059-9064. [PMID: 35715605 DOI: 10.1007/s11033-022-07630-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 05/17/2022] [Accepted: 05/19/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Multiple primary malignancies (MPM) are defined as tumors originating in the same individual without any correlation between them. In addition to morphological and immunohistochemical analyses, sensitive DNA sequencing methods such as next generation sequencing (NGS) may help to discriminate the common or different genetic alterations driving each malignancy, to better diagnose these uncommon cases. METHODS AND RESULTS Here we report the case of a man who developed a poorly differentiated gastric adenocarcinoma invading the pancreas followed, two years later, by a colorectal cancer involving also the kidney and the diaphragm. Despite the advanced stage of both diseases, adjuvant chemotherapy was successful. While the second tumor was initially interpreted as a relapse of his stomach cancer, NGS-based mutation profiling of the two carcinomas revealed two distinct malignances, independently developing in different times and indicative of metachronous MPM. Indeed, sequencing of cancer-associated genes identified somatic mutations only in the first gastric cancer, besides germline variants on three different genes (PDGFRA, APC and TP53). However, analysis of both somatic and germline mutations with bio-informatics prediction tools failed to find a correlation between these variants and the unexpectedly good prognosis of both cancers. CONCLUSIONS In summary, NGS analysis contributed to defined different molecular profiles for two tumors developed in the span of two years, thus allowing diagnosing the case as MPN. However, NGS was unable to establish a direct correlation between the identified alterations and cancer development.
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Affiliation(s)
- Chiara Romano
- Department of Clinical and Experimental Medicine, University of Catania, 95123, Catania, Italy. .,Center of Experimental Oncology and Hematology, A.O.U. Policlinico "G. Rodolico - San Marco", 95123, Catania, Italy.
| | - Sandra Di Gregorio
- Department of Clinical and Experimental Medicine, University of Catania, 95123, Catania, Italy.,Center of Experimental Oncology and Hematology, A.O.U. Policlinico "G. Rodolico - San Marco", 95123, Catania, Italy
| | - Maria Stella Pennisi
- Department of Clinical and Experimental Medicine, University of Catania, 95123, Catania, Italy.,Center of Experimental Oncology and Hematology, A.O.U. Policlinico "G. Rodolico - San Marco", 95123, Catania, Italy
| | - Elena Tirrò
- Center of Experimental Oncology and Hematology, A.O.U. Policlinico "G. Rodolico - San Marco", 95123, Catania, Italy.,Department of Surgical, Oncological and Stomatological Sciences, University of Palermo, 90127, Palermo, Italy
| | - Giuseppe Broggi
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Anatomic Pathology, University of Catania, 95123, Catania, Italy
| | - Rosario Caltabiano
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Anatomic Pathology, University of Catania, 95123, Catania, Italy
| | - Livia Manzella
- Department of Clinical and Experimental Medicine, University of Catania, 95123, Catania, Italy.,Center of Experimental Oncology and Hematology, A.O.U. Policlinico "G. Rodolico - San Marco", 95123, Catania, Italy
| | - Martino Ruggieri
- Unit of Rare Diseases of the Nervous System in Childhood, Department of Clinical and Experimental Medicine, Section of Pediatrics and Child Neuropsychiatry, University of Catania, 95123, Catania, Italy
| | - Paolo Vigneri
- Department of Clinical and Experimental Medicine, University of Catania, 95123, Catania, Italy.,Center of Experimental Oncology and Hematology, A.O.U. Policlinico "G. Rodolico - San Marco", 95123, Catania, Italy
| | - Antonio Di Cataldo
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, 95123, Catania, Italy
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27
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Yang J, Zeng Y, Zhang JW. Simultaneous multiple primary malignancies diagnosed by endoscopic ultrasound-guided fine-needle aspiration: A case report. World J Clin Cases 2022; 10:5764-5769. [PMID: 35979112 PMCID: PMC9258362 DOI: 10.12998/wjcc.v10.i17.5764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/13/2022] [Accepted: 04/21/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Multiple primary malignancies (MPMs) refer to more than one primary malignancy in the same or separate organs of the same patient, and MPMs are considered when different histological characteristics are detected in epidemiological studies. Herein, we report a case presumed to be primary pancreatic cancer with multiple liver metastases by positron-emission tomography/computed tomography (PET/CT) and confirmed to be synchronous liver and pancreatic MPMs by endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA).
CASE SUMMARY A 50-year-old man was referred to our hospital due to abdominal discomfort for 2 mo. Abdominal CT at a local hospital revealed a pancreatic mass with multiple liver nodules. After being transferred to our hospital, PET/CT confirmed all these lesions to have elevated metabolic activity, and therefore primary pancreatic cancer with multiple liver metastases was considered. EUS-guided liver aspiration unexpectedly found signet-ring cells with a high Ki-67 positive rate (20%), while EUS-guided pancreatic aspiration detected pancreatic neuroendocrine cells with a relatively low Ki-67 positive rate (1%). The final diagnosis from the multidisciplinary team was simultaneous liver and pancreatic MPMs. The patient returned to his local hospital for neoadjuvant chemotherapy and surgery, and he is still alive during the 6-mo postoperative follow-up.
CONCLUSION Although rare, MPMs should be considered when treating pancreatic mass with suspected metastatic lesions, and EUS-FNA has proved minimally invasive and accurate.
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Affiliation(s)
- Jian Yang
- Department of Gastroenterology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Yan Zeng
- Department of Psychology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - Jun-Wen Zhang
- Department of Gastroenterology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
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28
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Tadrosse AF, Tadrosse MF, Ezzat BM, Sadek DM, Langer PD. Second Primary Neoplasms in Patients With Sebaceous Carcinoma of the Eyelid: A Population-based Study, 2000 to 2016. Ophthalmic Plast Reconstr Surg 2022; 38:193-198. [PMID: 34366382 DOI: 10.1097/iop.0000000000002039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To investigate the risk of second primary neoplasms (SPNs) after primary sebaceous carcinoma of the eyelid (SCE). METHODS Data on patients diagnosed with primary SCE as their first malignancy were extracted from the Surveillance, Epidemiology, and End Results database from 2000 to 2016. Observed-to-expected ratios of SPNs were calculated to estimate standardized incidence ratios (SIRs). Patients were compared with a reference population (RP) matched for age, gender, and race. RESULTS Five hundred fifty-nine patients with primary SCE were identified, 16% of whom developed SPNs. SCE patients displayed a 61% increased risk of developing SPNs compared with the RP (p < 0.001). Overall, the risk of SPNs of the lungs (SIR = 1.82; p < 0.05), pancreas (SIR = 2.94; p < 0.05), salivary glands (SIR = 41.65; p < 0.001), and skin (SIR = 8.33; p < 0.05) was elevated. Only non-Hispanic Whites were at an increased risk (SIR = 1.51; p < 0.05). Patients 40-54 years old at the time of diagnosis were at the highest risk of developing SPNs compared with the RP (SIR = 3.15; p < 0.05). Women with SCE experienced an increased risk of breast cancer (SIR = 3.6; p < 0.05) and chronic lymphocytic leukemia (SIR = 8.8; p < 0.01). CONCLUSION SCE patients are more likely to develop SPNs of the lungs, pancreas, salivary gland, and skin than the RP. Forty to fifty-four years old Caucasian patients are at the highest risk. Women are at an increased risk of developing breast malignancies and chronic lymphocytic leukemia. Clinicians should be cognizant of these risks when managing SCE patients.
