Objective： To evaluate the clinical course of patients with small cell lung cancer （SCLC） as second primary malignancy. Methods： Among the 355 patients diagnosed with SCLC at Helen and Harry Gray Cancer Center of ...Objective： To evaluate the clinical course of patients with small cell lung cancer （SCLC） as second primary malignancy. Methods： Among the 355 patients diagnosed with SCLC at Helen and Harry Gray Cancer Center of Hartford Hospital Connecticut USA between 1988 and 1998, the records of 48 patients, which had been diagnosed with other malignancies before their diagnosis of SCLC, were retro- spectively reviewed. Results： Forty-eight patients （13.5%） were diagnosed with other malignancies prior to their SCLC among which 43 had documented smoking history and 93% of them （40/43） were current/former smokers. Of the 28-second primary SCLC patients who were treated with standard method, 11 （39.3%） achieved CR. 12 （42.8%） achieved PR, and the RR was 82.1%. The median survival of the 28 treated with standard method was 11.3 months （5.1-77.7 months）, while that of the rest 19 untreated patients （1 of 20 was lost to follow-up） was only 2.0 months （0.5 34.0 months）. There was no significant difference in the median survival and RR between 165 treated first primary SCLC （13.5 months and 77.6% respectively） and 28 treated secondary primary SCLC （11.3 months and 82.1% respectively） （P〉0.05）. The patients who had prostate cancer were older and subjected to less treatments than those with skin cancer, so their survival was shorter than the latter （3.5 months vs. 15 months, P〈0.05）. Conclusion： The response and survival of the treated patients with SCLC as a second malignancy showed no difference as compared to the treated ones with SCLC only. Therefore, an active medical treatment is important to relieve symptom and prolong survival of the second primary SCLC patients.展开更多
Testicular cancer survival rates improved dramatically after cisplatin-based therapy was introduced in the 1970s. However, chemotherapy and radiation therapy are potentially carcinogenic. The purpose of this study was...Testicular cancer survival rates improved dramatically after cisplatin-based therapy was introduced in the 1970s. However, chemotherapy and radiation therapy are potentially carcinogenic. The purpose of this study was to estimate the risk of developing second primary cancers including the risk associated with primary histologic type （seminoma and non-seminoma） among testicular cancer survivors in Germany. We identified 16 990 and 1401 cases of testicular cancer in population-based cancer registries of East Germany （1961-1989 and 1996-2008） and Saarland （a federal state in West Germany; 1970-2008）, respectively. We estimated the risk of a second primary cancer using standardized incidence ratios （SIRs） with 95% confidence intervals （95% Cls）. To determine trends, we plotted model-based estimated annual SIRs. In East Germany, a total of 301 second primary cancers of any location were observed between 1961 and 1989 （SIR： 1.9; 95% Ch 1.7-2.1）, and 159 cancers （any location） were observed between 1996 and 2008 （SIR： 1.7; 95% Ch 1.4-2.0）. The SIRs for contralateral testicular cancer were increased in the registries with a range from 6.0 in Saarland to 13.9 in East Germany. The SIR for seminoma, in particular, was higher in East Germany compared to the other registries. We observed constant trends in the model-based SIRs for contralateral testicular cancers. The majority of reported SIRs of other cancer sites including histology-specific risks showed low precisions of estimated effects, likely due to small sample sizes. Testicular cancer patients are at increased risk especially for cancers of the contralateral testis and should receive intensive follow-ups.展开更多
Niigata University Hospital is a regional center institution of cancer therapy where many patients with gastrointestinal stromal tumors （GISTs） are visiting to seek the latest treatment.During the time Ⅰ was treati...Niigata University Hospital is a regional center institution of cancer therapy where many patients with gastrointestinal stromal tumors （GISTs） are visiting to seek the latest treatment.During the time Ⅰ was treating GIST patients there with imatinib,a tyrosine kinase inhibitor,a small concern was raised：Ⅰ successively encountered patients who were newly diagnosed as having malignant neoplasms during the course of their treatment.Of the 70 GIST patients who were enrolled in our prospective study of imatinib therapy,seven suffered from second primary malignancies （SPMs）.One female GIST patient who suffered from advanced esophageal cancer died of the SPM,whereas the remaining six patients continued with their imatinib therapy and their prognoses were not affected by their SPMs.I reported on the risk of SPMs in GIST patients under imatinib therapy to an international journal of clinical oncology （1）.As the patient cohort of our study was so small in number to apply to statistical analysis,our observation was no more than a clinical alert.展开更多
