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Hirao M, Katada C, Yokoyama T, Yano T, Suzuki H, Furue Y, Yamamoto K, Doyama H, Koike T, Tamaoki M, Kawata N, Kawahara Y, Katagiri A, Ogata T, Yamanouchi T, Kiyokawa H, Kawakubo H, Konno M, Ishikawa H, Yokoyama A, Muto M. Metachronous primary gastric cancer after endoscopic resection in patients with esophageal squamous cell carcinoma. Gastric Cancer 2023; 26:988-1001. [PMID: 37368170 DOI: 10.1007/s10120-023-01413-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 06/14/2023] [Indexed: 06/28/2023]
Abstract
BACKGROUND This study aimed to evaluate the risk factors for developing metachronous primary Gastric Cancer (GC) after Endoscopic Resection (ER) for esophageal Squamous Cell Carcinoma (SCC). METHODS We studied 283 patients with esophageal SCC who underwent ER. The study outcomes were as follows: (1) incidence of metachronous primary GC after ER; and (2) predictors for the development of metachronous primary GC after ER by the Cox proportional hazards model. RESULTS The median follow-up was 43.1 months (1.81-79.1), and the 3-year cumulative incidence of metachronous primary GC was 6.5% (95%CI: 4.1-10.4). The incidence of metachronous primary GC during the follow-up period was 2.31 per 100 person-years. The frequencies of severe gastric atrophy and macrocytosis at the timing of ER were significantly higher in patients with than without metachronous primary GC (91.7% vs. 73.2%, p = 0.0422, 20.8% vs. 5.2%, p = 0.0046, respectively). Severe gastric atrophy was associated with the development of metachronous primary GC (sex-and-age adjusted hazard ratio (HR) [95%CI] = 4.12 [0.95-27.78], p = 0.0093). Macrocytosis was associated with the development of metachronous primary GC (sex-and-age adjusted HR = 4.76 [1.75-13.0], p = 0.0012) and found to be an independent predictor for metachronous primary GC by multivariate Cox proportional hazards analysis (HR [95%CI] = 4.35 [1.60-11.84], p = 0.004). CONCLUSIONS Severe gastric atrophy and macrocytosis should be noted in the development of metachronous primary GC after ER for esophageal SCC. In particular, macrocytosis at the timing of ER was considered an important predictor. CLINICAL TRIALS REGISTRY NUMBER UMIN000001676.
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Affiliation(s)
- Motohiro Hirao
- Department of Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Chikatoshi Katada
- Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, 54 Kawaharacho Syhogoin Sakyo, Kyoto, 606-8507, Japan.
| | - Tetsuji Yokoyama
- Department of Health and Promotion, National Institute of Public Health, Wako, Japan
| | - Tomonori Yano
- Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Kashiwa, Japan
| | - Haruhisa Suzuki
- Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
| | - Yasuaki Furue
- Department of Gasroenterology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Keiko Yamamoto
- Division of Endoscopy, Hokkaido University Hospital, Sapporo, Japan
| | - Hisashi Doyama
- Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
| | - Tomoyuki Koike
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masashi Tamaoki
- Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, 54 Kawaharacho Syhogoin Sakyo, Kyoto, 606-8507, Japan
| | - Noboru Kawata
- Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
| | - Yoshiro Kawahara
- Department of Practical Gastrointestinal Endoscopy, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Atsushi Katagiri
- Department of Medicine, Division of Gastroenterology, Showa University Hospital, Tokyo, Japan
| | - Takashi Ogata
- Department of Gastroenterology, Kanagawa Cancer Center, Yokohama, Japan
| | - Takenori Yamanouchi
- Department of Gastroenterology, Kumamoto Regional Medical Center, Kumamoto, Japan
| | - Hirofumi Kiyokawa
- Division of Gastroenterology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Hirofumi Kawakubo
- Department of Surgery, Kawasaki Municipal Kawasaki Hospital, Kawasaki, Japan
| | - Maki Konno
- Department of Gastroenterology, Tochigi Cancer Center, Utsunomiya, Japan
| | - Hideki Ishikawa
- Department of Molecular-Targeting Prevention, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Akira Yokoyama
- Clinical Research Unit, National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka, Japan
| | - Manabu Muto
- Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, 54 Kawaharacho Syhogoin Sakyo, Kyoto, 606-8507, Japan
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Carlin L, Paudice M, Ingaliso M, Pigozzi S, Trevisan L, Sciallero S, Pastorino A, Piol N, Grillo F, Mastracci L. Synchronous and metachronous primary colorectal cancers with concordant and discordant mismatch repair status. Hum Pathol 2023; 141:54-63. [PMID: 37742947 DOI: 10.1016/j.humpath.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 09/11/2023] [Accepted: 09/18/2023] [Indexed: 09/26/2023]
Abstract
Multiple primary colorectal carcinomas (CRCs) synchronous, when detected approximately at the same time, or metachronous, when a significant amount of time has elapsed between diagnoses can show both mismatch repair (MMR) status concordance and discordance between primary tumors. The aim was to evaluate the MMR status of a monoinstitutional, retrospective cohort of synchronous and metachronous CRCs, with a focus on the frequency of cases with discordant MMR status, and explore the MMR status of metastatic nodal deposits. All synchronous and metachronous CRCs diagnosed in our institution between 2011 and 2023 were collected. Clinicopathologic characteristics were evaluated, including MMR status of all CRCs, BRAF mutation, and MLH1 promoter methylation analyses. MMR status discordant cases were further analyzed, and MMR testing was performed on nodal metastases. Of 3671 patients, 107 (2.9%) had multiple CRCs (94 synchronous and 13 metachronous; total number of CRCs 220). Sixty CRCs were MMR deficient (dMMR) (27.3%), and most were right-sided and high-grade and showed special histologic features (P < .00001). Ninety-three patients showed intertumoral MMR concordance: 70 (65.4%) with MMR-proficient (pMMR) CRCs, and 23 (21.5%) were dMMR. Fourteen patients (13.1%) showed intertumoral MMR discordance (at least one dMMR and one pMMR), and in 5 patients, nodal metastases were present: 2 patients harbored metastases only from their pMMR cancer, 2 only from their dMMR cancer, and in 1 patient both pMMR and dMMR metastases were present. In conclusion, all multiple primary CRCs should be analyzed for MMR status as discordant MMR is possible as well as discordant metastatic nodal deposits, and this may be important for patient management.
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Affiliation(s)
- Luca Carlin
- Pathology Unit, Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, 16132, Genoa, Italy
| | - Michele Paudice
- Pathology Unit, Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, 16132, Genoa, Italy; University Pathology Unit, IRCCS Ospedale Policlinico San Martino, 16132, Genoa, Italy
| | - Marta Ingaliso
- Pathology Unit, Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, 16132, Genoa, Italy
| | - Simona Pigozzi
- Pathology Unit, Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, 16132, Genoa, Italy; University Pathology Unit, IRCCS Ospedale Policlinico San Martino, 16132, Genoa, Italy
| | - Lucia Trevisan
- Unit of Hereditary Cancer, IRCCS Ospedale Policlinico San Martino, 16132, Genoa, Italy
| | - Stefania Sciallero
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, 16132, Genoa, Italy
| | - Alessandro Pastorino
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, 16132, Genoa, Italy
| | - Nataniele Piol
- University Pathology Unit, IRCCS Ospedale Policlinico San Martino, 16132, Genoa, Italy
| | - Federica Grillo
- Pathology Unit, Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, 16132, Genoa, Italy; University Pathology Unit, IRCCS Ospedale Policlinico San Martino, 16132, Genoa, Italy.
| | - Luca Mastracci
- Pathology Unit, Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, 16132, Genoa, Italy; University Pathology Unit, IRCCS Ospedale Policlinico San Martino, 16132, Genoa, Italy
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Suzuki H, Nonaka S, Maetani I, Matsuda T, Abe S, Yoshinaga S, Oda I, Yamagata Y, Yoshikawa T, Saito Y. Clinical and endoscopic features of metachronous gastric cancer with possible lymph node metastasis after endoscopic submucosal dissection and Helicobacter pylori eradication. Gastric Cancer 2023; 26:743-754. [PMID: 37160633 DOI: 10.1007/s10120-023-01394-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 04/29/2023] [Indexed: 05/11/2023]
Abstract
BACKGROUND Several studies have reported the metachronous gastric cancers (MGCs) with possible lymph node metastasis (LNM) after endoscopic submucosal dissection (ESD) and Helicobacter pylori (H. pylori) eradication in which a curative ESD had not been achieved. There have been no published reports of evaluations of the features of patients with MGC with possible LNM after ESD and H. pylori eradication. METHODS We identified 264 patients with 369 MGCs after H. pylori eradication among the 4354 patients with 5059 early gastric cancers (EGCs) who underwent ESD between 1999 and 2017 and divided them into two groups: patients with MGCs with possible LNM (Group I) and patients with MGCs undergone curative ESD (Group II). We retrospectively compared the features of patients with MGCs and patients with EGCs at index ESD in the two groups. RESULT Group I consisted of 20 patients with 21 MGCs, and Group II consisted of 244 patients with 348 MGCs. Group I lesions were significantly more common in the posterior wall than in the lesser curvature (odds ratio [OR] = 3.97; 95% confidence intervals [CI] 1.20-13.10). Development of Group I was significantly more common in patients with a body mass index (BMI) < 19.0 kg/m2 than in patients with a BMI ≥ 19.0 kg/m2 at index ESD (OR = 4.44; 95% CI 1.30-15.20). CONCLUSIONS During surveillance endoscopy after gastric ESD and H. pylori eradication, the posterior wall should be carefully examined to detect MGCs early. Lower BMI may be associated with the development of MGCs with possible LNM.