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Affiliation(s)
- Abanoob F Tadrosse
- Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey
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29
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Jin S, Liu X, Peng D, Li D, Ye YN. Differences Between Cancer-Specific Survival of Patients With Anaplastic and Primary Squamous Cell Thyroid Carcinoma and Factors Influencing Prognosis: A SEER Database Analysis. Front Endocrinol (Lausanne) 2022; 13:830760. [PMID: 35360080 PMCID: PMC8960140 DOI: 10.3389/fendo.2022.830760] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 02/11/2022] [Indexed: 11/26/2022] Open
Abstract
PURPOSE Anaplastic thyroid carcinoma (ATC) and primary squamous cell carcinoma of the thyroid (PSCCTh) have similar histological findings and are currently treated using the same approaches; however, the characteristics and prognosis of these cancers are poorly researched. The objective of this study was to determine the differences in characteristics between ATC and PSCCTh and establish prognostic models. PATIENTS AND METHODS All variables of patients with ATC and PSCCTh, diagnosed from 2004-2015, were retrieved from the Surveillance, Epidemiology, and End Results Program (SEER) database. Percentage differences for categorical data were compared using the Chi-square test. Kaplan-Meier curves, log-rank test, and Cox-regression for survival analysis, and C-index value was used to evaluate the performance of the prognostic models. RESULTS After application of the inclusion and exclusion criteria, a total of 1164 ATC and 124 PSCCTh patients, diagnosed from 2004 to 2015, were included in the study. There were no differences in sex, ethnicity, age, marital status, or percentage of proximal metastases between the two cancers; however, radiotherapy, chemotherapy, incidence of surgical treatment, and presence of multiple primary tumors were higher in patients with ATC than those with PSCCTh. Further cancer-specific survival (CSS) of patients with PSCCTh was better than that of patients with ATC. Prognostic factors were not identical for the two cancers. Multivariate Cox model analysis indicated that age, sex, radiotherapy, chemotherapy, surgery, multiple primary tumors, marital status, and distant metastasis status are independent prognostic factors for CSS in patients with ATC, while for patients with PSCCTh, the corresponding factors are age, radiotherapy, multiple primary tumors, and surgery. The C-index values of the two models were both > 0.8, indicating that the models exhibited good discriminative ability. CONCLUSION Prognostic factors influencing CSS were not identical in patients with ATC and PSCCTh. These findings indicate that different clinical treatment and management plans are required for patients with these two types of thyroid cancer.
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Affiliation(s)
- Shuai Jin
- Bioinformatics and Biomedical Big Data Mining Laboratory, Department of Medical Informatics, School of Big Health, Guizhou Medical University, Guiyang, China
| | - Xiangmei Liu
- School of Clinical Medicine, Guizhou Medical University, Guiyang, China
| | - Dandan Peng
- School of Clinical Medicine, Guizhou Medical University, Guiyang, China
| | - Dahuan Li
- School of Clinical Medicine, Guizhou Medical University, Guiyang, China
| | - Yuan-Nong Ye
- Bioinformatics and Biomedical Big Data Mining Laboratory, Department of Medical Informatics, School of Big Health, Guizhou Medical University, Guiyang, China
- Cells and Antibody Engineering Research Center of Guizhou Province, Key Laboratory of Biology and Medical Engineering, School of Biology and Engineering, Guizhou Medical University, Guiyang, China
- Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
- *Correspondence: Yuan-Nong Ye,
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Tarrab R, Sabouni R, Jarad L, Mansour N, Saifo MS. Metachronous breast cancer in a male with previous history of liposarcoma: A case report from Syria. Ann Med Surg (Lond) 2021; 72:103151. [PMID: 34934489 PMCID: PMC8654778 DOI: 10.1016/j.amsu.2021.103151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 12/02/2021] [Accepted: 12/02/2021] [Indexed: 12/03/2022] Open
Abstract
Introduction Multiple primary cancers (MPC) are defined as the occurrence of two or more non-related cancers. The acquiring of male breast cancer (MBC) as secondary cancer in a sequence of MPC is extremely rare. Only one case of breast cancer following liposarcoma (LP) was previously reported in a female patient. We report the first case of MBC following LP. Case presentation A non-smoker male patient with a history of a well-differentiated liposarcoma was treated surgically and with radiotherapy 14 years ago with no signs of recurrence. The patient presented with a left breast mass; The excisional biopsy showed poorly differentiated grade III invasive ductal carcinoma. The patient underwent a mastectomy with axillary node resection and the final diagnosis was invasive ductal carcinoma stage IIA [T:2, N:0, M:0]. The tumor markers reported; Positive Estrogen Receptor (ER+), negative Progesterone Receptor (PR-), and negative Human Epidermal Receptor (HER-). He received eight sessions of chemotherapy with Docetaxel and 16 fractions of radiotherapy. The follow-up showed no signs of recurrence. Discussion Despite the rarity of diagnosis MBC as a second primary. Studies have found a relation between different types of breast cancer in male patients, and further, a relation was also found between MBC and lymphoma. While no studies that link MBC and LP were previously reported. Conclusion We found that acquiring a treated LP would not affect the MBC prognosis or its response to treatment, yet further studies are needed to confirm this outcome. Multiple primary cancers occur in 2.4–17% of all people. The diagnosis of male breast cancer as a second primary is rare. Having male breast cancer following liposarcoma is even rarer. Well treated liposarcoma would not affect male breast cancer prognosis.
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Affiliation(s)
- Rand Tarrab
- Faculty of Medicine, Damascus University, Damascus, Syria
| | - Rami Sabouni
- Faculty of Medicine, Damascus University, Damascus, Syria
| | - Lana Jarad
- Faculty of Medicine, Damascus University, Damascus, Syria
| | - Nour Mansour
- Faculty of Medicine, Damascus University, Damascus, Syria
| | - Maher S Saifo
- Department of Oncology, AL-Bairouni University Hospital, Damascus University, Damascus, Syria
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31
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Wang XK, Zhou MH. Clinical features and survival of patients with multiple primary malignancies. World J Clin Cases 2021; 9:10484-10493. [PMID: 35004980 PMCID: PMC8686159 DOI: 10.12998/wjcc.v9.i34.10484] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/09/2021] [Accepted: 09/16/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Multiple primary malignancies (MPM) are characterized by two or more primary malignancies in the same patient, excluding relapse or metastasis of prior cancer. We aimed to elucidate the clinical features and survival of MPM patients.