AIM： To identify a cost-effective strategy of second primary colorectal cancer （CRC） screening for cancer survivors in Korea using a decision-analytic model. METHODS： A Markov model estimated the clinical and econ...AIM： To identify a cost-effective strategy of second primary colorectal cancer （CRC） screening for cancer survivors in Korea using a decision-analytic model. METHODS： A Markov model estimated the clinical and economic consequences of a simulated 50-year- old male cancer survivors＇ cohort, and we compared the results of eight screening strategies： no screening, fecal occult blood test （FOBT） annually, FOBT every 2 years, sigmoidoscopy every 5 years, double contrast barium enema every 5 years, and colonoscopy every 10 years （COL10）, every 5 years （COL5）, and every 3 years （COL3）. We included only direct medical costs, and our main outcome measures were discounted lifetime costs, life expectancy, and incremental cost- effectiveness ratio （ICER）. RESULTS： In the base-case analysis, the non-dominat- ed strategies in cancer survivors were COL5, and COL3. The ICER for COL3 in cancer survivors was $5593/life- year saved （LYS）, and did not exceed $10000/LYS in one-way sensitivity analyses. If the risk of CRC in can- cer survivors is at least two times higher than that in the general population, COL5 had an ICER of less than $10500/LYS among both good and poor prognosis of index cancer. If the age of cancer survivors starting CRC screening was decreased to 40 years, the ICER of COL5 was tess than $7400/LYS regardless of screening compliance. CONCLUSION： Our study suggests that more strict and frequent recommendations for colonoscopy such as COL5 and COL3 could be considered as economically reasonable second primary CRC screening strategies for Korean male cancer survivors.展开更多
Gastrointestinal stromal tumor （GIST） is the most common mesenchymal malignancy of the gastrointestinal tract.GISTs may coexist with different types of cancer,either synchronous or metachronous （1）.Most GISTs deve...Gastrointestinal stromal tumor （GIST） is the most common mesenchymal malignancy of the gastrointestinal tract.GISTs may coexist with different types of cancer,either synchronous or metachronous （1）.Most GISTs develop in a sporadic fashion,but familial occurrence,such as neurofibromatosis and Carney-triad,has also been reported （2）.The overall frequency of second tumors in different series varied from 4.5% to 33%.The most frequent types of GIST-associated cancers were gastrointestinal carcinomas （47%）,lymphoma/leukemia （7%）,carcinomas of prostate （9%）,breast （7%）,kidney （6%）,lung （5%）,female genital tract （5%）,carcinoid tumors （3%）,soft tissue and bone sarcomas （3%）,malignant melanoma （2%） and seminoma （1%） （1,3-5）.展开更多
Dear Editor,In patients with early-stage non-small cell lung cancer(NSCLC),the risk of post-surgical recurrence(REC)is 20%–50%,[1]and the risk of developing a second primary lung cancer(2P)is 3–4 times higher than i...Dear Editor,In patients with early-stage non-small cell lung cancer(NSCLC),the risk of post-surgical recurrence(REC)is 20%–50%,[1]and the risk of developing a second primary lung cancer(2P)is 3–4 times higher than in the general population[2].Distinguishing between REC and 2P can be challenging,complicating treatment of these so called“equivocal”(EQU)cases.展开更多
Background:Patients with hematological malignancies face an increased risk of developing second primary neoplasms due to various factors,including immune system compromise and chemotherapy-related effects.However,the ...Background:Patients with hematological malignancies face an increased risk of developing second primary neoplasms due to various factors,including immune system compromise and chemotherapy-related effects.However,the incidence and associated risk factors in older patients remain poorly understood.This study aimed to assess the incidence,identify risk factors,and evaluate their impact on survival outcomes among older patients with hematological malignancies.Methods:This retrospective single-center study analyzed data from 163 patients,focusing on the occurrence of second primary neoplasms.Cumulative incidence rates were calculated,and risk factor analysis was conducted using a competing risk model.Results:Among 124 eligible patients with a total follow-up duration of 572.57 person-years,the incidence rate of second primary neoplasms was 15.72/1000 person-years.The standardized incidence ratio(SIR)was 0.81(95%confidence interval[CI][0.39–1.48],P=0.518).History of radiotherapy emerged as a significant risk factor(subdistribution hazard ratio[SHR]=21.61[2.81–166.14],P=0.003),whereas regular natural killer(NK)cell infusion was associated with reduced risk(SHR=3.25 e8[9.81 e9–1.08 e7],P<0.001).Conclusions:These findings underscore the importance of informing older patients with hematological malignancies about the long-term risks of second primary neoplasms.Healthcare providers should carefully weigh risk factors when formulating treatment strategies.The results are valuable for investigating the fundamental principles underlying the occurrence and progression of second primary neoplasms.展开更多
Background:Previous studies have revealed that the number of cancer survivors developing a second primary malignancy is increasing,especially among thyroid cancer patients,and lung cancer is still the main cause of ca...Background:Previous studies have revealed that the number of cancer survivors developing a second primary malignancy is increasing,especially among thyroid cancer patients,and lung cancer is still the main cause of cancer death.Therefore,we aimed to investigate the risk of second primary lung cancer(SPLC)in patients with thyroid cancer.Methods:We searched the PubMed,Web of Science,Embase,and Scopus databases up to November 24,2021,for relevant research and merged the standardized incidence ratios(SIRs)and 95%confidence intervals(95%CIs)to evaluate the risk of developing SPLC in patients with thyroid cancer.Results:Fourteen studies involving 1,480,816 cases were included in our meta-analysis.The pooled result demonstrated that thyroid cancer patients may have a higher risk of SPLC than the general population(SIR=1.21,95%CI:1.07-1.36,P<0.01,I^(2)=81%,P<0.01).Subgroup analysis stratified by sex indicated that female patients may have a markedly higher risk of SPLC than male patients(SIR=1.65,95%CI:1.40-1.94,P<0.01,I^(2)=75%,P<0.01).Conclusions:Thyroid cancer patients are more likely to develop SPLC than the general population,especially women.However,other risk factors must be investigated,and more prospective studies are needed to confirm our results.Registration:International Prospective Register of Systematic Reviews:No.CRD42021285399.展开更多