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Affiliation(s)
- Haruhisa Suzuki
- Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
| | - Satoru Nonaka
- Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Iruru Maetani
- Division of Gastroenterology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Takahisa Matsuda
- Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, Tokyo, Japan
| | - Seiichiro Abe
- Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Shigetaka Yoshinaga
- Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Ichiro Oda
- Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Yukinori Yamagata
- Gastric Surgery Division, National Cancer Center Hospital, Tokyo, Japan
| | - Takaki Yoshikawa
- Gastric Surgery Division, National Cancer Center Hospital, Tokyo, Japan
| | - Yutaka Saito
- Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
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Sl H, Konan B, Pottakkat B, Raja K, M P. Metachronous Adenocarcinoma at Stoma Site 50 Years After Abdominoperineal Resection for Carcinoma Rectum:a Case Report and Review of Literature. J Gastrointest Cancer 2023; 54:992-995. [PMID: 36447086 DOI: 10.1007/s12029-022-00883-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2022] [Indexed: 12/05/2022]
Affiliation(s)
- Harilal Sl
- Department of Surgical Gastroenterology, Jawaharlal Institute of Postgraduate Medical Education and Research, JIPMER, Fourth Floor, Superspeciality Block, 605006, Puducherry, India
| | - Bharat Konan
- Department of Surgical Gastroenterology, Jawaharlal Institute of Postgraduate Medical Education and Research, JIPMER, Fourth Floor, Superspeciality Block, 605006, Puducherry, India
| | - Biju Pottakkat
- Department of Surgical Gastroenterology, Jawaharlal Institute of Postgraduate Medical Education and Research, JIPMER, Fourth Floor, Superspeciality Block, 605006, Puducherry, India.
| | - Kalayarasan Raja
- Department of Surgical Gastroenterology, Jawaharlal Institute of Postgraduate Medical Education and Research, JIPMER, Fourth Floor, Superspeciality Block, 605006, Puducherry, India
| | - Priyanka M
- Department of Surgical Gastroenterology, Jawaharlal Institute of Postgraduate Medical Education and Research, JIPMER, Fourth Floor, Superspeciality Block, 605006, Puducherry, India
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Iwamoto M, Ariizumi T, Watanabe M, Yamamoto M, Narita M, Koyachi M, Akashi Y, Matsuzaka K, Shibahara T, Takano M, Katakura A. Second Primary Metachronous Malignancies Occurring in Oral Cavity of Young Adult-A Case Report. Bull Tokyo Dent Coll 2023; 64:23-30. [PMID: 36792150 DOI: 10.2209/tdcpublication.2022-0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
The incidence of oral cancer in Japan is increasing. Interestingly, the number of young patients with oral cancer is also rising. A 19-year-old man with no history of smoking or drinking alcohol presented with a 20×15-mm elastic, hard, protruding mass with a white surface on the right-hand margin of the tongue. A biopsy resulted in a diagnosis of a well-differentiated squamous cell carcinoma of the tongue, for which a partial resection was subsequently performed. During regular follow-up, the patient demonstrated no clinical or imaging abnormalities until 4 years and 9 months later, when erosion was observed at the right palatoglossal arch. A malignant tumor of the right palatoglossal arch was diagnosed based on cytology and imaging findings, and total resection of the lesion performed. Histopathological examination of the resected lesion revealed a moderately differentiated squamous cell carcinoma. Epithelial dysplasia on the right-hand margin of the tongue was diagnosed 4 years and 9 months after the second surgery and was subsequently resected. The patient's condition has been favorable for 7 years since the diagnosis of the second cancer, with no noted recurrence. This case emphasizes the importance of follow-up after initial treatment, as even young people, who are likely to have to endure long-lasting consequences from treatment, can develop metachronous cancer in the oral cavity.
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Affiliation(s)
- Masashi Iwamoto
- Department of Oral Pathobiological Science and Surgery, Tokyo Dental College
| | | | - Miki Watanabe
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College
| | - Masae Yamamoto
- Department of Oral Pathobiological Science and Surgery, Tokyo Dental College
| | - Masato Narita
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College
| | - Masahide Koyachi
- Department of Oral Pathobiological Science and Surgery, Tokyo Dental College
| | | | | | | | - Masayuki Takano
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College
| | - Akira Katakura
- Department of Oral Pathobiological Science and Surgery, Tokyo Dental College
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Almalki HS, Lim A, Allen JC, Teo SY, Lim GH. Usefulness of supplementary ultrasound surveillance in the detection of a second breast cancer in patients with ductal carcinoma in situ. Clin Breast Cancer 2021; 21:521-525. [PMID: 34544658 DOI: 10.1016/j.clbc.2021.08.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 08/07/2021] [Accepted: 08/17/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Supplementary ultrasound surveillance in breast cancer patients can detect additional cancers but is associated with unnecessary biopsies and follow-ups. We aim to determine, in patients with ductal carcinoma in situ (DCIS), the prevalence and factors associated with second breast cancers and the usefulness of supplementary ultrasound surveillance. This is the first study which focused on the usefulness of ultrasound surveillance in DCIS patients. METHODS DCIS patients were retrospectively analyzed to determine the prevalence and factors associated with second breast cancers. The prevalence of patients with benign biopsies, additional ultrasound follow-ups and second breast cancers, resulting from ultrasound surveillance, were calculated. RESULTS Three hundred and thirty- two patients were included. 25 (7.5%) patients developed second breast cancers after a mean follow-up of 77.7 months. Breast conservation (P= .0218), involved margins after lumpectomy (P = .0003) and shortened hormonal therapy (P= 0.0369) were associated with second cancers. Of the 314 patients who had ultrasound surveillance, ipsilateral, and contralateral ultrasounds yielded 1.7%/1.3% cancer detection, 5.8%/6.7% benign biopsies and 10.4%/15.3% additional follow-ups. Patients with involved margins after lumpectomy have ipsilateral cancer detection, benign biopsies and additional follow-ups of 4.5%, 4.5%, and 9.1% respectively. A total of 85.4% patients had mammographically dense breasts. CONCLUSION In DCIS patients, the rate of second breast cancers was 7.5%. Breast conservation, involved margins after lumpectomy and shortened hormonal therapy were associated with second cancers. Patients with involved margins after lumpectomy have the highest cancer detection rate and minimal unnecessary biopsies and follow-ups. Hence, ipsilateral breast ultrasound surveillance could be personalized for this high-risk group with mammographically dense breasts.
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MESH Headings
- Adult
- Aged
- Breast Neoplasms/diagnostic imaging
- Breast Neoplasms/pathology
- Breast Neoplasms/therapy
- Carcinoma, Ductal, Breast/diagnostic imaging
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/therapy
- Female
- Humans
- Middle Aged
- Neoplasm Recurrence, Local/diagnostic imaging
- Neoplasm Recurrence, Local/pathology
- Neoplasms, Second Primary/diagnostic imaging
- Neoplasms, Second Primary/pathology
- Retrospective Studies
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Affiliation(s)
| | - Annabelle Lim
- Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore
| | - John C Allen
- Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore
| | - Sze Yiun Teo
- Department of Diagnostic and Interventional Imaging, KK Women's and Children's Hospital, Singapore
| | - Geok Hoon Lim
- Breast Department, KK Women's and Children's Hospital, Singapore; Duke-NUS Medical School, Singapore.
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Yokota M, Muto J, Hashida K, Nagahisa Y, Okabe M, Kitagawa H, Kawamoto K. The necessity of intensive surveillance colonoscopy for patients with a remaining right colon after resection of colorectal cancer: a retrospective cohort study. Surg Today 2021; 52:502-509. [PMID: 34499260 DOI: 10.1007/s00595-021-02372-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 06/29/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE To clarify how often postoperative surveillance colonoscopy should be undertaken based on the risk factors for the development of metachronous cancer (MC) and advanced adenoma (AA) after surgery for colorectal cancer. METHODS We collected data of consecutive patients who underwent curative resection for primary colorectal cancer between 2005 and 2012, with preoperative colonoscopy and surveillance colonoscopy at 1 year after surgery (406 patients, mean age: 69 years, 59% male). The detection rates of AA (with villous features, > 10 mm or high-grade dysplasia) and MC by surveillance colonoscopy were the primary outcomes. RESULTS At 5 years, colonoscopy was performed as postoperative surveillance an average of 3.2 times. AA and MC were detected in 57 (14.0%) and 18 patients (4.4%), respectively. Both lesions were more common in the right colon (n = 43) than in the left colon (n = 28). The detection rate did not differ to a statistically significant extent according to the number of colonoscopies performed for surveillance (p = 0.21). However, after left-sided colectomy, both types of lesions were more commonly detected in those who received ≥ 3 colonoscopies than in those with one or two colonoscopies (p = 0.04). CONCLUSION A remaining right colon after left-sided colectomy was associated with a higher risk of developing AA and MC. Physicians should consider performing surveillance colonoscopy more frequently if the right colon remains after surgery.