AIM To elucidate the clinical features and survival of MPM patients.
METHODS A retrospective study of MPM patients was conducted in our hospital between June 2016 and June 2019. Overall survival (OS) was calculated using the Kaplan-Meier method. The log-rank test was used to compare the survival of different groups.
RESULTS A total of 243 MPM patients were enrolled, including 222 patients with two malignancies and 21 patients with three malignancies. Of patients with two malignancies, 51 (23.0%) had synchronous MPM, and 171 (77.7%) had metachronous MPM. The most common first cancers were breast cancer (33, 14.9%) and colorectal cancer (31, 14.0%). The most common second cancers were non-small cell lung cancer (NSCLC) (66, 29.7%) and gastric cancer (24, 10.8%). There was no survival difference between synchronous and metachronous MPM patients (36.4 vs 35.3 mo, P = 0.809). Patients aged > 65 years at diagnosis of the second cancer had a shorter survival than patients ≤ 65 years (28.4 vs 36.4 mo, P = 0.038). Patients with distant metastasis had worse survival than patients without metastasis (20.4 vs 86.9 mo, P = 0.000). Following multivariate analyses, age > 65 years and distant metastasis were independent adverse prognostic factors for OS.
CONCLUSION During follow-up of a first cancer, the occurrence of a second or more cancers should receive greater attention, especially for common concomitant MPM, to ensure early detection and treatment of the subsequent cancer.
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Affiliation(s)
- Xin-Kun Wang
- Department of Radiology, the Fourth Medical Center, Chinese PLA General Hospital, Beijing 100048, China
| | - Min-Hang Zhou
- Department of Geriatric Oncology, the Fourth Medical Center, Chinese PLA General Hospital, Beijing 100048, China
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32
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Li Y, Ye LS, Hu B. Synchronous multiple primary malignancies of the esophagus, stomach, and jejunum: A case report. World J Clin Cases 2021; 9:9889-9895. [PMID: 34877327 PMCID: PMC8610897 DOI: 10.12998/wjcc.v9.i32.9889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/26/2021] [Accepted: 09/08/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Treatment of synchronous multiple primary malignancies is quite often very challenging. Herein, we report on a rare case of synchronous multiple primary malignancies in the esophagus, stomach, and jejunum.
CASE SUMMARY A 50-year-old man who was a heavy drinker and smoker with a poor diet, and had a family history of cancer sought treatment due to dysphagia lasting for 4 mo. He was finally diagnosed with lower esophageal squamous cell carcinoma (pT3N2M0, G2, stage IIIB), gastric angular adenocarcinoma (pT3N2M0, G2-G3, stage IIIA) with greater omental lymph node metastasis, and jejunal stromal tumor (high risk). The high-risk jejunal stromal tumor was found during surgery. In spite of radical resection and adjuvant chemotherapy, lymph node metastasis occurred 21 mo later. The patient responded poorly to additional chemotherapy and refused further examination and therapy. He died of widespread metastases 33 mo after surgery.
CONCLUSION This case indicates a poor prognosis of synchronous multiple advanced primary malignancies and the importance of comprehensive assessment in the population at high risk for cancer.
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Affiliation(s)
- Yan Li
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Lian-Song Ye
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Bing Hu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
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Lee H, Lee HW, Park EJ, Kang J, Baik SH. Clinicopathologic Characteristics and Survival of Patients With Double Primary Malignancies: Breast and Colorectal Cancer. Ann Coloproctol 2021; 38:197-206. [PMID: 34657410 PMCID: PMC9263303 DOI: 10.3393/ac.2021.00640.0091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 08/26/2021] [Indexed: 11/15/2022] Open
Abstract
Purpose This study aimed to investigate the clinicopathologic features and survival in patients with both breast cancer (BrC) and colorectal cancer (CRC). Methods Between 1996 and 2019, patients who were diagnosed with both BrC and CRC were evaluated retrospectively. Patients with distant metastasis, palliative resection, and previous cancer histories except for BrCs or CRCs were excluded. Altogether, 105 patients were divided into the B=C group (n=21), B-first group (n=40), and C-first group (n=44) according to the definition of synchronous and metachronous cancers. The clinicopathologic features and overall survival were evaluated. Results TNM stages and histologic types were comparable among the 3 groups (P=0.434). The interval of diagnosis was 67.1±40.4 and 59.3±47.2 months in the B- and C-first groups, respectively. The incidence of adjuvant chemotherapy in the B-first group was 57.5%, which was higher than the B=C and C-first groups (P<0.001). The estrogen receptor, progesterone receptor, Ki-67, and HER-2 molecular markers were not significantly different among the groups. The overall survival of the B-first group showed lower survival rates than the C-first group (P=0.039). In the logistic regression, HER-2 status (hazard ratio [HR], 11.9; P=0.032) and lymph node metastasis of CRC (HR, 5.8; P=0.036) were prognostic factors affecting overall survival. Conclusion B-first group had poorer survival outcomes than the C-first group in patients with the metachronous BrC and CRC. HER2 positivity and CRC lymph node metastasis may be prognostic factors that affect overall survival in these patients. The findings support that a colorectal cancer screening program should be included during BrC surveillance.
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Affiliation(s)
- Hyundo Lee
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Hae Won Lee
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eun Jung Park
- Division of Colon and Rectal Surgery, Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jeonghyun Kang
- Division of Colon and Rectal Surgery, Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Seung Hyuk Baik
- Division of Colon and Rectal Surgery, Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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Tanjak P, Suktitipat B, Vorasan N, Juengwiwattanakitti P, Thiengtrong B, Songjang C, Therasakvichya S, Laiteerapong S, Chinswangwatanakul V. Risks and cancer associations of metachronous and synchronous multiple primary cancers: a 25-year retrospective study. BMC Cancer 2021; 21:1045. [PMID: 34556087 PMCID: PMC8461969 DOI: 10.1186/s12885-021-08766-9] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 09/06/2021] [Indexed: 01/22/2023] Open
Abstract
Background The situation of patients developing multiple primary cancers is becoming more frequent and graver. This study investigated the risks of developing second primary cancers that are related to first primary cancers, and the interval times of synchronous and metachronous multiple primary cancers. Patients and methods Retrospective data were retrieved from 109,054 patients aged ≥18 who were diagnosed with a first solid cancer and registered at Siriraj Cancer Center between 1991 and 2015. A two-month period between first- and second- primary cancers was used to differentiate metachronous and synchronous multiple primary cancers. The combinations of subsequent cancers and relative risks (RRs) of having multiple primary cancers versus having single primary cancer for the top-ten first and second primary cancers were examined. The RR was adjusted for age of the first primary cancer. A survival analysis of the time to second-primary-cancer development was performed. Results Multiple primary cancers were found in 1785 (1.63%) patients. Most (70.87%) second primary cancers occurred after 2 months of first breast, skin, colorectal, lung, head and neck, liver, male genital cancer–prostate, thyroid, and female genital cancer–non-uterine cancers, resulting in those cancers being classified as metachronous multiple primary cancer. After adjustment for age at first diagnosis, head and neck cancers had the highest metachronous association with second esophageal cancers (RR, 25.06; 95% CI, 13.41–50.77). Prostate cancer and second colorectal cancer also demonstrated a high metachronous association (RR, 2.00; 95% CI, 1.25–3.05). A strong synchronous association was found between uterine and ovarian cancers (RR, 27.77; 95% CI, 17.97–43.63). The median time from the first uterine cancer to second-cancer development was 55 days. Conclusions The top-ten most frequent multiple primary cancers were the following: breast; liver; head and neck; colorectal; male genital cancer–prostate; skin; female genital cancer–uterine; thyroid; lung; and female genital cancer–non-uterine. Second primary cancers showed specific associations that depended on the first primary cancer. Physicians should be cognizant of the most common combinations and the interval times of metachronous and synchronous multiple primary cancers.