Primary carcinoma of breast is common but breast is a rare site of metastasis and metastases from extramammary sites are even rarer.Metastasis to breast from rectal carcinoma is very unusual and till now 19 cases of b...Primary carcinoma of breast is common but breast is a rare site of metastasis and metastases from extramammary sites are even rarer.Metastasis to breast from rectal carcinoma is very unusual and till now 19 cases of breast secondaries from colorectal carcinoma have been reported in literature which include 14 cases where the primary site was colon and remaining 5 were from the rectum.Here the authors report a case of adenocarcinoma anorectum who had completed treatment and after 4 months developed a lump in her left breast which was metastatic.Metastatic lesions of breast are usually part of a widely disseminated disease but this case presented as a solitary breast metastasis which mimicked as second primary cancer of the breast.展开更多
Background:Secondary acute lymphoblastic leukemia(sALL)is rare in patients diagnosed with antecedent multiple myeloma(MM).This study aimed to elucidate the clinical features and outcomes of patients with sALL after MM...Background:Secondary acute lymphoblastic leukemia(sALL)is rare in patients diagnosed with antecedent multiple myeloma(MM).This study aimed to elucidate the clinical features and outcomes of patients with sALL after MM.Methods:We conducted this population-based study using the Surveillance,Epidemiology,and End Results(SEER)database and retrospectively reviewed patients with sALL following MM treatment at our institution.Cox regression analysis was performed to investigate the prognostic factors for survival in patients with sALL.Results:We identified 64,629 cases of MM(including 18 sALL from the SEER Plus 9 database,and three sALL from our institution).Younger patients with MM and those who received chemotherapy were at a higher risk of developing sALL.The novel agent era witnessed an increased incidence of sALL(post-novel agent era vs.pre-novel agent era:0.31%[10/32,640]vs.0.25%[8/31,989])and shorter latency time(post-novel agent era vs.pre-novel agent era[median]:51.5 vs.74.5 months,P=0.516),though the difference was not significant.The median age at sALL onset was 65(range:47-78)years.Significant cytopenia and absence of BCR/ABL fusion genes were common features in this patient population.The treatment of sALL is complicated by old age and poor performance status.The median survival of patients with sALL is 18 months,whereas those who received chemotherapy had significantlyprolonged survival Conclusions:Patients with sALL combined with an antecedent MM,especially those with long-term exposure to immunomodulatory agents such as thalidomide or lenalidomide,should be cautiously evaluated and managed with a comprehensive approach.展开更多
Chronic lymphocytic leukaemia(CLL)has one of the strongest familial risks of all cancers,as evidenced by the eight-fold increased risk seen in relatives of CLL patients,yet much of the heritable risk remains unexplain...Chronic lymphocytic leukaemia(CLL)has one of the strongest familial risks of all cancers,as evidenced by the eight-fold increased risk seen in relatives of CLL patients,yet much of the heritable risk remains unexplained[1].Patients with CLL also have a high rate of secondary cancer,i.e.,the development of second primary malignancy,compared to the general population,which may be explained by immune dysregulation due to CLL and/or its treatment,but also by environmental and genetic risk factors[2].The development of second cancer in patients with CLL contributes to higher morbidity in these patients[2].As the population of long-term CLL survivors expands due to novel agents used in therapy,the identification of patients with risk of developing the second cancer may help to improve longevity of CLL patients.展开更多
To determine the gastric adenocarcinoma (GAC) occurrence rate and related factors, we evaluated the follow-up results of patients confirmed to have gastric dysplasia after endoscopic resection (ER). METHODSWe retrospe...To determine the gastric adenocarcinoma (GAC) occurrence rate and related factors, we evaluated the follow-up results of patients confirmed to have gastric dysplasia after endoscopic resection (ER). METHODSWe retrospectively analyzed the medical records, endoscopic examination records, endoscopic procedure records, and histological records of 667 cases from 641 patients who were followed-up for at least 12 mo, from among 1273 patients who were conformed to have gastric dysplasia after Endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) of gastric mucosal lesions between January 2007 and August 2013 at the Chungnam National