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Affiliation(s)
- Mitsuru Yokota
- Department of General Surgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama, 710-8602, Japan.
| | - Jun Muto
- Department of General Surgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama, 710-8602, Japan
| | - Kazuki Hashida
- Department of General Surgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama, 710-8602, Japan
| | - Yoshio Nagahisa
- Department of General Surgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama, 710-8602, Japan
| | - Michio Okabe
- Department of General Surgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama, 710-8602, Japan
| | - Hirohisa Kitagawa
- Department of General Surgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama, 710-8602, Japan
| | - Kazuyuki Kawamoto
- Department of General Surgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama, 710-8602, Japan
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Bakos B, Kiss A, Árvai K, Szili B, Deák-Kocsis B, Tobiás B, Putz Z, Ármós R, Balla B, Kósa J, Dank M, Valkusz Z, Takács I, Tabák Á, Lakatos P. Co-occurrence of thyroid and breast cancer is associated with an increased oncogenic SNP burden. BMC Cancer 2021; 21:706. [PMID: 34130653 DOI: 10.1186/s12885-021-08377-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 05/18/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Epidemiological evidence suggests that synchronous or metachronous presentation of breast and thyroid cancers exceeds that predicted by chance alone. The following potential explanations have been hypothesized: common environmental or hormonal factors, oncogenic effect of the treatment for the first cancer, closer follow-up of cancer survivors, shared underlying genetic risk factors. While some cases were found to be related to monogenic disorders with autosomal inheritance, the genetic background of most cases of co-occurring breast and thyroid cancer is thought to be polygenic. METHODS In this retrospective case-control study we compared the genetic profile of patients with a history of breast cancer (n = 15) to patients with co-occurring breast and thyroid cancer (n = 19) using next generation sequencing of 112 hereditary cancer risk genes. Identified variants were categorized based on their known association with breast cancer and oncogenesis in general. RESULTS No difference between patients with breast and double cancers was observed in clinical and pathological characteristics or the number of neutral SNPs. The unweighted and weighted number of SNPs with an established or potential association with breast cancer was significantly lower in the group with breast cancer only (mean difference - 0.58, BCa 95% CI [- 1.09, - 0.06], p = 0.029, and mean difference - 0.36, BCa 95% CI [- 0.70, - 0.02], p = 0.039, respectively). The difference was also significant when we compared the number of SNPs with potential or known association with any malignancy (mean difference - 1.19, BCa 95% CI [- 2.27, - 0.11], p = 0.032 for unweighted, and mean difference - 0.73, BCa 95% CI [- 1.32, - 0.14], p = 0.017 for weighted scores). CONCLUSION Our findings are compatible with the hypothesis of genetic predisposition in the co-occurrence of breast and thyroid cancer. Further exploration of the underlying genetic mechanisms may help in the identification of patients with an elevated risk for a second cancer at the diagnosis of the first cancer.
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Ota Y, Ota K, Takahashi T, Suzki S, Sano R, Ota I, Moriya T, Shiota M. Primary endometrioid carcinoma of the uterosacral ligament arising from deep infiltrating endometriosis 6 years after bilateral salpingo-oophorectomy due to atypical proliferative endometrioid tumor of the ovary: a rare case report. World J Surg Oncol 2020; 18:329. [PMID: 33308243 PMCID: PMC7733300 DOI: 10.1186/s12957-020-02105-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 12/02/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Endometriosis can potentially lead to the development of a malignant tumor. Most malignant tumors arising from the endometriosis originate from the ovarian endometrioma, whereas those arising from extragonadal lesions are rare. We report a rare case of endometrioid carcinoma that developed from deep infiltrating endometriosis in the uterosacral ligament 6 years after treatment for atypical proliferative endometrioid tumor of the ovary in a 48-year-old woman. CASE PRESENTATION Six years ago, the patient underwent laparoscopic bilateral salpingo-oophorectomy for her right ovarian tumor with atypical proliferative (borderline) endometrioid tumor accompanied by ovarian endometrioma. The solid tumor in the cul-de-sac was detected during follow-up using magnetic resonance imaging. Positron emission tomography/computed tomography revealed an abnormal accumulation of 18F-fluorodeoxyglucose at the tumor site. Thus, tumor recurrence with borderline malignancy was suspected. The patient underwent diagnostic laparoscopy followed by hysterectomy and partial omentectomy. Retroperitoneal pelvic lymphadenectomy and para-aortic lymphadenectomy were also performed. The cul-de-sac tumor at the left uterosacral ligament was microscopically diagnosed as invasive endometrioid carcinoma arising from deep infiltrating endometriosis. The final diagnosis was primary stage IIB peritoneal carcinoma. The patient received six courses of monthly paclitaxel and carboplatin as adjuvant chemotherapy. The patient showed no evidence of recurrence for 2 years after the treatments. CONCLUSION This study reports a rare case of metachronous endometriosis-related malignancy that developed 6 years after treatment for borderline ovarian tumor. If endometriosis lesions remain after bilateral salpingo-oophorectomy, the physician should keep the malignant nature of endometriosis in mind.
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Affiliation(s)
- Yoshiaki Ota
- Department of Gynecological Oncology, Kawasaki Medical School, Kurashiki, Japan
| | - Kuniaki Ota
- Fukushima Medical Center for Children and Women, Fukushima Medical University, 1 Hikarigaoka, Fukushima City, Fukushima, 960-1295, Japan
| | - Toshifumi Takahashi
- Fukushima Medical Center for Children and Women, Fukushima Medical University, 1 Hikarigaoka, Fukushima City, Fukushima, 960-1295, Japan.
| | - Soichiro Suzki
- Department of Gynecological Oncology, Kawasaki Medical School, Kurashiki, Japan
| | - Rikiya Sano
- Department of Gynecological Oncology, Kawasaki Medical School, Kurashiki, Japan
| | - Ikuko Ota
- Department of Gynecology, Kurashiki Heisei Hospital, Kurashiki, Japan
| | - Takuya Moriya
- Department of Pathology, Kawasaki Medical School, Kurashiki, Japan
| | - Mitsuru Shiota
- Department of Gynecological Oncology, Kawasaki Medical School, Kurashiki, Japan
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Megaro G, Rossi L, Ceddia S, Sinjari M, Mannino A, Gozzi E, Cosimati A, Brandi M, Bitca V, Toscani I, Cimino G, Tomao S. Synchronous and Metachronous Metastatic Breast Cancer, with Different Histology and Opposite Immunophenotype, Treated with Combination of Chemotherapy, Anti-Her2, and Endocrine Therapy: A Case Report. Case Rep Oncol 2020; 13:544-549. [PMID: 32547382 PMCID: PMC7275194 DOI: 10.1159/000507433] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 03/23/2020] [Indexed: 11/19/2022] Open
Abstract
In the case of our patient, the synergic action of endocrine therapy and chemotherapy plus dual anti-HER2 combination allowed a complete disease control. Therapy should be scheduled by considering the two cancers as individual entities. The approach to breast cancer is changing from being considered a singular disease to a multiform one, according to current research focused on biological markers such as HER2, ERs, and PRs, with important implications in clinical, prognostic, and therapeutic features.
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Affiliation(s)
- Giacomina Megaro
- Department of Paediatric Haematology and Oncology, Ospedale Bambin Gesù, Rome, Italy
| | - Luigi Rossi
- UOC of Oncology - ASL Latina - Distretto 1, University of Rome "Sapienza", Aprilia, Italy
| | - Serena Ceddia
- UOC of Oncology - ASL Latina - Distretto 1, University of Rome "Sapienza", Aprilia, Italy
| | - Marsela Sinjari
- UOC of Oncology - ASL Latina - Distretto 1, University of Rome "Sapienza", Aprilia, Italy
| | - Adele Mannino
- UOC of Oncology - ASL Latina - Distretto 1, University of Rome "Sapienza", Aprilia, Italy
| | - Elisa Gozzi
- UOC of Oncology - ASL Latina - Distretto 1, University of Rome "Sapienza", Aprilia, Italy
| | - Antonella Cosimati
- UOC of Oncology - ASL Latina - Distretto 1, University of Rome "Sapienza", Aprilia, Italy
| | - Martina Brandi
- UOC of Oncology - ASL Latina - Distretto 1, University of Rome "Sapienza", Aprilia, Italy
| | - Victoria Bitca
- UOC of Oncology - ASL Latina - Distretto 1, University of Rome "Sapienza", Aprilia, Italy
| | - Ilaria Toscani
- Medical Oncology Ospedale G. da Saliceto, Piacenza, Italy
| | - Giuseppe Cimino
- Department of Cellular Biotechnology and Haematology, University of Rome "Sapienza", Rome, Italy
| | - Silverio Tomao
- Medical Oncology Unit A Policlinico Umberto I, University of Rome "Sapienza", Rome, Italy
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11
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Miyagawa Y, Kitazawa M, Kitahara H, Karasawa Y, Orii T, Soejima Y. Three Curative Pancreatectomies for the Metachronous Appearance of Pancreatic Invasive Ductal Adenocarcinoma. Case Rep Oncol 2020; 13:392-397. [PMID: 32355495 PMCID: PMC7184847 DOI: 10.1159/000506732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 02/20/2020] [Indexed: 11/19/2022] Open
Abstract
We report a rare case of a patient who underwent 3 successful curative operations for the metachronous appearance of pancreatic cancer. In July 2007, a 54-year-old woman underwent pylorus-preserving pancreaticoduodenectomy. In March 2010, a tumor measuring 9 mm in diameter was detected in the tail of the pancreas on computed tomography (CT) and magnetic resonance imaging. The pancreas tail was subsequently resected while preserving the pancreatic body. In February 2011, CT revealed a cystic tumor measuring 2.5 cm in diameter in the remnant pancreatic body without any metastasis; therefore, total resection of the residual pancreas was performed in April 2011. The first resected tumor was histopathologically diagnosed as undifferentiated adenocarcinoma with osteoclast-like giant cells. Additionally, the third resected tumor had similar undifferentiated components. Contrarily, the second resected tumor was diagnosed as a well-differentiated tubular adenocarcinoma. We consider that the tumor from the third operation was an intra-pancreatic metastasis of the primary cancer and that the tumor from the second operation was the second primary cancer. The patient responded well with good control of surgical diabetes for 92 months since the last pancreatectomy. This case suggested that aggressive repeated resection for recurrent pancreatic invasive ductal adenocarcinoma is beneficial in limited cases.