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Affiliation(s)
- Pariyada Tanjak
- Siriraj Cancer Center, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok Noi, Bangkok, 10700, Thailand.,Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Bhoom Suktitipat
- Department of Biochemistry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.,Siriraj Center of Excellent for Research in Bioinformatics and Clinical Data Management, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.,Integrative Computational Bioscience Center, Mahidol University, Nakhon Pathom, Thailand
| | - Nutchavadee Vorasan
- Siriraj Genomics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Panudeth Juengwiwattanakitti
- Siriraj Cancer Center, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok Noi, Bangkok, 10700, Thailand.,Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Benjarat Thiengtrong
- Siriraj Cancer Center, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok Noi, Bangkok, 10700, Thailand.,Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Cholticha Songjang
- Siriraj Cancer Center, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok Noi, Bangkok, 10700, Thailand
| | - Suwanit Therasakvichya
- Department of Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Somsri Laiteerapong
- Department of Transfusion Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Vitoon Chinswangwatanakul
- Siriraj Cancer Center, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok Noi, Bangkok, 10700, Thailand. .,Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
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Agapov MA, Donchenko KA, Kubyshkin VA, Kakotkin VV, Kasheev AA, Poltorako EN, Sigaleva TV, Bondar SV, Britikova MV. MULTIPLE PRIMARY SYNCHRONOUS NEOPLASMS OF THE SIGMOID COLON AND BREAST IN COMBINATION WITH SPINAL CORD MENINGIOMA. CLINICAL CASE. SURGICAL PRACTICE 2021. [DOI: 10.38181/2223-2427-2021-2-48-60] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The incidence of multiple primary oncological diseases ranges from 2.4% to 17%. The main causes of primary multiple diseases include factors related to the patient's lifestyle, environmental and genetic factors, as well as factors related to the comprehensive treatment of previously identified malignant diseases.We demonstrate a clinical case of treatment of a patient with synchronous primary multiple cancer of the sigmoid colon and breast in combination with spinal cord meningioma. An interesting fact is the possible correlation between meningioma and breast cancer. Thus, the risk of meningioma in women who have had breast cancer and the risk of breast cancer in women with a history of meningioma is moderately increased (RR = 1.40-1.64 and 1.54, respectively). This two-way statistical association may be a consequence of common risk factors and a partial coincidence of gene-environmental interactions that determine carcinogenesis. Further research is needed to identify problems of prevention, screening, diagnosis, treatment and disease-free survival. It is important that patients diagnosed with cancer have information about possible late and long-term consequences of treatment and its symptoms, as well as possible signs of relapse and the appearance of secondary tumors. It is important that patients receiving treatment for malignant neoplasms follow the recommendations for cancer prevention and early detection, including smoking cessation, physical activity, nutrition and diet, a healthy weight and all standard cancer screening tests.
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Affiliation(s)
- M. A. Agapov
- Federal State Budget Educational Institution of Higher Education M.V. Lomonosov Moscow State University (Lomonosov MSU); Medical Research Educational Center, Lomonosov Moscow State University
| | - K. A. Donchenko
- Medical Research Educational Center, Lomonosov Moscow State University
| | - V. A. Kubyshkin
- Federal State Budget Educational Institution of Higher Education M.V. Lomonosov Moscow State University (Lomonosov MSU)
| | - V. V. Kakotkin
- Medical Research Educational Center, Lomonosov Moscow State University
| | - A. A. Kasheev
- Medical Research Educational Center, Lomonosov Moscow State University
| | - E. N. Poltorako
- Medical Research Educational Center, Lomonosov Moscow State University
| | - T. V. Sigaleva
- Medical Research Educational Center, Lomonosov Moscow State University
| | - S. V. Bondar
- Medical Research Educational Center, Lomonosov Moscow State University
| | - M. V. Britikova
- Medical Research Educational Center, Lomonosov Moscow State University
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Survival analysis of patients with primary breast duct carcinoma and lung adenocarcinoma: a population-based study from SEER. Sci Rep 2021; 11:14790. [PMID: 34285322 PMCID: PMC8292419 DOI: 10.1038/s41598-021-94357-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 07/08/2021] [Indexed: 11/09/2022] Open
Abstract
The appeal to enroll patients with primary breast and lung cancer in clinical trials is increasing, but survival of these two primary cancers remains to be elucidated. This study analyzed the prognosis of primary breast duct carcinoma with subsequent lung adenocarcinoma (BCLA) and primary breast duct carcinoma with prior lung adenocarcinoma (LABC). Cohorts of 3,515 patients with BCLA and 654 patients with LABC were identified from the Surveillance, Epidemiology, and End Results database. Patients were classified into simultaneous two primary cancer (sTPC), metachronous two primary cancer (mTPC1), or mTPC2 groups when the interval times between breast and lung cancer were within 6 months, between 7 and 60 months, or over 60 months, respectively. The propensity score matching program (PSM) was applied to determine the survival of BCLA/LABC relative to single breast/lung cancer. Cox proportional hazard regression model and competing risk modes were performed to identify confounders associated with all-cause and cancer-specific death, respectively. Survival of patients with LABC/BCLA relative to single breast/lung cancer was accessed via median survival time. The survival of patients with BCLA/LABC was generally poor compared with the survival of those with single breast cancer. The PSM-estimated HR in the sTPC group with BCLA and in the mTPC1 and mTPC2 groups with LABC were 0.75 (95% CI 0.62–0.90), 0.52 (95% CI 0.27–0.98), and 0.36 (95% CI 0.20–0.65), respectively, whereas the SHRs were 0.80 (95% CI 0.66–0.97), 0.68 (95% CI 0.34–1.34), and 0.46 (95% CI 0.27–0.80), respectively, compared with those in the single lung cancer group. By contrast, the survival rates of the remaining patients did not differ. The median survival times since secondary malignancy were 42, 23, and 20 months in the sTPC, mTPC1, and mTPC2 groups with BCLA, respectively, and 18, 60, and 180 months in those with LABC, respectively. For patients with BCLA, the adjusted Cox regression suggested incidences of all-cause deaths in mTPC1group were statically higher than those in sTPC group, whereas the incidences of all-cause and cancer-specific death in the mTPC1 and mTPC2 groups were statistically lower than those in the sTPC group. The prognosis of patients with breast cancer and subsequent lung cancer of over 18 months was not significantly different than that of single lung cancer, which supported the profound appeal to increase the involvement of these two primary cancers in potential beneficial clinical trials. For patients with lung cancer and prior breast cancer of within 6 months and subsequent breast cancer of over 18 months, prognosis was improved relative to single lung cancer. Therefore, additional attention is needed to eliminate the potential bias may when these patients are recruited in the clinical trials.