University Hospital. RESULTSThe mean follow-up period was 33.8 mo, and the median follow-up period was 29 mo (range: 12-87). During the follow-up period, the occurrence of metachronous GAC was 4.0% (27/667). The mean and median interval periods between the occurrence of metachronous GAC and endoscopic treatment of gastric dysplasia were 36.3 and 34 mo, respectively (range: 16-71). The factors related to metachronous GAC occurrence after ER for gastric dysplasia were male sex (5.3% vs 1.0%), open-type atrophic gastritis (9.5% vs 3.4%), intestinal metaplasia (6.8% vs 2.4%), and high-grade dysplasia (HGD; 8.4% vs 3.2%). Among them, male sex [OR: 5.05 (1.18-21.68), P = 0.029], intestinal metaplasia [OR: 2.78 (1.24-6.23), P = 0.013], and HGD [OR: 2.70 (1.16-6.26), P = 0.021] were independent related factors in multivariate analysis. Furthermore, 24 of 27 GAC cases (88.9%) occurred at sites other than the previous resection sites, and 3 (11.1%) occurred at the same site as the previous resection site. CONCLUSIONMale sex, intestinal metaplasia, and HGD were significantly related to the occurrence of metachronous GAC after ER of gastric dysplasia, and most GACs occurred at sites other than the previous resection sites.展开更多
BACKGROUND Epidermal growth factor receptor tyrosine kinase inhibitors(EGFR-TKIs)are tolerable drugs used for patients with EGFR-mutant advanced non-small cell lung cancer(NSCLC).Serious adverse reactions are uncommon...BACKGROUND Epidermal growth factor receptor tyrosine kinase inhibitors(EGFR-TKIs)are tolerable drugs used for patients with EGFR-mutant advanced non-small cell lung cancer(NSCLC).Serious adverse reactions are uncommon compared with cytotoxic drugs.CASE SUMMARY A 52-year-old man presented with general weakness and cytopenia.He had been taking erlotinib for 11 mo to treat NSCLC.The pathological diagnosis from the right upper lobe mass was adenocarcinoma with an EGFR mutation in exon 21(L858R).He had previously received paclitaxel/carboplatin,gemcitabin/vinorelbine chemotherapy,stereotactic radiosurgery for brain metastasis,and whole-brain radiotherapy as treatment for NSCLC.We diagnosed the patient with acute myeloid leukemia(AML).During the induction and consolidation chemotherapy for AML,the erlotinib was discontinued.When complete remission of the AML was achieved,since the lung masses were increased,pemetrexed/cisplatin for the NSCLC was initiated.After two cycles of chemotherapy,the cytopenia was prolonged.AML relapse occurred with the same karyotype.CONCLUSION Therapy-related acute myeloid neoplasm(t-MN)is a rare but fatal late complication.Although a patient may be taking EGFR-TKIs,the possibility of t-MN should be considered.Further studies are needed to determine whether EGFR-TKI usage is a predisposing factor for t-MN.展开更多
Cancers of the head and neck account for more than half a million cases worldwide annually, with a significant majority diagnosed as squamous cell carcinoma(HNSCC). Imaging studies such as contrast-enhanced computed t...Cancers of the head and neck account for more than half a million cases worldwide annually, with a significant majority diagnosed as squamous cell carcinoma(HNSCC). Imaging studies such as contrast-enhanced computed tomography(CT), magnetic resonance imaging(MRI) and ^(18)F-2-fluoro-2-deoxy-D-glucose positron-emission tomography/computed tomography(^(18)F-FDG PET/CT) are widely used to determine the presence and extent of tumors and metastatic disease, both before and after treatment. Advances in PET/CT imaging have allowed it to emerge as a superior imaging modality compared to both CT and MRI, especially in detection of carcinoma of unknown primary, cervical lymph node metastasis, distant metastasis, residual/recurrent cancer and second primary tumors, often leading to alteration in management. PET/CT biomarker may further provide an overall assessment of tumor aggressiveness with prognostic implications. As new developments emerged leading to better understanding and use of PET/CT in head and neck oncology, the aim of this article is to review the roles of PET/CT in both pre- and post-treatment management of HNSCC and PET-derived parameters as prognostic indicators.展开更多
Triterpenoid saponins are metabolites produced in most plant species through complex biosynthetic pathways. They play important roles to humans owing to their diverse medicinal effects, including antiinflammatory, ant...Triterpenoid saponins are metabolites produced in most plant species through complex biosynthetic pathways. They play important roles to humans owing to their diverse medicinal effects, including antiinflammatory, antimicrobial, and anticancer activities. In our laboratory, the author have been investigating the anticancer activities of a mixture of triterpenoid saponins （designated GpMix） extracted from a medicinal plant, known as Jiao Gu Lan （Gynostemma pentaphyllum, 胶股蓝 ） or southern ginseng in China. The key findings are summed up as following.展开更多
