Clinicopathologic variables and outcomes in elderly colorectal cancer patients with microsatellite instability and multiple primary malignancies.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e15516-e15516
Author(s):  
Suleyman Yasin Goksu ◽  
Mohammad Faizan Zahid ◽  
Muhammet Ozer ◽  
Nina Niu Sanford ◽  
Aravind Sanjeevaiah ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Microsatellite Instability ◽  
Female Gender ◽  
Primary Malignancy ◽  
Chi Square ◽  
White Ethnicity ◽  
Multiple Primary Malignancies ◽  
Multiple Neoplasms ◽  
Multiple Primary ◽  
Hispanic White

e15516 Background: The biology of microsatellite instability-high (MSI-H) in elderly colorectal cancer (CRC) patients is attributed to hypermethylation of promoter region of genes coding for mismatch repair proteins. It is unknown if such patients are predisposed to other malignancies. It is also unknown if the presence or absence of multiple primary malignancies affects elderly MSI-H CRC patients' survival. We aimed to evaluate the clinicopathologic features and outcomes in elderly CRC patients with MSI-H and multiple primary malignancies. Methods: We analyzed the National Cancer Database and included elderly (≥ 65 years) patients with CRC diagnosed between 2010-2016. MSI status was determined using genetic and immunohistochemical testing and categorized as microsatellite stable (MSS) and MSI-H. We further categorized the population into single primary malignancy versus multiple primary malignancies. We compared the baseline characteristics using the Chi-square test. Kaplan-Meier and log-rank tests were performed to calculate the overall survival (OS). Results: Among 52,494 elderly CRC patients, 78.0% were MSS, and 22.0% were MSI-H. The probability of MSI-H disease increased with increasing age, female gender, and non-Hispanic White ethnicity (all p < .001). MSI-H patients were associated with elevated CEA, wild-type KRAS, multiple neoplasms, right-sided tumors, stage II disease, and grade III/IV histology. The proportion of patients with multiple primary malignancies was higher in the MSI-H population versus MSS (36% vs. 31%, p < 0.001). The rate of multiple primary malignancies increased with age in both groups. Among MSI-H CRC patients, the factors associated with multiple primary malignancies included female gender (61.6%), non-Hispanic White ethnicity (86.3%), comorbidity index ≥ 2 (14.8%), and right-sided tumors (77.2%). Multiple primary malignancies were more frequently associated with stage I-III CRC as compared to metastatic CRC. For stage III-IV elderly MSI-H patients, the utilization of chemotherapy was 57.8% overall, but it was not significantly different between single primary malignancy versus multiple primary malignancies groups. MSI-H patients with single primary malignancy had the highest OS, followed by MSS patients with single primary malignancy, MSI-H patients with multiple primary malignancies, and MSS patients with multiple primary malignancies (74.7, 66.7, 58.1, 54.8 mos, respectively) (log-rank p < 0.001). Conclusions: Elderly CRC patients with MSI-H had a higher rate of multiple primary malignancies than MSS. This was associated with female gender, non-Hispanic White ethnicity, and right-sided tumor. MSI-H patients with single primary malignancy had the highest survival while the presence of multiple primary malignancies adversely affected survival in both MSI-H and MSS populations.

scholarly journals Multiple primary cancers: An enigma

2016 ◽  
Vol 05 (01) ◽  
pp. 29-32 ◽  
Author(s):  
Amitabh Jena ◽  
Rashmi Patnayak ◽  
Amancharla Yadagiri Lakshmi ◽  
Banoth Manilal ◽  
Mandyam Kumaraswamy Reddy
Keyword(s):  
Cancer Patients ◽  
Surgical Oncology ◽  
Diagnostic Techniques ◽  
Multiple Primary Cancers ◽  
Primary Malignancy ◽  
Term Survival ◽  
Multiple Primary Malignancies ◽  
Multiple Primary ◽  
Synchronous Malignancies ◽  
Age Range

Abstract Background: Incidence of multiple primary cancers though uncommon, is being frequently reported now-a-days owing to better diagnostic techniques, the prolonged life span and the increased incidence of long-term survival of cancer patients. Materials and Methods: This is a retrospective study. Cases of multiple malignancies diagnosed histopathologically were retrieved from the archives of department of surgical oncology. Clinical data were obtained from the medical records. They were categorized as synchronous malignancies if the interval between them was less or equal to 6 months and metachronous, if the interval was more than 6 months. Results: A total of 13 cases were encountered in the 5 year study period. Out of them two were in the metachronous category and the rest were synchronous as the 2nd malignancy was detected mostly during clinical evaluation of the patients for the primary malignancy. There was female predominance with age range being 43-68 years. Majority of the cases were in the 7th decade. The most common organ involved was breast, followed by cervix. Apart from bilateral breast malignancies, there were combinations like breast with uterine endometrial carcinoma, cervical carcinoma and even papillary thyroid carcinoma. Conclusion: Detection of multiple primary malignancies is becoming increasingly common in day-to-day practice. Greater awareness of this is required among both cancer patients and their treating clinicians.