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The effect of a gastric second primary cancer on the survival of patients with a previous cancer history. Eur J Cancer Prev 2021; 29:215-221. [PMID: 31651567 DOI: 10.1097/cej.0000000000000540] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Second primary cancers (SPCs) are an increasing concern among cancer survivors. In Northern Portugal, gastric cancer incidence is high, and alone corresponds to one in 10 SPCs diagnosed. Therefore, this study aims to estimate the contribution of gastric SPCs to the mortality of patients with a previous cancer. A population-based cohort of nongastric first primary cancer (FPC) patients from the North Region Cancer Registry of Portugal, diagnosed between 2000 and 2006, was followed for a gastric SPC until the end of 2012, and for death by any cause until the end of 2017. Patients with a gastric SPC (85 synchronous and 215 metachronous, diagnosed within one and >1 year after the FPC, respectively) were matched (1:3, by sex, five-year age group, year and site of FPC diagnosis) to those who did not develop a gastric SPC and were alive when the corresponding SPC was diagnosed. Significantly higher hazards for mortality [hazard ratio (95% confidence interval)] were observed among patients diagnosed with a synchronous [3.74 (2.69-5.21) in males and 3.36 (2.02-5.58) in females] or metachronous [6.93 (5.41-8.87) in males and 5.93 (4.04-8.72) in females] gastric SPC. The differences in the 10-year cumulative mortality between gastric SPC patients and those with no SPC were approximately 30% for synchronous and over 40% for metachronous gastric SPCs, corresponding to a 1.5- to 2-fold higher relative risk, respectively. In conclusion, cancer patients with a gastric SPC have a nearly two-fold higher risk of death over 10 years than those with a corresponding FPC only.
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Malik A, Asad UR, Hammad Ali SM. Unexplained anemia: A case report of metachronous adenocarcinoma arising in the transverse colon following right hemicolectomy for a primary cecal carcinoma. Qatar Med J 2021; 2021:16. [PMID: 33996527 PMCID: PMC8091625 DOI: 10.5339/qmj.2021.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 02/04/2021] [Indexed: 11/09/2022] Open
Abstract
Metachronous colonic carcinomas arise from months to years after the resection of the first or index primary colorectal cancer. They are not a result of tumor recurrence or metastasis and likely arise as a result of the field cancerization effect. This report presents the case of a 63-year-old male patient without family history of a colorectal cancer but had an index primary adenocarcinoma of the cecum (stage IIIC) five years ago that was treated with surgical resection and adjuvant radiotherapy and chemotherapy. He presented with fatigue and anemia of 6-month duration secondary to recurrent melena, and the specific cause of which remained obscure despite intensive diagnostic workup. Recurrence of a malignancy at the previous anastomosis site was ruled out. The patient continued to have recurrent and intermittent gastrointestinal bleeding until a nuclear red blood cell scan detected a bleeding spot in the epigastric region, which actually turned out to be a second primary carcinoma (stage I) arising from an adenoma in the transverse colon. The patient underwent a left colectomy with ileosigmoid anastomosis formation. During a two-month postoperative follow-up, the patient did not experience any episode of melena or anemia. Even though metachronous colon cancers rarely present with a recurrent and intermittent gastrointestinal bleeding with melena, an aggressive workup must be aimed at ruling out a second independent malignancy in patients who are in remission after an index primary colorectal cancer resection through hemicolectomy. Any neoteric lesion found on colonoscopy in such cases should be dealt with a higher degree of suspicion. Therefore, the need for surveillance colonoscopy as recommended by the National Comprehensive Cancer Network guidelines is imperative and should be practiced in resource-limited countries.
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Affiliation(s)
- Asim Malik
- Department of Surgery, FMH College of Medicine & Dentistry, Lahore, Pakistan E-mail:
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Loya A, Ramachandran V, Ayaz T, Weng CY. Second primary malignancies after ocular adnexal lymphoma diagnosis. BMC Ophthalmol 2021; 21:162. [PMID: 33827494 PMCID: PMC8028208 DOI: 10.1186/s12886-021-01921-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 03/25/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although studies have investigated the risk of second primary malignancies (SPMs) associated with lymphoma of various sites, limited studies have investigated this risk in patients with lymphoma originating within the ocular adnexa. We conducted a retrospective study to assess incidence of secondary malignancies in patients with a prior diagnosis of ocular adnexal lymphoma (OAL) and to determine latency periods and age-groups at increased risk for SPM occurrence. METHODS Retrospective analysis was performed on data obtained from Surveillance, Epidemiology, and End Results (SEER) 9 database. Patients with an initial primary malignancy diagnosis of OAL between 1973 and 2015 were included in the study. Standardized incidence ratios (SIR) and excess absolute risks (EAR) compared to a SEER reference population with similar sex, race, age, and calendar year were computed for SPMs. Excess absolute risk is per 10,000 individuals; alpha of 0.05 was used. RESULTS Of 1834 patients with primary ocular adnexal lymphoma, 279 developed a secondary malignancy during average follow-up of 110.03 months (+/- 88.46), denoting higher incidence than expected (SIR 1.20; 95% CI, 1.07 to 1.35; EAR 30.56). Amongst the primary lymphoma cohort, 98.7% (1810/1834) of patients had non-Hodgkin's lymphoma and amongst those that developed secondary malignancies, 99.6% (278/279) had non-Hodgkin's lymphoma. Patients exhibited increased incidence of lymphohematopoietic and non-lymphohematopoietic second malignancies and no secondary malignancies of the eye or orbit. Patients had increased incidence of secondary malignancies in the first year (SIR 2.07; 95% CI, 1.49 to 2.79; EAR 150.37) and 1-5 years following lymphoma diagnosis (SIR 1.24; 95% CI, 1.01 to 1.51; EAR 34.89). Patients with various OAL subtypes demonstrated differing patterns of site-specific and overall SPM risk. CONCLUSIONS Patients with prior diagnosis of ocular adnexal lymphoma possess increased risk of hematologic and non-hematologic secondary malignancies. Risk of secondary malignancy could vary by lymphoma subtype. Patients with ocular adnexal lymphoma may benefit from regular surveillance to promote early detection of second primary malignancies.