Semiparasitic plants, mistletoes, distributed in Europe and East-Asia mainly, China, Korea and Japan have long been recognised as therapeutic herbs. Since the 1920s, extracts from European mistletoe （Viscum album L）...Semiparasitic plants, mistletoes, distributed in Europe and East-Asia mainly, China, Korea and Japan have long been recognised as therapeutic herbs. Since the 1920s, extracts from European mistletoe （Viscum album L） have been popular in Europe as an unconventional cancer treatment. These extracts have been used in adjuvant cancer therapy because their immunostimulatory, cytostatic/cytotoxic and DNA stabilising activities. The main biological activities are addressed to sugar binding proteins, the Mistletoe Lectins, and to micro proteins named viscotoxins. The mistletoe lectins are members of the family of toxic lectins and recognize sugars and glycoconjugates containing galactose and/or N-acetyl-galactosamine groups. In vitro and in vivo assays confirm that the mistletoe lectins, isolated from the plant and compared with recombinant forms, play an important role as biologically active principles in mistletoe extracts. Limited experimental evidence indicates that other components like glycosides, polysaccharides, amines etc, may also have anticancer activity. Under discussion in Europe is the principal question of using holo plant extracts or single component lectin preparations： wild type lectins or recombinant ones in cancer therapy. Finally problems of preparation, characterization and standardization of commercial mistletoe preparations and evaluation of biological activities are discussed.展开更多
文摘Objective： To evaluate the clinical course of patients with small cell lung cancer （SCLC） as second primary malignancy. Methods： Among the 355 patients diagnosed with SCLC at Helen and Harry Gray Cancer Center of Hartford Hospital Connecticut USA between 1988 and 1998, the records of 48 patients, which had been diagnosed with other malignancies before their diagnosis of SCLC, were retro- spectively reviewed. Results： Forty-eight patients （13.5%） were diagnosed with other malignancies prior to their SCLC among which 43 had documented smoking history and 93% of them （40/43） were current/former smokers. Of the 28-second primary SCLC patients who were treated with standard method, 11 （39.3%） achieved CR. 12 （42.8%） achieved PR, and the RR was 82.1%. The median survival of the 28 treated with standard method was 11.3 months （5.1-77.7 months）, while that of the rest 19 untreated patients （1 of 20 was lost to follow-up） was only 2.0 months （0.5 34.0 months）. There was no significant difference in the median survival and RR between 165 treated first primary SCLC （13.5 months and 77.6% respectively） and 28 treated secondary primary SCLC （11.3 months and 82.1% respectively） （P〉0.05）. The patients who had prostate cancer were older and subjected to less treatments than those with skin cancer, so their survival was shorter than the latter （3.5 months vs. 15 months, P〈0.05）. Conclusion： The response and survival of the treated patients with SCLC as a second malignancy showed no difference as compared to the treated ones with SCLC only. Therefore, an active medical treatment is important to relieve symptom and prolong survival of the second primary SCLC patients.
文摘Testicular cancer survival rates improved dramatically after cisplatin-based therapy was introduced in the 1970s. However, chemotherapy and radiation therapy are potentially carcinogenic. The purpose of this study was to estimate the risk of developing second primary cancers including the risk associated with primary histologic type （seminoma and non-seminoma） among testicular cancer survivors in Germany. We identified 16 990 and 1401 cases of testicular cancer in population-based cancer registries of East Germany （1961-1989 and 1996-2008） and Saarland （a federal state in West Germany; 1970-2008）, respectively. We estimated the risk of a second primary cancer using standardized incidence ratios （SIRs） with 95% confidence intervals （95% Cls）. To determine trends, we plotted model-based estimated annual SIRs. In East Germany, a total of 301 second primary cancers of any location were observed between 1961 and 1989 （SIR： 1.9; 95% Ch 1.7-2.1）, and 159 cancers （any location） were observed between 1996 and 2008 （SIR： 1.7; 95% Ch 1.4-2.0）. The SIRs for contralateral testicular cancer were increased in the registries with a range from 6.0 in Saarland to 13.9 in East Germany. The SIR for seminoma, in particular, was higher in East Germany compared to the other registries. We observed constant trends in the model-based SIRs for contralateral testicular cancers. The majority of reported SIRs of other cancer sites including histology-specific risks showed low precisions of estimated effects, likely due to small sample sizes. Testicular cancer patients are at increased risk especially for cancers of the contralateral testis and should receive intensive follow-ups.
文摘Niigata University Hospital is a regional center institution of cancer therapy where many patients with gastrointestinal stromal tumors （GISTs） are visiting to seek the latest treatment.During the time Ⅰ was treating GIST patients there with imatinib,a tyrosine kinase inhibitor,a small concern was raised：Ⅰ successively encountered patients who were newly diagnosed as having malignant neoplasms during the course of their treatment.Of the 70 GIST patients who were enrolled in our prospective study of imatinib therapy,seven suffered from second primary malignancies （SPMs）.One female GIST patient who suffered from advanced esophageal cancer died of the SPM,whereas the remaining six patients continued with their imatinib therapy and their prognoses were not affected by their SPMs.I reported on the risk of SPMs in GIST patients under imatinib therapy to an international journal of clinical oncology （1）.As the patient cohort of our study was so small in number to apply to statistical analysis,our observation was no more than a clinical alert.