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Affiliation(s)
- Yusuke Miyagawa
- Department of Surgery, Shinshu University School of Medicine, Matsumoto City, Japan
| | - Masato Kitazawa
- Department of Surgery, Shinshu University School of Medicine, Matsumoto City, Japan
| | - Hiroe Kitahara
- Department of Surgery, Showa-Inan General Hospital, Komagane, Japan
| | | | - Takashi Orii
- Department of Surgery, Showa-Inan General Hospital, Komagane, Japan
| | - Yuji Soejima
- Department of Surgery, Shinshu University School of Medicine, Matsumoto City, Japan
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12
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Sugimoto M, Murata M, Yamaoka Y. Chemoprevention of gastric cancer development after Helicobacter pylori eradication therapy in an East Asian population: Meta-analysis. World J Gastroenterol 2020; 26:1820-1840. [PMID: 32351296 PMCID: PMC7183870 DOI: 10.3748/wjg.v26.i15.1820] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 03/05/2020] [Accepted: 03/31/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Helicobacter pylori (H. pylori) infection is a risk factor for gastric cancer (GC), especially in East Asian populations. Most East Asian populations infected with H. pylori are at higher risk for GC than H. pylori-positive European and United States populations. H. pylori eradication therapy reduces gastric cancer risk in patients after endoscopic and operative resection for GC, as well as in non-GC patients with atrophic gastritis.
AIM To clarify the chemopreventive effects of H. pylori eradication therapy in an East Asian population with a high incidence of GC.
METHODS PubMed and the Cochrane library were searched for randomized control trials (RCTs) and cohort studies published in English up to March 2019. Subgroup analyses were conducted with regard to study designs (i.e., RCTs or cohort studies), country where the study was conducted (i.e., Japan, China, and South Korea), and observation periods (i.e., ≤ 5 years and > 5 years). The heterogeneity and publication bias were also measured.
RESULTS For non-GC patients with atrophic gastritis and patients after resection for GC, 4 and 4 RCTs and 12 and 18 cohort studies were included, respectively. In RCTs, the median incidence of GC for the untreated control groups and the treatment groups was 272.7 (180.4–322.4) and 162.3 (72.5–588.2) per 100000 person-years in non-GC cases with atrophic gastritis and 1790.7 (406.5–2941.2) and 1126.2 (678.7–1223.1) per 100000 person-years in cases of after resection for GC. Compared with non-treated H. pylori-positive controls, the eradication groups had a significantly reduced risk of GC, with a relative risk of 0.67 [95% confidence interval (CI): 0.47–0.96] for non-GC patients with atrophic gastritis and 0.51 (0.36–0.73) for patients after resection for GC in the RCTs, and 0.39 (0.30–0.51) for patients with gastritis and 0.54 (0.44–0.67) for patients after resection in cohort studies.
CONCLUSION In the East Asian population with a high risk of GC, H. pylori eradication effectively reduced the risk of GC, irrespective of past history of previous cancer.
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Affiliation(s)
- Mitsushige Sugimoto
- Department of Gastroenterological Endoscopy, Tokyo Medical University Hospital, Sinjuku, Tokyo 1600023, Japan
| | - Masaki Murata
- Department of Gastroenterology, National Hospital Organization Kyoto Medical Center, Kyoto 6128555, Japan
| | - Yoshio Yamaoka
- Department of Gastroenterology, Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu, Oita 8795593, Japan
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13
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Katada C, Yokoyama T, Yano T, Oda I, Shimizu Y, Doyama H, Koike T, Takizawa K, Hirao M, Okada H, Yoshii T, Kubota Y, Yamanouchi T, Tsuda T, Omori T, Kobayashi N, Suzuki H, Tanabe S, Hori K, Nakayama N, Kawakubo H, Kakushima N, Matsuo Y, Ishikawa H, Yokoyama A, Muto M. Association between macrocytosis and metachronous squamous cell carcinoma of the esophagus after endoscopic resection in men with early esophageal squamous cell carcinoma. Esophagus 2020; 17:149-158. [PMID: 31281950 DOI: 10.1007/s10388-019-00685-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 07/03/2019] [Indexed: 02/03/2023]
Abstract
BACKGROUND Macrocytosis is associated with an increased risk of squamous cell carcinoma (SCC) arising in the esophagus in men. The aim of this study was to evaluate the association between macrocytosis and metachronous SCC of the esophagus after endoscopic resection (ER) of early esophageal SCC in men. METHODS The study group comprised 278 men with early esophageal SCC after ER. The main study variables were as follows: (1) cumulative incidence and total number of metachronous SCC of the esophagus according to the presence or absence of macrocytosis (mean corpuscular volume ≥ 106 fl) and (2) predictors of metachronous SCC of the esophagus as assessed with a multivariate Cox proportional-hazards model. RESULTS The median follow-up was 50.3 months. Macrocytosis was associated with a higher 2-year cumulative incidence of metachronous SCC of the esophagus (without macrocytosis vs. with macrocytosis: 11.4% vs. 38.1%, p = 0.002). Macrocytosis was also associated with a higher total number of metachronous SCC of the esophagus per 100 person-years (without macrocytosis vs. with macrocytosis: 7.7 vs. 31.5 per 100 person-years, p < 0.0001). In addition, macrocytosis was a significant predictor of metachronous SCC of the esophagus on multivariate Cox proportional-hazards analysis (relative risk 2.23). CONCLUSION Macrocytosis is a useful predictor of the risk of metachronous SCC of the esophagus after ER of early esophageal SCC in men.
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Affiliation(s)
- Chikatoshi Katada
- Department of Gastroenterology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, 252-0374, Japan.
| | - Tetsuji Yokoyama
- Department of Health Promotion, National Institute of Public Health, 2-3-6 Minami, Wako, Saitama, 351-0197, Japan
| | - Tomonori Yano
- Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, 277-8577, Japan
| | - Ichiro Oda
- Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Yuichi Shimizu
- Department of Gastroenterology, Hokkaido University Graduate School of Medicine, Kita 15 jo Nishi 7 chome, Kitaku, Sapporo, 060-8638, Japan
| | - Hisashi Doyama
- Department of Gastroenterology, Ishikawa Prefectural Central Hospital, 2-1 Kuratsuki-Higashi, Kanazawa, Ishikawa, 920-8530, Japan
| | - Tomoyuki Koike
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Kohei Takizawa
- Division of Endoscopy, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumicho, Suntougun, Shizuoka, 411-8777, Japan
| | - Motohiro Hirao
- Department of Surgery, National Hospital Organization, Osaka National Hospital, 2-1-14 Hoenzaka, Tyuoku, Osaka, 540-0006, Japan
| | - Hiroyuki Okada
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Takako Yoshii
- Department of Gastroenterology, Kanagawa Cancer Center, 2-3-2, Nakao, Asahi-ku, Yokohama, 241-8515, Japan
| | - Yutaro Kubota
- Division of Gastroenterology, Department of Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Takenori Yamanouchi
- Department of Gastroenterology, Kumamoto Regional Medical Center, 5-16-10 Honjyo, Tyuuou, Kumamoto, 860-0811, Japan
| | - Takashi Tsuda
- Department of Clinical Oncology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, 216-8511, Japan
| | - Tai Omori
- Department of Surgery, Kawasaki Municipal Kawasaki Hospital, 12-1 Sinkawa dori, Kawasaki ku, Kawasaki City, Kanagawa, 210-0013, Japan
| | - Nozomu Kobayashi
- Department of Gastroenterology, Tochigi Cancer Center, 4-9-13 Yonan, Utsunomiya, Tochigi, 320-0834, Japan
| | - Haruhisa Suzuki
- Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Satoshi Tanabe
- Research and Development Center for New Frontiers, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, 252-0374, Japan
| | - Keisuke Hori
- Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, 277-8577, Japan
| | - Norisuke Nakayama
- Department of Gastroenterology, Kanagawa Cancer Center, 2-3-2, Nakao, Asahi-ku, Yokohama, 241-8515, Japan
| | - Hirofumi Kawakubo
- Department of Surgery, Kawasaki Municipal Kawasaki Hospital, 12-1 Sinkawa dori, Kawasaki ku, Kawasaki City, Kanagawa, 210-0013, Japan
| | - Naomi Kakushima
- Division of Endoscopy, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumicho, Suntougun, Shizuoka, 411-8777, Japan
| | - Yasumasa Matsuo
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, 216-8511, Japan
| | - Hideki Ishikawa
- Department of Molecular-Targeting Cancer Prevention, Kyoto Prefectural University of Medicine, Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Akira Yokoyama
- Clinical Research Unit, National Hospital Organization Kurihama Medical and Addiction Center, 5-3-1 Nobi, Yokosuka, Kanagawa, 239-0841, Japan
| | - Manabu Muto
- Department of Clinical Oncology, Kyoto University Hospital, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
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14
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Aramin H, Koirala P, Shah A, Adams K, Buza N, Desai S, Fairbairn M, Goldenberg D, Gao W, Chuang L, Vidhun R, Andikyan V. Metachronous vulvar ectopic breast cancer, a case report and literature review. Gynecol Oncol Rep 2019; 30:100515. [PMID: 31867432 PMCID: PMC6890968 DOI: 10.1016/j.gore.2019.100515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 10/28/2019] [Accepted: 11/04/2019] [Indexed: 11/11/2022] Open
Abstract
When two or more primary tumors arise at the same time, they are considered synchronous. A metachronous tumor in a new primary that develops after an initial cancer diagnosis. The diagnosis of vulvar breast cancer is primarily histopathologic, based on morphology and immunostaining. Identifying a cancer as a metastasis versus as synchronous/metachronous significantly impacts staging and treatment.