scholarly journals Immunosuppression and Multiple Primary Malignancies in Kidney-Transplanted Patients: A Single-Institute Study

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Michele L. Santangelo ◽  
Carmen Criscitiello ◽  
Andrea Renda ◽  
Stefano Federico ◽  
Giuseppe Curigliano ◽  
...  
Keyword(s):  
Second Primary ◽  
Second Primary Malignancy ◽  
Primary Malignancy ◽  
Predisposing Factor ◽  
Multiple Cancers ◽  
Multiple Primary Malignancies ◽  
Multiple Primary ◽  
Second Tumor ◽  
Tumor Types

Immunodeficiency is associated with higher cancer incidence. However, it is unknown whether there is a link between immunodeficiency and development of multiple primary malignancies. In the present study we analyse this link focusing on kidney-transplanted patients, as they are at higher risk of developing cancer due to the chronic assumption of immunosuppressants. We followed up 1200 patients who underwent kidney transplantation between 1980 and 2012. A total of 77/1200 kidney-transplanted patients developed cancer and 24 of them developed multiple cancers. Most multiple cancers were synchronous with a nonsignificant association between cancer and rejection episodes. In the general cancer population, one-ninth of patients are at higher risk of developing a second tumor over a lifetime; hence it would be reasonable to conclude that, from a merely theoretical and statistical viewpoint, long-term transplanted patients potentially have a higher risk of developing MPMs. However, data did not confirm this assumption, probably because these patients die before a second primary malignancy appears. Despite many observations on the increased incidence of different tumor types in immunodeficient patients and despite immunosuppression certainly being a predisposing factor for the multicancer syndrome, data so far are not robust enough to justify a correlation between immunodeficiency and multiple primary malignancies in transplanted patients.

Multiple primary malignancies involving colorectal cancer—clinical characteristics and prognosis with reference to surveillance

2009 ◽  
Vol 395 (4) ◽  
pp. 359-364 ◽  
Author(s):  
Won-Suk Lee ◽  
Jung Nam Lee ◽  
Sangtae Choi ◽  
Min Jung ◽  
Jeong-Heum Baek ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Clinical Characteristics ◽  
Multiple Primary Malignancies ◽  
Multiple Primary

scholarly journals Microsatellite Instability assessment in Black South African Colorectal Cancer patients reveal an increased incidence of suspected Lynch syndrome

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
M. McCabe ◽  
Y. Perner ◽  
R. Magobo ◽  
P. Magangane ◽  
S. Mirza ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Lynch Syndrome ◽  
Microsatellite Instability ◽  
Mutational Analysis ◽  
Statistical Tests ◽  
Biological Information ◽  
Protein Loss ◽  
Braf Mutations ◽  
Chi Square ◽  
Black South African

Abstract Microsatellite Instability (MSI) is a hallmark of colorectal cancer (CRC) and occurs in 15–16% of CRC. Molecular biological information of CRC in South Africa (SA) is largely unrecorded. This study was undertaken to determine the frequency of MSI, with particular reference to Lynch syndrome (LS) with a view to improve surveillance and prevention strategies. This was a retrospective study on CRC samples diagnosed between 2011–2015 at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH). Samples diagnosed between 2011–2012 were screened for MSI by PCR and mismatch repair (MMR) immunohistochemistry (IHC), and additional BRAFV600E mutational analysis performed. T-tests, Fischer’s exact and Chi square statistical tests were applied. Twelve percent of patients displayed MSI, with increased frequency in black (15%) versus other ethnic group (OEG) (8%) patients. MSI patients were significantly younger than microsatellite stable (MSS) patients, however when stratified by ethnicity, black patients were predominantly younger (median age: 47), with increased MSH2/6 loss, and no BRAF mutations. These findings suggest a large proportion of young black SA CRC patients develop via the LS pathway due to earlier age onset and predominant MSH2/6 protein loss. SA patients of other ethnicities appear to follow the more well established sporadic MSI pathway.