基金Supported by Takemi Program in International Health at Harvard School of Public Health and by National Cancer Center Grant,No.07104221
文摘AIM： To identify a cost-effective strategy of second primary colorectal cancer （CRC） screening for cancer survivors in Korea using a decision-analytic model. METHODS： A Markov model estimated the clinical and economic consequences of a simulated 50-year- old male cancer survivors＇ cohort, and we compared the results of eight screening strategies： no screening, fecal occult blood test （FOBT） annually, FOBT every 2 years, sigmoidoscopy every 5 years, double contrast barium enema every 5 years, and colonoscopy every 10 years （COL10）, every 5 years （COL5）, and every 3 years （COL3）. We included only direct medical costs, and our main outcome measures were discounted lifetime costs, life expectancy, and incremental cost- effectiveness ratio （ICER）. RESULTS： In the base-case analysis, the non-dominat- ed strategies in cancer survivors were COL5, and COL3. The ICER for COL3 in cancer survivors was $5593/life- year saved （LYS）, and did not exceed $10000/LYS in one-way sensitivity analyses. If the risk of CRC in can- cer survivors is at least two times higher than that in the general population, COL5 had an ICER of less than $10500/LYS among both good and poor prognosis of index cancer. If the age of cancer survivors starting CRC screening was decreased to 40 years, the ICER of COL5 was tess than $7400/LYS regardless of screening compliance. CONCLUSION： Our study suggests that more strict and frequent recommendations for colonoscopy such as COL5 and COL3 could be considered as economically reasonable second primary CRC screening strategies for Korean male cancer survivors.
文摘Gastrointestinal stromal tumor （GIST） is the most common mesenchymal malignancy of the gastrointestinal tract.GISTs may coexist with different types of cancer,either synchronous or metachronous （1）.Most GISTs develop in a sporadic fashion,but familial occurrence,such as neurofibromatosis and Carney-triad,has also been reported （2）.The overall frequency of second tumors in different series varied from 4.5% to 33%.The most frequent types of GIST-associated cancers were gastrointestinal carcinomas （47%）,lymphoma/leukemia （7%）,carcinomas of prostate （9%）,breast （7%）,kidney （6%）,lung （5%）,female genital tract （5%）,carcinoid tumors （3%）,soft tissue and bone sarcomas （3%）,malignant melanoma （2%） and seminoma （1%） （1,3-5）.
基金supported by the National Cancer Institute(Grants No.R01-80127,Yang and R01-84354,P.Y.)the National Institutes of Health(Grant No.LM-R01-13438,L.L.,J.W.,and P.Y.).
文摘Dear Editor,In patients with early-stage non-small cell lung cancer(NSCLC),the risk of post-surgical recurrence(REC)is 20%–50%,[1]and the risk of developing a second primary lung cancer(2P)is 3–4 times higher than in the general population[2].Distinguishing between REC and 2P can be challenging,complicating treatment of these so called“equivocal”(EQU)cases.
基金supported by the National Key Research and Development Plan of China(No.2020YFC2002706-2)the National Clinical Research Center for Geriatrics of China Open Project(No.NCRCGPLAGH-2022011).
文摘Background:Patients with hematological malignancies face an increased risk of developing second primary neoplasms due to various factors,including immune system compromise and chemotherapy-related effects.However,the incidence and associated risk factors in older patients remain poorly understood.This study aimed to assess the incidence,identify risk factors,and evaluate their impact on survival outcomes among older patients with hematological malignancies.Methods:This retrospective single-center study analyzed data from 163 patients,focusing on the occurrence of second primary neoplasms.Cumulative incidence rates were calculated,and risk factor analysis was conducted using a competing risk model.Results:Among 124 eligible patients with a total follow-up duration of 572.57 person-years,the incidence rate of second primary neoplasms was 15.72/1000 person-years.The standardized incidence ratio(SIR)was 0.81(95%confidence interval[CI][0.39–1.48],P=0.518).History of radiotherapy emerged as a significant risk factor(subdistribution hazard ratio[SHR]=21.61[2.81–166.14],P=0.003),whereas regular natural killer(NK)cell infusion was associated with reduced risk(SHR=3.25 e8[9.81 e9–1.08 e7],P<0.001).Conclusions:These findings underscore the importance of informing older patients with hematological malignancies about the long-term risks of second primary neoplasms.Healthcare providers should carefully weigh risk factors when formulating treatment strategies.The results are valuable for investigating the fundamental principles underlying the occurrence and progression of second primary neoplasms.