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Affiliation(s)
- Hermineh Aramin
- Department of Pathology, Danbury Hospital, Western Connecticut Health Network Danbury, CT, USA
| | - Pratistha Koirala
- Department of Obstetrics and Gynecology, Danbury Hospital, Western Connecticut Health Network Danbury, CT, USA
| | - Abhishek Shah
- Department of Pathology, Danbury Hospital, Western Connecticut Health Network Danbury, CT, USA
| | - Kendall Adams
- Department of Obstetrics and Gynecology, Danbury Hospital, Western Connecticut Health Network Danbury, CT, USA
| | - Natalia Buza
- Department of Pathology Yale School of Medicine New Haven, CT, USA
| | - Sapna Desai
- Department of Pathology, Danbury Hospital, Western Connecticut Health Network Danbury, CT, USA
| | - Melissa Fairbairn
- Department of Gynecologic Oncology, Danbury Hospital, Western Connecticut Health Network Danbury, CT, USA
| | - David Goldenberg
- Department of Plastic Reconstructive Surgery, Danbury Hospital, Western Connecticut Health Network Danbury, CT, USA
| | - Wenli Gao
- Department of Oncology, Danbury Hospital, Western Connecticut Health Network Danbury, CT, USA
| | - Linus Chuang
- Department of Obstetrics and Gynecology, Danbury Hospital, Western Connecticut Health Network Danbury, CT, USA.,Department of Gynecologic Oncology, Danbury Hospital, Western Connecticut Health Network Danbury, CT, USA
| | - Ramapriya Vidhun
- Department of Pathology, Danbury Hospital, Western Connecticut Health Network Danbury, CT, USA
| | - Vaagn Andikyan
- Department of Obstetrics and Gynecology, Danbury Hospital, Western Connecticut Health Network Danbury, CT, USA.,Department of Gynecologic Oncology, Danbury Hospital, Western Connecticut Health Network Danbury, CT, USA
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15
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Haremza C, Baert M, Pascual C, Biet-Hornstein A, Page C. Head and neck squamous cell carcinoma and metachronous second primaries. Eur Ann Otorhinolaryngol Head Neck Dis 2019; 136:367-372. [PMID: 31208879 DOI: 10.1016/j.anorl.2019.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To assess the rate of second (or more) primaries after treatment for head and neck squamous cell carcinoma (HNSCC), and survival compared to patients with a single head and neck cancer. MATERIAL AND METHOD A single-center retrospective study was performed in a University Hospital Center in 541 patients between 2002 and 2010. RESULTS One hundred and forty-one patients (26.06%) presented 172 metachronous cancers. Overall 5-year survival was 20.3% with and 38.1% without metachronous cancer. Median and mean survival were respectively 21.9 and 51 months in patients with a single cancer, versus 13.9 and 26.5 months in case of metachronous cancer. Specific survival was comparable to overall survival. All-cause and specific survival were significantly poorer in metachronous cancer (P=0.001; log-rank α=0.05). CONCLUSION At least a quarter of HNSCC patients go on to develop a metachronous second primary. These are of poor prognosis, whatever their location.
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Affiliation(s)
- C Haremza
- ENT and Head & Neck Surgery Department, University Hospital Centre, 80054 Amiens cedex 1, France
| | - M Baert
- ENT and Head & Neck Surgery Department, University Hospital Centre, 80054 Amiens cedex 1, France
| | - C Pascual
- ENT and Head & Neck Surgery Department, University Hospital Centre, 80054 Amiens cedex 1, France
| | - A Biet-Hornstein
- ENT and Head & Neck Surgery Department, University Hospital Centre, 80054 Amiens cedex 1, France
| | - C Page
- ENT and Head & Neck Surgery Department, University Hospital Centre, 80054 Amiens cedex 1, France.
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16
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Kohli PS, Mangal H, Neduvanchery S, Penumadu P. Carcinoma in a Colonic Conduit Post Esophagectomy: a Case Report. Indian J Surg Oncol 2019; 10:406-409. [PMID: 31168274 DOI: 10.1007/s13193-019-00903-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 03/07/2019] [Indexed: 10/27/2022] Open
Abstract
Colon Conduit is a commonly used form of reconstruction post esophagectomy either for malignancy, strictures due to caustic acid ingestion, or other benign conditions. Carcinoma of the Colon Conduit following esophagectomy is a complication with an extremely low incidence and the management options are not clear. Thorough search of literature showed only 16 such cases. Hence, we report a case of a patient who underwent colon conduit reconstruction for a gastroesophageal (GE) junction tumor and developed a recurrence 4 years after the initial surgery.
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17
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Iwatsubo T, Ishihara R, Morishima T, Maekawa A, Nakagawa K, Arao M, Ohmori M, Iwagami H, Matsuno K, Inoue S, Nakahira H, Matsuura N, Shichijo S, Kanesaka T, Yamamoto S, Takeuchi Y, Higashino K, Uedo N, Miyashiro I, Higuchi K, Fujii T. Impact of age at diagnosis of head and neck cancer on incidence of metachronous cancer. BMC Cancer 2019; 19:3. [PMID: 30606157 PMCID: PMC6318848 DOI: 10.1186/s12885-018-5231-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 12/17/2018] [Indexed: 12/18/2022] Open
Abstract
Background Metachronous cancer in patients with head and neck cancer (HNC) is common and is associated with a poor prognosis. We aimed to evaluate the incidence of metachronous cancer at different sites according to age at diagnosis of index HNC. Methods We collected data on 2011 patients with oral cancer, oropharynx cancer, hypopharyngeal cancer, and laryngeal cancer as index cancers using the Osaka International Cancer Institute Cancer Registry database between 2005 and 2016. Among these, we analyzed 1953 patients after excluding 5 patients who were not followed-up and 53 patients with simultaneous multiple index cancers. We evaluated the cumulative incidence of metachronous cancer in the esophagus, lung, and other sites according to age at diagnosis of the index HNC using the Kaplan–Meier method. Multivariate logistic regression analysis was performed to identify factors that influenced the incidence of metachronous cancers following HNC. Results The cumulative incidence of metachronous esophageal cancer in young patients (< 65 years) was significantly higher than that in old patients (≥ 65 years) (12.1% vs 8.5% at 5 years, and 16.5% vs 11.2% at 10 years; p = 0.015). On the other hand, the cumulative incidence of the other cancers in young patients was significantly lower than that in old patients (7.8% vs 12.2% at 5 years, and 13.9% vs 15.3% at 10 years; p = 0.017). The cumulative incidence of lung cancer was not significance according to age at diagnosis of the index HNC. In the multivariate analysis, histological type (squamous cell carcinoma) and lesion location (hypopharynx and larynx) were independently associated with metachronous cancers. Moreover, age at diagnosis of the index HNC (< 65 years), histological type (squamous cell carcinoma) and lesion location (hypopharynx) were significant predictors of metachronous esophageal cancer incidence and lesion location (hypopharynx) was a significant predictor of metachronous lung cancer incidence. Conclusion Risk stratification of metachronous cancers with age and other predictors may help to properly manage patients with HNC. Trial registration The present study is a non-intervention trial.
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Affiliation(s)
- Taro Iwatsubo
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan.,Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Ryu Ishihara
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan.
| | - Toshitaka Morishima
- Department of Cancer Strategy, Osaka International Cancer Institute, Osaka, Japan
| | - Akira Maekawa
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Kentaro Nakagawa
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Masamichi Arao
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Masayasu Ohmori
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Hiroyoshi Iwagami
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Kenshi Matsuno
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Shuntaro Inoue
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Hiroko Nakahira
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Noriko Matsuura
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Satoki Shichijo
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Takashi Kanesaka
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Sachiko Yamamoto
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Yoji Takeuchi
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Koji Higashino
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Noriya Uedo
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Isao Miyashiro
- Department of Cancer Strategy, Osaka International Cancer Institute, Osaka, Japan
| | - Kazuhide Higuchi
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Takashi Fujii
- Department of Head and Neck Surgery, Osaka International Cancer Institute, Osaka, Japan
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18
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Lindberg LJ, Ladelund S, Bernstein I, Therkildsen C, Nilbert M. Risk of Synchronous and Metachronous Colorectal Cancer: Population-Based Estimates in Denmark with Focus on Non-Hereditary Cases Diagnosed After Age 50. Scand J Surg 2018; 108:152-158. [PMID: 30196753 DOI: 10.1177/1457496918798212] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS The risk of synchronous and metachronous colorectal cancer is influenced by heritable and environmental factors. As a basis for comparative studies, we provide population-based estimates of synchronous and metachronous colorectal cancer with a focus on non-heritable cases. MATERIAL AND METHODS Based on data from national Danish cancer registers, we estimated the proportion of synchronous colorectal cancer and the incidence rates and risks for metachronous colorectal cancer in 28,504 individuals, who developed 577 metachronous colorectal cancer above age 50. RESULTS Synchronous colorectal cancer was diagnosed in 1.3% of the cases. The risk of metachronous colorectal cancer was associated with sex, tumor location, and age with the strongest influence from the latter. The incidence rate ratios for metachronous colorectal cancer ranged from above 6 in patients below age 65 to <1-3.2 in patients above age 65. The absolute risk of metachronous colorectal cancer was ⩾10% in patients below age 65 and 1.0%-8.0% in patients above age 65. CONCLUSION Individuals who develop sporadic, non-inherited colorectal cancer above age 50 are at a significantly increased risk of metachronous colorectal cancer with risk estimates that are strongly affected by age. This observation underscores the need for development of targeted surveillance in the most common clinical subset of colorectal cancer.
