Clinical features and survival of patients with multiple primary malignancies

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.

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Clinical Features and Surgical Treatment of Synchronous Multiple Primary Lung Adenocarcinomas With Different EGFR Mutations

Frontiers in Oncology ◽

10.3389/fonc.2021.785777 ◽

2022 ◽

Vol 11 ◽

Author(s):

Rirong Qu ◽

Fan Ye ◽

Dehao Tu ◽

Yixin Cai ◽

Xiangning Fu

Keyword(s):

Clinical Features ◽

Mutation Rate ◽

Surgical Outcomes ◽

Clinical Characteristics ◽

Egfr Mutations ◽

Driver Gene ◽

Invasive Adenocarcinoma ◽

Significant Difference ◽

Multiple Primary ◽

Lung Adenocarcinomas

BackgroundWith the popularity of lung cancer screening and advances in imaging technology, more and more synchronous multiple primary lung adenocarcinomas (SMPLA) are being diagnosed clinically, however, the clinical characteristics and prognosis of SMPLA with different EGFR mutations remains unclear. We aimed to explore clinical features and surgical outcomes of these patients to aid in the diagnosis and treatment of SMPLA.MethodsMedical records of patients with different EGFR mutations who have been diagnosed as SMPLA and underwent surgical resection from March 2015 to December 2019 were retrospectively analyzed. Clinical characteristics, surgical outcomes, recurrence-free survival (RFS) and overall survival (OS) were investigated.ResultsA total of 70 patients (68.6% female and 77.1% non-somkers) were included. Total of 161 lesions in all patients, 84.4% were ground-glass opacity (GGO) lesions. EGFR mutations were detected in 108 lesions, most of which were L858R (35.4%) and 19Del (20.5%). The mutation rate of mixed GGO is significantly higher than that of pure GGO and solid nodules (SN); the mutation rate of invasive adenocarcinoma is significantly higher than that of other histology subtypes; the mutation rate of lesions >20 mm was significantly higher than that of ≤20 mm. However, there is no significant difference in the mutation rate of specific driver gene between different radiological features, pathological characteristics and sizes. After a median follow-up time of 29 months, the 3-year OS and RFS were 94.4% and 86.0%, respectively.ConclusionsA high discordance of EGFR mutations were identified between tumors in patients with SMPLA. Synchronous multiple lung adenocarcinomas with predominantly multiple GGO should be considered as SMPLA, and surgery may be aggressively performed for these patients due to a good prognosis.

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High-Tech radiotherapy for primary prostate cancers and synchronous other tumor in elderly

Journal of Clinical Images and Medical Case Reports ◽

10.52768/2766-7820/1157 ◽

2021 ◽

Vol 2 (3) ◽

Author(s):

Alessia Surgo ◽

◽

Ilaria Bonaparte ◽

Fabiana Gregucci ◽

Roberta Carbonara ◽

...

Keyword(s):

Elderly Patients ◽

Seminal Vesicles ◽

High Tech ◽

Multiple Primary Malignancies ◽

Primary Prostate Cancer ◽

Multiple Primary ◽

Synchronous Cancers ◽

Prostate Cancers ◽

Radio Chemotherapy

Aims: To report feasibility and efficacy of high-tech Radiotherapy (RT) for the treatment of synchronous Multiple Primary Malignancies (sMPM) for elderly patients with primary Prostate Cancer (PC). Methods: Two elderly patients with PC and synchronous Anal Cancer (AC) and sacrum chordoma, respectively, were described. The first one was treated with radical radio-chemotherapy. A total dose of 70 Gy / 65.5 Gy (28 fractions) was prescribed to prostate/ seminal vesicles, and concomitantly, 56 Gy / 50.4 Gy / 45 Gy were prescribed to tumor, anal canal/mesorectum/pelvic nodes, and inguinal nodes, respectively. For the second case, after resection of chordoma, adjuvant and prostate radical RT (65.5 Gy / 70 Gy) in 28 fractions were used. In both cases, Volumetric-Arc RT was performed. Results: Patients completed the planned treatment without severe toxicities. After a median follow-up of 12 months, no sign of PC and a controlled/reduction of chordoma/AC were observed. Conclusion: High-tech RT is safe and effective for sMPM elderly patients. Keywords: Synchronous cancers; Elderly; Treatment; Radiotherapy; Multidisciplinary evaluation.

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