基金National Natural Science Foundation of China(Nos.92159302,81871890,91859203)
文摘Background:Previous studies have revealed that the number of cancer survivors developing a second primary malignancy is increasing,especially among thyroid cancer patients,and lung cancer is still the main cause of cancer death.Therefore,we aimed to investigate the risk of second primary lung cancer(SPLC)in patients with thyroid cancer.Methods:We searched the PubMed,Web of Science,Embase,and Scopus databases up to November 24,2021,for relevant research and merged the standardized incidence ratios(SIRs)and 95%confidence intervals(95%CIs)to evaluate the risk of developing SPLC in patients with thyroid cancer.Results:Fourteen studies involving 1,480,816 cases were included in our meta-analysis.The pooled result demonstrated that thyroid cancer patients may have a higher risk of SPLC than the general population(SIR=1.21,95%CI:1.07-1.36,P<0.01,I^(2)=81%,P<0.01).Subgroup analysis stratified by sex indicated that female patients may have a markedly higher risk of SPLC than male patients(SIR=1.65,95%CI:1.40-1.94,P<0.01,I^(2)=75%,P<0.01).Conclusions:Thyroid cancer patients are more likely to develop SPLC than the general population,especially women.However,other risk factors must be investigated,and more prospective studies are needed to confirm our results.Registration:International Prospective Register of Systematic Reviews:No.CRD42021285399.
文摘Primary carcinoma of breast is common but breast is a rare site of metastasis and metastases from extramammary sites are even rarer.Metastasis to breast from rectal carcinoma is very unusual and till now 19 cases of breast secondaries from colorectal carcinoma have been reported in literature which include 14 cases where the primary site was colon and remaining 5 were from the rectum.Here the authors report a case of adenocarcinoma anorectum who had completed treatment and after 4 months developed a lump in her left breast which was metastatic.Metastatic lesions of breast are usually part of a widely disseminated disease but this case presented as a solitary breast metastasis which mimicked as second primary cancer of the breast.
文摘Background:Secondary acute lymphoblastic leukemia(sALL)is rare in patients diagnosed with antecedent multiple myeloma(MM).This study aimed to elucidate the clinical features and outcomes of patients with sALL after MM.Methods:We conducted this population-based study using the Surveillance,Epidemiology,and End Results(SEER)database and retrospectively reviewed patients with sALL following MM treatment at our institution.Cox regression analysis was performed to investigate the prognostic factors for survival in patients with sALL.Results:We identified 64,629 cases of MM(including 18 sALL from the SEER Plus 9 database,and three sALL from our institution).Younger patients with MM and those who received chemotherapy were at a higher risk of developing sALL.The novel agent era witnessed an increased incidence of sALL(post-novel agent era vs.pre-novel agent era:0.31%[10/32,640]vs.0.25%[8/31,989])and shorter latency time(post-novel agent era vs.pre-novel agent era[median]:51.5 vs.74.5 months,P=0.516),though the difference was not significant.The median age at sALL onset was 65(range:47-78)years.Significant cytopenia and absence of BCR/ABL fusion genes were common features in this patient population.The treatment of sALL is complicated by old age and poor performance status.The median survival of patients with sALL is 18 months,whereas those who received chemotherapy had significantlyprolonged survival Conclusions:Patients with sALL combined with an antecedent MM,especially those with long-term exposure to immunomodulatory agents such as thalidomide or lenalidomide,should be cautiously evaluated and managed with a comprehensive approach.
基金supported by the project JG_2024_035 implemented within the PalackýUniversity Young Researcher Grantby the Internal grant agency of Palacky University(IGA_LF_2025_014)in part by Ministry of Health of Czech Republic(MH CZ-DRO(FNOL,00098892)).
文摘Chronic lymphocytic leukaemia(CLL)has one of the strongest familial risks of all cancers,as evidenced by the eight-fold increased risk seen in relatives of CLL patients,yet much of the heritable risk remains unexplained[1].Patients with CLL also have a high rate of secondary cancer,i.e.,the development of second primary malignancy,compared to the general population,which may be explained by immune dysregulation due to CLL and/or its treatment,but also by environmental and genetic risk factors[2].The development of second cancer in patients with CLL contributes to higher morbidity in these patients[2].As the population of long-term CLL survivors expands due to novel agents used in therapy,the identification of patients with risk of developing the second cancer may help to improve longevity of CLL patients.
文摘To determine the gastric adenocarcinoma (GAC) occurrence rate and related factors, we evaluated the follow-up results of patients confirmed to have gastric dysplasia after endoscopic resection (ER). METHODSWe retrospectively analyzed the medical records, endoscopic examination records, endoscopic procedure records, and histological records of 667 cases from 641 patients who were followed-up for at least 12 mo, from among 1273 patients who were conformed to have gastric dysplasia after Endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) of gastric mucosal lesions between January 2007 and August 2013 at the Chungnam National University Hospital. RESULTSThe mean follow-up period was 33.8 mo, and the median follow-up period was 29 mo (range: 12-87). During the follow-up period, the occurrence of metachronous GAC was 4.0% (27/667). The mean and median interval periods between the occurrence of metachronous GAC and endoscopic treatment of gastric dysplasia were 36.3 and 34 mo, respectively (range: 16-71). The factors related to metachronous GAC occurrence after ER for gastric dysplasia were male sex (5.3% vs 1.0%), open-type atrophic gastritis (9.5% vs 3.4%), intestinal metaplasia (6.8% vs 2.4%), and high-grade dysplasia (HGD; 8.4% vs 3.2%). Among them, male sex [OR: 5.05 (1.18-21.68), P = 0.029], intestinal metaplasia [OR: 2.78 (1.24-6.23), P = 0.013], and HGD [OR: 2.70 (1.16-6.26), P = 0.021] were independent related factors in multivariate analysis. Furthermore, 24 of 27 GAC cases (88.9%) occurred at sites other than the previous resection sites, and 3 (11.1%) occurred at the same site as the previous resection site. CONCLUSIONMale sex, intestinal metaplasia, and HGD were significantly related to the occurrence of metachronous GAC after ER of gastric dysplasia, and most GACs occurred at sites other than the previous resection sites.