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Affiliation(s)
- L J Lindberg
- 1 HNPCC Register, Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark
| | - S Ladelund
- 1 HNPCC Register, Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark
| | - I Bernstein
- 2 Department of Gastroenterology, Aalborg University Hospital, Aalborg, Denmark
| | - C Therkildsen
- 1 HNPCC Register, Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark
| | - M Nilbert
- 1 HNPCC Register, Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark.,3 Division of Oncology and Pathology, Department of Clinical Sciences, Lund University, Lund, Sweden.,4 Danish Cancer Society Research Center, Copenhagen, Denmark
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Yoshikawa T, Abe T, Amano H, Hanada K, Minami T, Kobayashi T, Yonehara S, Nakahara M, Ohdan H, Noriyuki T. Metachronous triple cancer associated with Peutz-Jeghers syndrome treated with curative surgery: a case report. Surg Case Rep 2018; 4:84. [PMID: 30069736 PMCID: PMC6070452 DOI: 10.1186/s40792-018-0492-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 07/23/2018] [Indexed: 12/17/2022] Open
Abstract
Background Peutz–Jeghers syndrome (PJS) is an autosomal dominant disorder characterized by mucocutaneous pigmentation and hamartomatous gastrointestinal polyposis. It is well known that individuals with PJS are at an increased risk of cancer in a variety of organs. Case presentation Here, we present a patient with PJS who achieved long-term survival by undergoing repeat curative surgery for metachronous triple cancer. Her medical history included hilar cholangiocarcinoma and cervical carcinoma; curative surgery was performed for both conditions. On annual follow-up, the level of carcinoembryonic antigen was elevated at 6.9 ng/ml. Enhanced computed tomography revealed a cystic tumor consisting of mural nodules at the pancreatic head; the maximal diameter was 15 mm. Magnetic resonance imaging clearly demonstrated the tumor with low intensity on T1-weighted images and high intensity on T2-weighted images. Endoscopic ultrasound sonography showed a high echoic tumor at the pancreatic head, which was confirmed as adenocarcinoma by fine-needle aspiration biopsy. The preoperative diagnosis was intraductal papillary mucinous carcinoma (IPMC; T1N0M0, stage IA). Subtotal stomach-preserving pancreaticoduodenectomy was performed and the final diagnosis was IPMC, stage 0 (TisN0M0). Conclusions Aggressive surgery for metachronous triple cancer resulted in good long-term prognosis. Continuous and systematic follow-up would allow the detection of malignancy at an early stage and make treatment with curative surgery possible.
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Affiliation(s)
- Toru Yoshikawa
- Department of Surgery, Onomichi General Hospital, 1-10-23, Onomichi, Hiroshima, 722-8508, Japan
| | - Tomoyuki Abe
- Department of Surgery, Onomichi General Hospital, 1-10-23, Onomichi, Hiroshima, 722-8508, Japan.
| | - Hironobu Amano
- Department of Surgery, Onomichi General Hospital, 1-10-23, Onomichi, Hiroshima, 722-8508, Japan.,Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Keiji Hanada
- Department of Gastroenterology, Onomichi General Hospital, Onomichi, Hiroshima, Japan
| | - Tomoyuki Minami
- Department of Gastroenterology, Onomichi General Hospital, Onomichi, Hiroshima, Japan
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shuji Yonehara
- Department of Pathology, Onomichi General Hospital, Onomichi, Hiroshima, Japan
| | - Masahiro Nakahara
- Department of Surgery, Onomichi General Hospital, 1-10-23, Onomichi, Hiroshima, 722-8508, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Toshio Noriyuki
- Department of Surgery, Onomichi General Hospital, 1-10-23, Onomichi, Hiroshima, 722-8508, Japan.,Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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20
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Sharma N, Thiek JL, Rituparna D, Mishra J, Singh AS. Metachronous Cancer of Breast and Adenocarcinoma of Cervix: A Rare Case Report. J Menopausal Med 2017; 23:131-134. [PMID: 28951862 PMCID: PMC5606911 DOI: 10.6118/jmm.2017.23.2.131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 06/23/2017] [Accepted: 07/22/2017] [Indexed: 11/05/2022] Open
Abstract
The occurrence of a second primary cancer in a cancer survivor is well documented. It may be synchronous or metachronous. Incidence of metachronous cancer involving cervix is 0.82% to 1.33%. One such metachronous cancer is that of breast and cervix. We present a case of a woman who received tamoxifen for invasive ductal cancer of breast following a modified radical mastectomy and subsequently developed adenocarcinoma of cervix after six month of tamoxifen therapy. The role of tamoxifen in pathogenesis of cervical cancer and that of human papillomavirus infection in pathogenesis of both cancer of cervix and breast cancer has been well recognized. In our patient, the adenocarcinoma of cervix (rare occurrence) which is likely due to six month of tamoxifen therapy is a perplexing question. Women diagnosed and treated for breast cancer need to be followed up for development of other metachronous gynecological cancers.
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Affiliation(s)
- Nalini Sharma
- Department of Obstetrics and Gynecology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
| | - J Lalnunnem Thiek
- Department of Obstetrics and Gynecology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
| | - Das Rituparna
- Department of Obstetrics and Gynecology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
| | - Jaya Mishra
- Department of Pathology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
| | - Ahanthem Santa Singh
- Department of Obstetrics and Gynecology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
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21
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Nagami Y, Ominami M, Shiba M, Minamino H, Fukunaga S, Kameda N, Sugimori S, Machida H, Tanigawa T, Yamagami H, Watanabe T, Tominaga K, Fujiwara Y, Arakawa T. The five-year survival rate after endoscopic submucosal dissection for superficial esophageal squamous cell neoplasia. Dig Liver Dis 2017; 49:427-33. [PMID: 28096057 DOI: 10.1016/j.dld.2016.12.009] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 12/04/2016] [Accepted: 12/09/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Endoscopic submucosal dissection (ESD) is a widely accepted procedure for superficial esophageal squamous cell neoplasia (ESCN) because of a high complete resection rate. However, there were a few reports about the long-term outcomes of these patients due to short follow-up periods. AIMS We aimed to evaluate the 5-year survival after ESD for superficial ESCN. METHODS This was a retrospective cohort study performed at a single institution. Between 2006 and 2009, 94 patients with superficial ESCN underwent ESD. Eighty-three patients (93.3%) who had completed an extended period of observation of at least 5 years were enrolled. The main outcomes were the 5-year survival rates. The secondary outcomes were the cumulative incidence rate of metachronous ESCN, and the clinical outcomes. RESULTS The 5-year relative overall survival rate was 99.0%, whereas the cause specific survival rate was 100% during 72.9 months of median follow up period. Subgroup analysis showed that the 5year survival of patients with EP/LPM and MM/SM1 (submucosal invasion ≤200μm) were 100% and 89.0%, respectively. The cumulative incidence rate of metachronous ESCN at 5 years was 16.8%. CONCLUSION ESD for superficial ESCN is a curative treatment with a favorable 5-year survival rate.
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Rzechonek A, Błasiak P, Muszczyńska-Bernhard B, Pawełczyk K, Pniewski G, Ornat M, Grzegrzółka J, Brzecka A. Metachronous Lung Cancer: Clinical Characteristics and Effects of Surgical Treatment. Adv Exp Med Biol 2018; 1039:9-17. [PMID: 28795361 DOI: 10.1007/5584_2017_82] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The occurrence of a second lung tumor after surgical removal of lung cancer usually indicates a lung cancer metastasis, but sometimes a new lesion proves to be a new primary lung cancer, i.e., metachronous lung cancer. The goal of the present study was to conduct a clinical evaluation of patients with metachronous lung cancer and lung cancer metastasis, and to compare the early and distant outcomes of surgical treatment in both cancer types. There were 26 age-matched patients with lung cancer metastases and 23 patients with metachronous lung cancers, who underwent a second lung cancer resection. We evaluated the histological type of a resected cancer, the extent of thoracosurgery, the frequency of early postoperative complications, and the probability of 5-year survival after the second operation. The findings were that metachronous lung cancer was adenocarcinoma in 52% of patients, with a different histopathological pattern from that of the primary lung cancer in 74% of patients. In both cancer groups, mechanical resections were the most common surgery type (76% of all cases), with anatomical resections such as segmentectomy, lobectomy, or pneumectomy being much rarer conducted. The incidence of early postoperative complications in metachronous lung cancer and lung cancer metastasis (30% vs. 31%, respectively) and the probability of 5-year survival after resection of either cancer tumor (60.7% vs. 50.9%, respectively) were comparable. In conclusion, patients undergoing primary lung cancer surgery require a long-term follow-up due to the risk of metastatic or metachronous lung cancer. The likelihood of metachronous lung cancer and pulmonary lung cancer metastases, the incidence of postoperative complications, and the probability of 5-year survival after resection of metachronous lung cancer or lung cancer metastasis are similar.