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Affiliation(s)
- Asad Loya
- Baylor College of Medicine, School of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA
| | - Vignesh Ramachandran
- Baylor College of Medicine, School of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA
| | - Talha Ayaz
- University of Texas Medical Branch at Galveston, School of Medicine, 301 University Blvd., Galveston, TX, 77555, USA
| | - Christina Y Weng
- Baylor College of Medicine, Department of Ophthalmology-Cullen Eye Institute, 1977 Butler Boulevard, Houston, TX, 77030, USA.
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Li T, Wang X, Chen C, Song X, Li J, Zhao Z, Zhang N, Li W, Zhang K, Liu T. Metachronous primary colon and periampullary duodenal cancer: A case report. Medicine (Baltimore) 2021; 100:e24378. [PMID: 33546078 PMCID: PMC7837966 DOI: 10.1097/md.0000000000024378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 12/29/2020] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Primary periampullary duodenal cancer accounts for 3% to 17% of periampullary cancers. There are no previous reports of metachronous primary colon and periampullary duodenal cancer. PATIENT CONCERNS We present a case of primary periampullary duodenal cancer that occurred metachronously after colon cancer. DIAGNOSES Imaging and endoscopic examinations, serum tumor marker levels, and pathology confirmed metachronous colon and periampullary duodenal cancer, with 14-month interval between the diagnoses of the 2 malignancies. INTERVENTION The patient received right hemicolectomy combined with mFOLFOX6 chemotherapy for colon cancer and pancreatoduodenectomy for periampullary duodenal cancer. OUTCOMES The patient has been followed up for 6 years since the pancreatoduodenectomy and shows no signs of recurrence or metastasis. LESSONS The risk of developing a second malignancy may be associated with the site of the first tumor. Patients with right colon cancer may have particularly high risk of developing small intestinal cancer, including duodenal cancer. Early detection and active surgical treatments can improve prognosis. Long-term regular follow-up is necessary to detect new malignancies occurring after the diagnosis colon cancer.
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Affiliation(s)
- Tao Li
- Department of Colorectal and Anal Surgery, the Second Hospital of Jilin University, Changchun
| | - Xinyu Wang
- Department of Colorectal and Anal Surgery, the Second Hospital of Jilin University, Changchun
| | - Chen Chen
- Department of Emergency Surgery, Jilin Province People's Hospital, Changchun
| | - Xiaobin Song
- Department of Emergency Surgery, Jilin Province People's Hospital, Changchun
| | - Jiannan Li
- Department of Colorectal and Anal Surgery, the Second Hospital of Jilin University, Changchun
| | - Zeyun Zhao
- Department of Colorectal and Anal Surgery, the Second Hospital of Jilin University, Changchun
| | - Nan Zhang
- Department of Colorectal and Anal Surgery, the Second Hospital of Jilin University, Changchun
- Department of Burn, the First Hospital of Jilin University, Changchun, Jilin Province, China
| | - Wei Li
- Department of Colorectal and Anal Surgery, the Second Hospital of Jilin University, Changchun
| | - Kai Zhang
- Department of Colorectal and Anal Surgery, the Second Hospital of Jilin University, Changchun
| | - Tongjun Liu
- Department of Colorectal and Anal Surgery, the Second Hospital of Jilin University, Changchun
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Bai J, Xie Z, Sun L. Case Report: Metachronous Quadruple Cancers Including Breast Cancer and Triple Genital Cancer. Int J Gen Med 2020; 13:1575-1580. [PMID: 33364819 PMCID: PMC7751715 DOI: 10.2147/ijgm.s278219] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 11/19/2020] [Indexed: 12/14/2022] Open
Abstract
Most multiple primary cancers(MPCs) are double primaries, while quadruple cancer is rare, especially breast cancer and triple genital cancer. Our work is the first report about ametachronous quadruple cancer in the reproductive system, including breast, ovary, fallopian tube and cervix. A54-year-old woman, who underwent modified radical mastectomy and right breast tumor resection 3 years ago, presented with abnormal vaginal discharge for 2 months, and she was subsequently diagnosed with stage IIA2 cervical squamous cell carcinoma. She then underwent radiotherapy and chemotherapy, as well as radical hysterectomy, bilateral salpingo-oophorectomy and bilateral pelvic lymphadenectomy. Postoperative pathological findings revealed that the patient had cervical, ovarian and tubal triple cancers with different histopathology for all lesions, also different from breast cancer, implying that these tumors had separate etiology and were not metastatic tumors. Our work might provide aseries of diagnostic, etiological and therapeutic strategies for MPC patients.
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Affiliation(s)
- Jing Bai
- Department of Maternity, Jinan Maternity and Child Care Hospital Affiliated to Shandong First Medical University, Jinan 250001, People's Republic of China
| | - Zhaoguang Xie
- Department of Maternity, Jinan Maternity and Child Care Hospital Affiliated to Shandong First Medical University, Jinan 250001, People's Republic of China
| | - Li Sun
- Department of Gynecological Oncology, Qingdao Central Hospital, The Second Affiliated Hospital of Medical College of Qingdao University, Qingdao 266042, People's Republic of China
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Huang HY, Lu MW, Chen MC, Chang HM, Kuo CH, Lin SM, Wang CH, Chung FT. Clinic image surveillance reduces mortality in patients with primary hepato-gastrointestinal cancer who develop second primary lung cancer: A STROBE-compliant retrospective study. Medicine (Baltimore) 2020; 99:e23440. [PMID: 33327274 PMCID: PMC7738109 DOI: 10.1097/md.0000000000023440] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Second primary cancer is prevalent in patients with gastrointestinal (GI) cancer, for which lung cancer is the most common and associated with high lethality. Image screening for lung cancer was proved to be effective in early diagnosis and lower mortality. However, trials of screen for lung cancer generally excluded patients with a previous diagnosis of malignancy. The study aimed to investigate the outcome of second primary lung cancer and the factor that improve survival in patients with hepato-GI cancer.A total of 276 patients with secondary lung cancer were found among 3723 newly-diagnosed lung cancer patients diagnosed in Chang Gung Memorial Hospital, between 2010 and 2014. Patients' clinical characteristics, stages and survival were recorded and analyzed. The patients were separated into 2 groups: Group I was defined as lung cancer detected in original primary cancer clinic and group II patients defined as lung cancer detected in other medical places.Sixty-nine cases with primary GI-hepatic and secondary lung cancer were diagnosed (42 (60.8%) in Group I and 27 (39.1%) in Group II). Although both groups had comparable primary cancer stages and treatment, more patients in Group I than Group II were diagnosed as early stage lung cancer (stage I-II: 40.5% vs 11.1%; P = .023). Group II had larger lung tumor sizes than Group I (4.7 vs 3.5 cm; P = .025). Group I showed better 5-year overall survival than Group II (P = .014, median survival: 27 vs 10 months). Among Group II, only 37% had received image follow up in clinic compared with 67% of Group I cases (P = .025). Patients with chest image follow up in clinics also had better 5-year overall survival (P = .043).GI-hepatic cancer was the most common primary malignancy in the lung cancer cohort. Patients had better survival outcome when secondary lung cancer was diagnosed in original primary cancer clinic. Chest image screening strategy may contribute better survival in secondary lung cancer due to detection at an earlier stage.