Clinicopathologic and Pedigree Differences in Amsterdam I–Positive Hereditary Nonpolyposis Colorectal Cancer Families According to Tumor Microsatellite Instability Status

2007 ◽  
Vol 25 (7) ◽  
pp. 781-786 ◽  
Author(s):  
Laura Valle ◽  
Jose Perea ◽  
Pablo Carbonell ◽  
Victoria Fernandez ◽  
Ana M. Dotor ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Protein Expression ◽  
Microsatellite Instability ◽  
Mismatch Repair ◽  
Hereditary Nonpolyposis Colorectal Cancer ◽  
Repair System ◽  
Primary Tumors ◽  
Multiple Primary Tumors ◽  
Hereditary Nonpolyposis ◽  
Multiple Primary

Purpose To establish the clinicopathologic and familial differences within Amsterdam I–positive families, showing either tumor microsatellite instability (MSI) or microsatellite stability (MSS) in order to confirm or deny the existence of hereditary nonpolyposis colorectal cancer (HNPCC) without defects in the mismatch repair system. Patients and Methods Sixty-four Amsterdam I–positive families were included in the study for which full, three-generation, family medical histories and colorectal paraffin-embedded tumors were obtained. Both personal and clinicopathologic information of patients were collected. In all cases, both the MSI status and the mismatch repair (MMR) protein expression were analyzed. MMR genetic testing was performed on the MSI families. Results Of the Amsterdam I–positive families, 59.4% were tumor MSI, and 40.6% were tumor MSS. When comparing both groups, the statistical differences were observed in the age of onset (MSI, 41 years; MSS, 53 years); in the colorectal tumor location, more frequently proximal in MSI cases; in fewer mucinous tumors in MSS; and loss of MMR protein expression in the MSI tumors. Regarding the individual and familial cancer history, we observed a predominance of individuals with multiple primary tumors in MSI pedigrees, as well as differences in the type of tumors developed within the family. Conclusion Our findings support the suspicion of another hereditary colorectal syndrome different from HNPCC and characterized by MSS, the normal MMR immunohistochemical expression, the presence of only colorectal tumors, and the absence of individuals with multiple primary tumors. All these circumstances suggest the existence of a non-MMR gene being responsible for this new syndrome.

scholarly journals Pacific Islander Organization’s Approach towards Increasing Community Colorectal Cancer Knowledge and Beliefs

2013 ◽  
Vol 11 (2) ◽  
pp. 12-20 ◽  
Author(s):  
Roger Sur ◽  
Ruth Peters ◽  
Leah Leilani Beck ◽  
Melevesi Fifita ◽  
Maria Gonzalez ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Knowledge Score ◽  
Female Gender ◽  
Positive Change ◽  
Cancer Knowledge ◽  
Chi Square ◽  
Logistic Regression Models ◽  
Crc Screening ◽  
Knowledge And Beliefs ◽  
Post Test

Purpose: Evaluate the educational intervention and determine if changes in knowledge and beliefs are associated with positive intentions to screen among Pacific Islanders (PIs). Design: Pre- and post-test surveys were utilized to evaluate the intervention. Educational materials included an in-language presentation, educational videos, and bookmarks with screening re-enforcement messages for communitybased PI groups. Methods: One hundred and ninety-six PIs aged 50 years and older residing in Orange County completed the educational workshop. The dependent variable is intention and the independent variables are demographic, enabling, and predisposing characteristics. Statistical analyses included paired samples t-tests, chi-square tests, and two logistic regression models. Results: Knowledge and belief scores increased pre- to post-test. A majority intended to (1) talk to a doctor about colorectal cancer (CRC) screening (74.5%), and (2) participate in CRC screening (73.5%). Positive change in knowledge score was a significant predictor for intending to talk to a doctor about CRC screening; female gender and positive change in knowledge score were significant predictors for intending to participate in screening. Conclusion: The study highlighted the effectiveness of tailored education in addressing cultural and linguistic needs of the community. Moreover, it demonstrated the education’s potential for moving participants with limited CRC screening knowledge to intend to screen.

Prolonged survival with maintenance pemetrexed for a multiple primary malignancy

2018 ◽  
Vol 9 (1) ◽  
pp. 51-53
Author(s):  
Md Shuayb ◽  
Md Salim Reza
Keyword(s):  
Case Reports ◽  
Colon Adenocarcinoma ◽  
Stage Iv ◽  
Primary Malignancy ◽  
Metastatic Recurrence ◽  
Multiple Primary Malignancies ◽  
Multiple Primary ◽  
Chemotherapy Protocol ◽  
Therapeutic Protocols

Despite the fact that multiple primary malignancies (MPMs) are not new and have been diagnosed for about a hundred-year time, literatures on lung and colon primaries are scarce. We report a case of a 62-year-old Asian Bangladeshi man with stage IV lung adenocarcinoma who developed a metachronous stage II colon adenocarcinoma approximately 3 years later. A chemotherapy protocol of six cycles of pemetrexed/cisplatin followed by maintenance pemetrexed was used, and surgery was done for the colon primary. With more than 5 years of periodic follow-up, his disease remains stable without any local or metastatic recurrence. Definitive therapeutic protocols are unavailable, but information taken with caution from case reports may be of importance for treatment decisions of MPMs. We believe that management with careful judgement by a multidisciplinary team may result in a good outcome with longer survival.

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