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23
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Arjunan R, Kumar D, Kumar KVV, Premlatha CS. Breast Cancer with Synchronous Renal Cell Carcinoma: A Rare Presentation. J Clin Diagn Res 2016; 10:XD03-XD05. [PMID: 27891445 DOI: 10.7860/jcdr/2016/20362.8683] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 07/08/2016] [Indexed: 01/30/2023]
Abstract
Primary cancer arising from multiple organs is a well known fact. Synchronous tumours have been most commonly associated with kidney cancer. Bladder, prostate, colorectal and lung cancer are the most common synchronous primaries with Renal Cell Carcinoma (RCC) identified till date. We found metachronous tumours of breast with RCC in literature search which included both metastatic tumours as well second primaries. Overall, 25 cases of metastatic breast tumours and eight cases of second primary in previously treated RCC have been reported in the literature. Here, we are reporting a case of synchronous presentation of carcinoma breast with RCC which is very rare because most of the multiple malignancies reported in the literature are metastatic tumours or metachronous breast malignancy with RCC.
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Affiliation(s)
- Ravi Arjunan
- Associate Professor, Department of Surgical Oncology, Kidwai Memlorial Institute of Oncology , Bangalore, Karnataka, India
| | - Durgesh Kumar
- Senior Resident, Department of Surgical Oncology, Kidwai Memlorial Institute of Oncology , Bangalore, Karnataka, India
| | - K V Veerendra Kumar
- Professor, Department of Surgical Oncology, Kidwai Memlorial Institute of Oncology , Bangalore, Karnataka, India
| | - C S Premlatha
- Associate Professor, Department of Pathology, Kidwai Memlorial Institute of Oncology , Bangalore, Karnataka, India
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24
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Roth RM, Haraldsdottir S, Hampel H, Arnold CA, Frankel WL. Discordant Mismatch Repair Protein Immunoreactivity in Lynch Syndrome-Associated Neoplasms: A Recommendation for Screening Synchronous/Metachronous Neoplasms. Am J Clin Pathol 2016; 146:50-6. [PMID: 27357288 DOI: 10.1093/ajcp/aqw067] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES Lynch syndrome (LS) predisposes individuals to developing synchronous and metachronous LS-associated neoplasms (LSANs). Mismatch repair protein (MMRP) immunohistochemistry (IHC) is widely used to identify LS, but its utility in patients with synchronous/metachronous lesions has not been studied. We studied MMRP IHC in patients with LS with more than one LSAN to provide screening recommendations in patients with synchronous/metachronous neoplasms. METHODS All patients with LS diagnosed at The Ohio State University Wexner Medical Center from 2009 through 2014 with more than one LSAN and available tumor tissue for immunostaining were identified. Tumors were stained for MLH1, MSH2, MSH6, and PMS-2 proteins, and immunoreactivity was scored as intact or lost. RESULTS Thirteen patients with LS with 29 synchronous and/or metachronous primary LSANs were identified. Neoplasms involved large and small intestine (n = 19), ampulla (n = 1), endometrium (n = 1), and skin (sebaceous neoplasms, n = 8). Nine (69%) of 13 patients showed concordant MMRP results in all tumors, and four (31%) showed discordant MMRP results. CONCLUSIONS LS diagnosis could have been missed in 31% of the study cases if only the LSAN exhibiting intact MMRP expression was screened. Accordingly, our findings support the recommendation to perform LS screening in all primary, synchronous, and metachronous intestinal and endometrial cancers if a previous tumor screened intact.
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25
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Kochi M, Shimomura M, Hinoi T, Niitsu H, Yano T, Mukai S, Sawada H, Miguchi M, Saito Y, Adachi T, Ishizaki Y, Egi H, Ohdan H. Total colectomy for multiple metachronous colon cancers in a patient with Lynch syndrome. Surg Case Rep 2015; 1:78. [PMID: 26380806 PMCID: PMC4564456 DOI: 10.1186/s40792-015-0081-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 09/01/2015] [Indexed: 10/25/2022] Open
Abstract
Lynch syndrome (LS) is a disorder caused by mismatch repair gene mutations, which have been recognized to be associated with an increased frequency of colorectal and extracolorectal tumors. However, it remains controversial as to whether total or segmental colectomy should be performed to treat colorectal cancer in patients with LS. A 58-year-old male underwent total colectomy with ileostomy for advanced transverse colon cancer. He was also found to have LS based on his characteristic family history and the findings of a preoperative examination, including a microsatellite instability analysis of past multiple metachronous cancers. The postoperative histological findings showed mucinous adenocarcinoma without lymph node metastasis, and the loss of the MSH2 protein expression was confirmed on an immunohistochemical examination. The present case provided important information on the clinical management of multiple developing metachronous colorectal cancers in patients with LS.
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Affiliation(s)
- Masatoshi Kochi
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551 Japan
| | - Manabu Shimomura
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551 Japan
| | - Takao Hinoi
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551 Japan
| | - Hiroaki Niitsu
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551 Japan
| | - Takuya Yano
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551 Japan
| | - Shoichiro Mukai
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551 Japan
| | - Hiroyuki Sawada
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551 Japan
| | - Masashi Miguchi
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551 Japan
| | - Yasufumi Saito
- Department of surgery, Hiroshima General Hospital of West Japan Railway Company, 3-1-36 Futabanosato, Higashi-ku, Hiroshima, 732-0057 Japan
| | - Tomohiro Adachi
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551 Japan
| | - Yasuyo Ishizaki
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551 Japan
| | - Hiroyuki Egi
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551 Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551 Japan
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Shirahige A, Suzuki H, Oda I, Sekiguchi M, Mori G, Abe S, Nonaka S, Yoshinaga S, Sekine S, Kushima R, Saito Y, Fukagawa T, Katai H. Fatal submucosal invasive gastric adenosquamous carcinoma detected at surveillance after gastric endoscopic submucosal dissection. World J Gastroenterol 2015; 21:4385-4390. [PMID: 25892891 PMCID: PMC4394102 DOI: 10.3748/wjg.v21.i14.4385] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 11/28/2014] [Accepted: 01/30/2015] [Indexed: 02/06/2023] Open
Abstract
An 80-year-old man was under annual surveillance esophagogastroduodenoscopy after endoscopic submucosal dissection (ESD) for early gastric cancer (EGC). Two years after the initial ESD, a 0-IIc type metachronous EGC lesion, 8 mm in size, without an ulcer scar, was found in the gastric antrum. The estimated tumor depth was up to the mucosa, and biopsy revealed well and poorly differentiated adenocarcinoma. ESD was performed for this lesion and en bloc resection with negative margins was achieved. Histopathological examination revealed an adenosquamous carcinoma 8 mm in size invading the deep submucosal layer (1600 μm), with lymphovascular invasion, consistent with the diagnosis of non-curative resection. Additional gastrectomy was recommended for this patient; however, two months after the ESD, preoperative computed tomography revealed multiple liver metastases, and the patient was considered as an unsuitable candidate for surgical resection. Systemic chemotherapy was therefore started; however, the patient died of gastric cancer 27 mo after the second ESD. Early gastric adenosquamous carcinoma localized to the mucosa and submucosa is extremely rare and its clinical behavior is not well known. The present report is very significant in that it underscores the distinct possibility of gastric adenosquamous carcinoma being very aggressive and fatal even when detected at an early cancer.
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MESH Headings
- Adenocarcinoma/pathology
- Adenocarcinoma/surgery
- Aged, 80 and over
- Biomarkers, Tumor/analysis
- Biopsy
- Carcinoma, Adenosquamous/chemistry
- Carcinoma, Adenosquamous/pathology
- Carcinoma, Adenosquamous/secondary
- Carcinoma, Adenosquamous/surgery
- Chemotherapy, Adjuvant
- Dissection/methods
- Early Detection of Cancer
- Endoscopy, Digestive System
- Fatal Outcome
- Gastrectomy/methods
- Gastric Mucosa/chemistry
- Gastric Mucosa/pathology
- Gastric Mucosa/surgery
- Humans
- Immunohistochemistry
- Liver Neoplasms/secondary
- Male
- Neoplasm Invasiveness
- Neoplasms, Second Primary/chemistry
- Neoplasms, Second Primary/pathology
- Reoperation
- Stomach Neoplasms/chemistry
- Stomach Neoplasms/pathology
- Stomach Neoplasms/surgery
- Time Factors
- Tomography, X-Ray Computed
- Treatment Outcome
- Tumor Burden
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Nakano T, Sakurai T, Maruyama S, Ozawa Y, Kamei T, Miyata G, Ohuchi N. Indocyanine green fluorescence and three-dimensional imaging of right gastroepiploic artery in gastric tube cancer. World J Gastroenterol 2015; 21:369-372. [PMID: 25574113 PMCID: PMC4284357 DOI: 10.3748/wjg.v21.i1.369] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 06/19/2014] [Accepted: 07/16/2014] [Indexed: 02/06/2023] Open
Abstract
A 79-year-old male was admitted to our hospital for the treatment of cancer of the gastric tube. Gastrointestinal examination revealed a T1b Union for International Cancer Control (UICC) tumor at the pyloric region of the gastric tube. Laparotomy did not reveal infiltration into the serosa, peritoneal dissemination, regional lymph node swelling, or distant metastasis. We performed a distal gastrectomy preserving the right gastroepiploic artery by referencing the preoperative three-dimensional computed tomoangiography. We also evaluated the blood flow of the right gastroepiploic artery and in the proximal gastric tube by using indocyanine green fluorescence imaging intra-operatively and then followed with a gastrojejunal anastomosis with Roux-en-Y reconstruction. The definitive diagnosis was moderately differentiated adenocarcinoma of the gastric tube, pT1bN0M0, pStage IA (UICC). His postoperative course was uneventful. Three-dimensional computed tomographic imaging is effective for assessing the course of blood vessels and the relationship with the surrounding structures. Intraoperative evaluation of blood flow of the right gastroepiploic artery and of the gastric tube in the anastomotic portion is very valuable information and could contribute to a safe gastrointestinal reconstruction.