文摘BACKGROUND Epidermal growth factor receptor tyrosine kinase inhibitors(EGFR-TKIs)are tolerable drugs used for patients with EGFR-mutant advanced non-small cell lung cancer(NSCLC).Serious adverse reactions are uncommon compared with cytotoxic drugs.CASE SUMMARY A 52-year-old man presented with general weakness and cytopenia.He had been taking erlotinib for 11 mo to treat NSCLC.The pathological diagnosis from the right upper lobe mass was adenocarcinoma with an EGFR mutation in exon 21(L858R).He had previously received paclitaxel/carboplatin,gemcitabin/vinorelbine chemotherapy,stereotactic radiosurgery for brain metastasis,and whole-brain radiotherapy as treatment for NSCLC.We diagnosed the patient with acute myeloid leukemia(AML).During the induction and consolidation chemotherapy for AML,the erlotinib was discontinued.When complete remission of the AML was achieved,since the lung masses were increased,pemetrexed/cisplatin for the NSCLC was initiated.After two cycles of chemotherapy,the cytopenia was prolonged.AML relapse occurred with the same karyotype.CONCLUSION Therapy-related acute myeloid neoplasm(t-MN)is a rare but fatal late complication.Although a patient may be taking EGFR-TKIs,the possibility of t-MN should be considered.Further studies are needed to determine whether EGFR-TKI usage is a predisposing factor for t-MN.
文摘Cancers of the head and neck account for more than half a million cases worldwide annually, with a significant majority diagnosed as squamous cell carcinoma(HNSCC). Imaging studies such as contrast-enhanced computed tomography(CT), magnetic resonance imaging(MRI) and ^(18)F-2-fluoro-2-deoxy-D-glucose positron-emission tomography/computed tomography(^(18)F-FDG PET/CT) are widely used to determine the presence and extent of tumors and metastatic disease, both before and after treatment. Advances in PET/CT imaging have allowed it to emerge as a superior imaging modality compared to both CT and MRI, especially in detection of carcinoma of unknown primary, cervical lymph node metastasis, distant metastasis, residual/recurrent cancer and second primary tumors, often leading to alteration in management. PET/CT biomarker may further provide an overall assessment of tumor aggressiveness with prognostic implications. As new developments emerged leading to better understanding and use of PET/CT in head and neck oncology, the aim of this article is to review the roles of PET/CT in both pre- and post-treatment management of HNSCC and PET-derived parameters as prognostic indicators.
文摘Triterpenoid saponins are metabolites produced in most plant species through complex biosynthetic pathways. They play important roles to humans owing to their diverse medicinal effects, including antiinflammatory, antimicrobial, and anticancer activities. In our laboratory, the author have been investigating the anticancer activities of a mixture of triterpenoid saponins （designated GpMix） extracted from a medicinal plant, known as Jiao Gu Lan （Gynostemma pentaphyllum, 胶股蓝 ） or southern ginseng in China. The key findings are summed up as following.
文摘Semiparasitic plants, mistletoes, distributed in Europe and East-Asia mainly, China, Korea and Japan have long been recognised as therapeutic herbs. Since the 1920s, extracts from European mistletoe （Viscum album L） have been popular in Europe as an unconventional cancer treatment. These extracts have been used in adjuvant cancer therapy because their immunostimulatory, cytostatic/cytotoxic and DNA stabilising activities. The main biological activities are addressed to sugar binding proteins, the Mistletoe Lectins, and to micro proteins named viscotoxins. The mistletoe lectins are members of the family of toxic lectins and recognize sugars and glycoconjugates containing galactose and/or N-acetyl-galactosamine groups. In vitro and in vivo assays confirm that the mistletoe lectins, isolated from the plant and compared with recombinant forms, play an important role as biologically active principles in mistletoe extracts. Limited experimental evidence indicates that other components like glycosides, polysaccharides, amines etc, may also have anticancer activity. Under discussion in Europe is the principal question of using holo plant extracts or single component lectin preparations： wild type lectins or recombinant ones in cancer therapy. Finally problems of preparation, characterization and standardization of commercial mistletoe preparations and evaluation of biological activities are discussed.