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Affiliation(s)
- Hung-Yu Huang
- Division of Pulmonary and Critical Care, Department of Internal Medicine, Saint Paul's Hospital
- Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taipei
- College of Medicine, Chang Gung University
| | - Min-Wei Lu
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan
- Medical Education Department, Far Eastern Memorial Hospital, New Taipei City
| | - Mei-Chi Chen
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan
- Department of Pediatrics, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan
| | - Hsiu-Mei Chang
- Department of Respiratory Care, New Taipei City Municipal TuCheng Hospital, Managed by Chang Gung Medical Foundation, New Taipei City
| | - Chih-Hsi Kuo
- Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taipei
- College of Medicine, Chang Gung University
| | - Shu-Min Lin
- Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taipei
- College of Medicine, Chang Gung University
| | - Chun-Hua Wang
- Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taipei
- College of Medicine, Chang Gung University
| | - Fu-Tsai Chung
- Division of Pulmonary and Critical Care, Department of Internal Medicine, Saint Paul's Hospital
- Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taipei
- College of Medicine, Chang Gung University
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan
- Department of Respiratory Care, New Taipei City Municipal TuCheng Hospital, Managed by Chang Gung Medical Foundation, New Taipei City
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan
- Department of Thoracic Medicine, New Taipei City Municipal TuCheng Hospital, Managed by Chang Gung Medical Foundation, New Taipei City, Taiwan
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A potential treatment option for elderly non-Hodgkin lymphoma patients with multiple comorbidities: Two case reports and literature review. Explore (NY) 2020; 17:265-269. [PMID: 33132079 DOI: 10.1016/j.explore.2020.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 10/12/2020] [Indexed: 01/22/2023]
Abstract
Non-Hodgkin lymphoma (NHL) is a heterogeneous lymphoproliferative malignancy. More than half of the NHL cases occur in patients over 65 years of age. As elderly patients have a poor performance status and multiple comorbidities, the use of standard chemotherapy is often limited, leading to poor clinical outcomes and an increasing need for an alternate therapeutic modalities. A 73-year-old man was diagnosed with extranodal NK/T-cell lymphoma concurrently combined with recurrent gastric adenocarcinoma and metastatic prostate cancer. A 79-year-old woman was diagnosed with T-cell and B-cell dual-phenotype NHL on the right chest wall showing tumor thrombosis and multiple enlarged lymph nodes under chronic emphysema with extensive pleural calcification. Both elderly patients had multiple comorbidities and pathologically confirmed non-Hodgkin lymphoma. Both patients achieved tumor responses following anticancer treatment with Korean medicine (KM), suggesting that the extracts of Angelica gigas Nakai and Geopungtang are potential options for treating NHL in elderly patients with multiple comorbidities. Considering the clinical outcomes of KM treatment in the two elderly patients with NHL and multiple comorbidities, this study generates a research hypothesis for future prospective clinical studies in patients with NHL who are ineligible for conventional anticancer therapy.
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Ventura L, Carbognani P, Gnetti L, Rossi M, Tiseo M, Silini EM, Sverzellati N, Silva M, Succi M, Braggio C, Cattadori S, Bocchialini G, Balestra V, Rusca M, Ampollini L. Multiple primary malignancies involving lung cancer: a single-center experience. TUMORI JOURNAL 2020; 107:196-203. [PMID: 32578517 DOI: 10.1177/0300891620933678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Currently, unlike earlier years, patients affected by multiple primary malignancies (MPM) are significantly increased, thus representing a clinical-pathologic category worthy of attention. Their clinical features and prognosis still need to be studied thoroughly, and this is the aim of our study. METHODS Patients with MPM involving lung cancer admitted in our center between January 2006 and December 2016 were considered. Parametric and nonparametric testing was used for statistical comparisons. Univariate and multivariate analysis was used to evaluate the variables associated with a prognostic value. RESULTS MPM incidence was 19.8%. Among the 222 patients with MPM enrolled, 204 (91.8%) had two malignancies, while 18 (8.2%) had three malignancies, 38 (17.1%) were synchronous, 41 (18.5%) had lung cancer first (LCF) and 181 (81.5%) had other cancer first (OCF). A significant difference between the time of first cancer diagnosis to the second cancer diagnosis in the LCF vs OCF group was found (median 32 vs 51 months; p-value: 0.038). The most frequent anatomical sites of malignancies preceding or following lung cancer were prostate, colorectal, bladder, and larynx. Multivariate analysis revealed that sex, histologic pattern, and time and order of occurrence were independent factors for overall survival, with male sex, squamous cell lung carcinoma, synchronous and LCF MPM significantly associated with poorer overall survival. CONCLUSIONS Prostate, colorectal, bladder, and larynx were the most frequent anatomical sites of malignancies preceding or following lung cancer. Male sex, squamous cell lung carcinoma, synchronous and LCF MPM might be associated with poorer prognosis.
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Affiliation(s)
- Luigi Ventura
- Thoracic Surgery, Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
| | - Paolo Carbognani
- Thoracic Surgery, Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
| | - Letizia Gnetti
- Pathology Unit, Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
| | - Maurizio Rossi
- Department of Clinical and Experimental Medicine, University Hospital of Parma, Parma, Italy
| | - Marcello Tiseo
- Medical Oncology, Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
| | - Enrico Maria Silini
- Pathology Unit, Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
| | - Nicola Sverzellati
- Section of Radiology, Diagnostic Department, University Hospital of Parma, Parma, Italy
| | - Mario Silva
- Section of Radiology, Diagnostic Department, University Hospital of Parma, Parma, Italy
| | - Marcello Succi
- Anesthesiology, Critical Care and Pain Medicine Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Cesare Braggio
- Thoracic Surgery, Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
| | - Sara Cattadori
- Thoracic Surgery, Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
| | - Giovanni Bocchialini
- Thoracic Surgery, Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
| | - Valeria Balestra
- Thoracic Surgery, Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
| | - Michele Rusca
- Thoracic Surgery, Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
| | - Luca Ampollini
- Thoracic Surgery, Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
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Synchronous tumours detected during cancer patient staging: prevalence and patterns of occurrence in multidetector computed tomography. Pol J Radiol 2020; 85:e261-e270. [PMID: 32612725 PMCID: PMC7315052 DOI: 10.5114/pjr.2020.95781] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 05/01/2020] [Indexed: 01/17/2023] Open
Abstract
Purpose The incidental detection of one or more additional primary tumours during computed tomography (CT) staging of a patient with known malignancy is rare but possible. This occurrence should be considered by the radiologist when a new lesion is detected, especially if the lesion location is atypical for metastases. The purpose of this report was to document the usefulness of total body CT scan to detect synchronous primary malignancies in cancer patients undergoing a staging workup. Material and methods This was done by reviewing the staging CT studies of the adult patients with a newly diagnosed cancer evaluated during a five-year period in a single cancer institute in order to identify any possible correlation, establishing which tumours are more frequently combined with a second tumour and which second tumours are more commonly present. Results Among the patients with a second tumour, the most frequent first primary tumours were melanoma (eight patients, 17.8%), lymphoma (seven patients, 15.6%), and prostate carcinoma (seven patients, 15.6%). The most frequent incidentally detected second tumours were hepatocellular carcinoma (nine patients, 20% of 45 incidental tumours), renal carcinoma (eight patients, 17.8%), lung carcinoma (seven patients, 15.6%), and bladder carcinoma (four patients, 8.9%). One patient had three primary tumours synchronously. Conclusions We believe that the radiologist’s knowledge of the prevalence and pattern of occurrence of these multiple primary malignancies represents added diagnostic value.