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Jang JY, Chun HJ. Efficacy of Helicobacter pylori eradication for the prevention of metachronous gastric cancer after endoscopic resection for early gastric cancer. World J Gastroenterol 2014; 20:2760-2764. [PMID: 24659868 PMCID: PMC3961962 DOI: 10.3748/wjg.v20.i11.2760] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Revised: 11/09/2013] [Accepted: 11/29/2013] [Indexed: 02/06/2023] Open
Abstract
Helicobacter pylori (H. pylori) plays an important role in gastric carcinogenesis, as the majority of gastric cancers develop from H. pylori-infected gastric mucosa. The rate of early gastric cancer diagnosis has increased in Japan and Korea, where H. pylori infection and gastric cancer are highly prevalent. Early intestinal-type gastric cancer without concomitant lymph node metastasis is usually treated by endoscopic resection. Secondary metachronous gastric cancers often develop because atrophic mucosa left untreated after endoscopic treatment confers a high risk of gastric cancer. The efficacy of H. pylori eradication for the prevention of metachronous gastric cancer remains controversial. However, in patients who undergo endoscopic resection of early gastric cancer, H. pylori eradication is recommended to suppress or delay metachronous gastric cancer. Careful and regularly scheduled endoscopy should be performed to detect minute metachronous gastric cancer after endoscopic resection.
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Lu HI, Li SH, Huang WT, Rau KM, Fang FM, Wang YM, Lin WC, Tien WY. A comparative study of isolated and metachronous oesophageal squamous cell carcinoma with antecedent upper aerodigestive tract cancer. Eur J Cardiothorac Surg 2013; 44:860-5. [PMID: 23471149 DOI: 10.1093/ejcts/ezt112] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Metachronous oesophageal squamous cell carcinoma (OSCC) has been increasing in long-term survivors of upper aerodigestive tract (UADT) cancers in recent years, but the treatment of such cases is not well established. The aim of this study was to compare the prognosis between patients with metachronous OSCC who had antecedent UADT cancers and patients with isolated OSCC. METHODS From January 1995 to December 2009, we retrospectively compared the data from 84 patients with metachronous OSCC who had antecedent UADT cancers (metachronous group) with the data from 527 patients with isolated OSCC (isolated group) according to their treatment modalities at Kaohsiung Chang Gung Memorial Hospital. RESULTS Overall, the metachronous group had significantly (P = 0.03) worse overall survival than the isolated group. For patients receiving surgery or preoperative chemoradiotherapy followed by surgery, the overall survival rates and incidence of postoperative complications were not significantly different. For patients receiving definite chemoradiotherapy or radiotherapy alone, the metachronous group had significantly (P = 0.02) inferior overall survival compared with the isolated group. CONCLUSIONS Offering a radical approach for the treatment of patients with metachronous OSCC who had antecedent UADT cancers is justifiable, with survival rates similar to those of patients with isolated OSCC.
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Affiliation(s)
- Hung-I Lu
- Department of Thoracic and Cardiovascular Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
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Fukuchi M, Sakurai S, Tsukagoshi R, Suzuki M, Yamauchi H, Tabe Y, Fukasawa T, Kiriyama S, Naitoh H, Kuwano H. Eleven metachronous early gastric cancers in an elderly woman. Clin J Gastroenterol 2012; 5:367-71. [PMID: 26181077 DOI: 10.1007/s12328-012-0331-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2012] [Accepted: 08/26/2012] [Indexed: 11/29/2022]
Abstract
We report on a patient with 11 metachronous multiple early gastric cancers treated by gastrectomy after endoscopic resection. An 87-year-old Japanese woman was admitted to our hospital for treatment of four synchronous multiple early gastric cancers detected by endoscopic examination. The patient had a history of two endoscopic treatments for four metachronous early gastric cancers. The pathological findings of four lesions resected by endoscopic resection and four biopsy specimens showed well-differentiated carcinoma. In March 2012, we performed a distal gastrectomy for four lesions. The surgical specimen revealed 3 minute lesions after surgery in addition to these four lesions. Histologically, all seven lesions were intramucosal well-differentiated adenocarcinomas without vascular invasion. Although the incidence of synchronous and metachronous early gastric cancer is reportedly 11-14.5 % and 8.5-14 %, respectively, only two or three lesions are generally present. Moreover, multiple early gastric cancers usually originate as differentiated adenocarcinoma in male elderly patients with intestinal metaplasia. In the present case, there were multiple early gastric cancers, whose origin may be correlated with the background of intestinal metaplasia, in excess of the number generally expected.
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Affiliation(s)
- Minoru Fukuchi
- Department of Surgery, Social Insurance Gunma Chuo General Hospital, 1-7-13, Kouun-cho, Maebashi, Gunma, 371-0025, Japan.
| | - Shinji Sakurai
- Department of Diagnostic Pathology, Social Insurance Gunma Chuo General Hospital, 1-7-13, Kouun-cho, 371-0025, Maebashi, Gunma, Japan
| | - Ritsuko Tsukagoshi
- Department of Surgery, Social Insurance Gunma Chuo General Hospital, 1-7-13, Kouun-cho, Maebashi, Gunma, 371-0025, Japan
| | - Masaki Suzuki
- Department of Surgery, Social Insurance Gunma Chuo General Hospital, 1-7-13, Kouun-cho, Maebashi, Gunma, 371-0025, Japan
| | - Hayato Yamauchi
- Department of Surgery, Social Insurance Gunma Chuo General Hospital, 1-7-13, Kouun-cho, Maebashi, Gunma, 371-0025, Japan
| | - Yuichi Tabe
- Department of Surgery, Social Insurance Gunma Chuo General Hospital, 1-7-13, Kouun-cho, Maebashi, Gunma, 371-0025, Japan
| | - Takaharu Fukasawa
- Department of Surgery, Social Insurance Gunma Chuo General Hospital, 1-7-13, Kouun-cho, Maebashi, Gunma, 371-0025, Japan
| | - Shinsuke Kiriyama
- Department of Surgery, Social Insurance Gunma Chuo General Hospital, 1-7-13, Kouun-cho, Maebashi, Gunma, 371-0025, Japan
| | - Hiroshi Naitoh
- Department of Surgery, Social Insurance Gunma Chuo General Hospital, 1-7-13, Kouun-cho, Maebashi, Gunma, 371-0025, Japan
| | - Hiroyuki Kuwano
- Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22, Showa-machi, 371-8511, Maebashi, Gunma, Japan
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Ikematsu Y, Tamura H, Hayashi T, Tokunaga Y, Misawa Y, Mori H, Hasegawa S, Okawada T, Ozawa T, Momiki S, Nishiwaki Y. Metachronous double cancer after curative resection for pancreatic adenocarcinoma: report of four cases. Clin J Gastroenterol 2012; 5:108-12. [PMID: 26182152 DOI: 10.1007/s12328-011-0280-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Accepted: 11/25/2011] [Indexed: 01/11/2023]
Abstract
We experienced four cases of metachronous double cancer after curative resection for pancreatic adenocarcinoma without the background of intraductal papillary mucinous neoplasm. Case 1, a 67-year-old Japanese female developed tongue cancer 53 months after a pylorus-preserving Whipple resection for pancreatic head adenocarcinoma. Case 2, a 66-year-old female developed multiple breast cancers 52 months after a pylorus-preserving pancreaticoduodenectomy for pancreatic head adenocarcinoma. Case 3, a 59-year-old male developed an adenocarcinoma in the remnant pancreatic head 63 months after a distal pancreatectomy for pancreatic body cancer. Case 4, a 68-year-old male developed lung cancer 92 months after a Whipple procedure for pancreatic head adenocarcinoma. Gemcitabine was administered to three patients as adjuvant chemotherapy at an average administrated dose of 38,199 mg per body surface area. Since primary pancreatic ductal adenocarcinoma is aggressive and always associated with a devastating outcome, metachronous double cancer is scarcely seen. All four cases received curative-intent surgery for each metachronous cancer and were alive for at least 20 months.
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Xia CF, Li Q, Li YF, Pan DG, Feng R. Metachronous multiple primary colon cancer with primary adenocarcinoma of the jejunum: a report of one case. Shijie Huaren Xiaohua Zazhi 2010; 18:2062-2063. [DOI: 10.11569/wcjd.v18.i19.2062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Metachronous multiple primary colon cancer is defined as two or more newly developed cancers occurring at least 6 months after the initial colon cancer in different parts of the colon. Here, we reported a patient who developed primary colon cancers of the transverse colon, ascending colon, sigmoid colon and descending colon, and adenocarcinoma of the jejunum successively in 20 years. All cancers were subjected to surgical resection and postoperative chemotherapy. The patient had a good outcome and long-term postoperative survival, which is rarely seen in patients with such disease.
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