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Does minimum follow-up time post-diagnosis matter? An assessment of changing loss of life expectancy for people with cancer in Western Australia from 1982 to 2016. Cancer Epidemiol 2020; 66:101705. [PMID: 32224327 DOI: 10.1016/j.canep.2020.101705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 03/03/2020] [Accepted: 03/14/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Cancer survival has improved in Western Australia (WA) over recent decades. Loss of life expectancy (LOLE) is a useful measure for assessing cancer survival at a population-level. Some previous studies estimating LOLE have required a minimum follow-up beyond diagnosis to reduce the impact of modelled extrapolation, while others have not. The first aim of this study was to assess the impact of minimum length of follow-up on LOLE estimates for people diagnosed in 2006 with female breast, colorectal, prostate, lung, cervical, combined oesophageal and stomach cancers, and melanoma. Based on these results, the second aim was to assess temporal changes in LOLE for these cancer types for diagnoses between 1982 and 2016. METHODS Person-level linked cancer registry and mortality data were used for invasive primary cancer diagnoses for WA residents aged 15-89 years. The analysis for aim one included cases diagnosed from 1982 to the end of 2006, followed to the end of 2006 (i.e. no minimum follow-up), 2011 (i.e. five years minimum follow-up, assuming survival) or 2016 (i.e. 10 years minimum follow-up). To achieve the second study aim, the diagnostic period was extended to the end of 2016. Life expectancy estimates were obtained after fitting flexible parametric relative survival models. Single-year age and sex-specific death rates were used as a reference to estimate LOLE and proportionate loss of life expectancy. RESULTS Temporal changes were not reported for prostate, cervical, oesophageal and stomach cancers or melanoma, due to differences in LOLE estimates by minimum follow-up time, or estimate imprecision. Marked reductions in LOLE were observed for female breast and colorectal cancer. There was minimal absolute reduction for lung cancer, where LOLE remained high. CONCLUSION This study considered the appropriateness of including recent cancer diagnoses when assessing temporal changes in LOLE, finding variation in estimates with differing minimum follow-up or high parameter uncertainty for most included cancer types. Temporal changes in LOLE in-turn reflected changes in the life expectancy of the general population, cancer detection and management. These factors must be considered when estimating and interpreting LOLE estimates.
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Hwang KT, Kim MJ, Chu AJ, Park JH, Kim J, Lee JY, Choi IS, Park JH, Chang JH, Hwang KR. Metachronous Sporadic Sextuple Primary Malignancies Including Bilateral Breast Cancers. J Breast Cancer 2020; 23:438-446. [PMID: 32908793 PMCID: PMC7462815 DOI: 10.4048/jbc.2020.23.e21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 03/11/2020] [Indexed: 01/22/2023] Open
Abstract
Multiple primary malignancies are defined as the presence of more than one malignant neoplasm with a distinct histology occurring at different sites in the same individual. They are classified as synchronous or metachronous according to the diagnostic time interval of different malignancies. Diagnosis of multiple primary malignancies should avoid misclassification from multifocal/multicentric tumors or recurrent/metastatic lesions. In multiple primary malignancies, with increase in the number of primary tumors, the frequency rapidly decreases. Here, we report an exceptionally rare case of a woman who was diagnosed with metachronous sporadic sextuple primary malignancies including bilateral breast cancers (gastric cancer, ovarian Sertoli-Leydig cell tumor, left breast cancer, thyroid cancer, right breast cancer, and rectal neuroendocrine tumor). The sextuple primary malignancies in this case involved 5 different organs: the stomach, ovary, thyroid, rectum, and bilateral breasts. Further studies are needed to elucidate the current epidemiologic status of patients with multiple primary malignancies.
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Affiliation(s)
- Ki-Tae Hwang
- Department of Surgery, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Myong Jin Kim
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - A Jung Chu
- Department of Radiology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Jeong Hwan Park
- Department of Pathology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Jongjin Kim
- Department of Surgery, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Jong Yoon Lee
- Department of Radiology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - In Sil Choi
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Jin Hyun Park
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Ji Hyun Chang
- Department of Radiation Oncology, Seoul National University Hospital, Seoul, Korea
| | - Kyu Ri Hwang
- Department of Obstetrics and Gynecology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
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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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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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50
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Zhang Y, Ge Y, Wu X, Liu S. Clinical treatment of advanced synchronous triple primary malignancies: comprehensive treatment based on targeted therapy. Onco Targets Ther 2019; 12:2421-2430. [PMID: 31118660 PMCID: PMC6498978 DOI: 10.2147/ott.s200625] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 03/06/2019] [Indexed: 01/22/2023] Open
Abstract
The prevalence of cancer remains high. With the improvement of diagnosis and treatment level and the increase of cancer survivors after treatment, multiple primary tumors are more common than before. The diagnosis and treatment of synchronous multiple primary tumors is more complicated than that of single or metachronous multiple tumors, and patients also suffer more. Because of the different conditions of these patients, lack of large-scale clinical observation data, it is necessary for clinicians to make realistic decisions on the specific conditions of patients. It is a challenge for clinicians to apply the advances of modern medicine to the diagnosis and treatment of such patients so as to prolong their survival time and improve their quality of life. This report describes the survival of an advanced elderly patient with lung, prostate and bladder cancer after receiving targeted therapy-based comprehensive treatment.
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Affiliation(s)
- Ying Zhang
- Department of Internal Medicine, Municipal Hospital, Qingdao, Shandong, People's Republic of China
| | - Yunjie Ge
- Department of Internal Medicine, Municipal Hospital, Qingdao, Shandong, People's Republic of China
| | - Xiaohui Wu
- Department of Internal Medicine, Municipal Hospital, Qingdao, Shandong, People's Republic of China
| | - Shuangmei Liu
- Department of Internal Medicine, Municipal Hospital, Qingdao, Shandong, People's Republic of China
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