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Fustes OJH, Rodriguez CA. Relevance of the Hoover´s signal and the Babinski´s test for the diagnosis of functional hemiparesis. CASPIAN JOURNAL OF INTERNAL MEDICINE 2024; 15:364-366. [PMID: 38807715 PMCID: PMC11129068 DOI: 10.22088/cjim.15.2.364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 11/23/2022] [Accepted: 12/14/2022] [Indexed: 05/30/2024]
Affiliation(s)
- Otto J Hernandez Fustes
- Complexo Hospital de Clínicas da Universidade Federal do Paraná, Serviço de Neurologia, Hospital de Clínicas, Curitiba PR, Brasil
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Ebrahimian S, Soleimani Varaki S, Nasr Esfahani F. Second primary common bile duct neuroendocrine tumor after 10 years in a patient with rectal adenocarcinoma: A case report. CASPIAN JOURNAL OF INTERNAL MEDICINE 2024; 15:360-363. [PMID: 38807717 PMCID: PMC11129070 DOI: 10.22088/cjim.15.2.360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 04/12/2022] [Accepted: 04/30/2022] [Indexed: 05/30/2024]
Abstract
Background With the improvement of cancer treatment methods and increased life expectancy of patients, the prevalence of second primary cancers has gradually increased. Case Presentation In the present study, the case was a 58-year-old man diagnosed with rectal adenocarcinoma and underwent chemotherapy and neoadjuvant radiotherapy 10 years ago. After 5 years, he underwent a lobectomy due to lung metastasis. At the research time, he presented with itching; in ERCP, a 16-millimeter hypoechoic lesion was detected, and an FNA biopsy was performed, indicating malignancy. The patient underwent Whipple surgery, and pathology revealed a well-differentiated neuroendocrine tumor. He was discharged in good general condition. Conclusion This article emphasized the necessity of early detection and diagnosis of second primary cancer, as well as acting as if it was primary cancer to treat.
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Affiliation(s)
- Saba Ebrahimian
- Department of Surgery, Babol University of Medical Sciences, Babol, Iran
| | - Sakineh Soleimani Varaki
- Clinical Oncologist (Radiotherapy & Oncology), Babol University of Medical Sciences, Babol. Iran
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Schlesinger-Raab A, Schubert-Fritschle G, Kim M, Werner J, Belka C, Wolff H, Agha A, Fuchs M, Friess H, Combs S, Häussler B, Engel J, Halfter K. Secondary Primary Cancer Risk After Radiation Therapy in Rectal Cancer: A Population-Based Cohort Study With Propensity Score Matching. Clin Colorectal Cancer 2023; 22:485-495.e3. [PMID: 37838522 DOI: 10.1016/j.clcc.2023.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/27/2023] [Accepted: 07/29/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND It remains unclear whether radiation therapy (RT) has an impact on the development of secondary primary cancer (SC) in rectal cancer (RC) patients, especially within the true pelvis. AIM To examine the incidence of SC in a population-based cohort of RC after surgical treatment with or without radiation therapy (RT, NRT). PATIENTS AND METHODS The epidemiological cohort consisting of 13,919 RC patients with primary M0 stage diagnosed between 1998 and 2019 was collected from cancer registry data of Upper Bavaria. Competing risk analyses were conducted regarding the development of SC on 11 687 first malignancies, stratified by RT/NRT. A propensity score (PS) was generated by logistic regression modeling of RT to repeat competing risk analyses on a PS-matched cohort. RESULTS The median age (interquartile range) of the epidemiological cohort was 68.9 years (60.4-76.7). About 60.8%, were men, 38.7% had UICC III, 35.8% of tumors were localized lower than 8 cm, 41.3% underwent RT. Only 17.1% of patients older than 80 years at diagnosis received RT. In general, RT patients were 5 years younger than NRT patients (65.9 years [58.0-73.0] vs. 71.3 years [62.4-79.2], P < .0001). The 20-year cumulative incidence of SC was 16.5% in RT and 17.4% in NRT patients (P = .2298). Men with RT had a lower risk of prostate cancer (HR = 0.55, 95%CI [0.34-0.91], P = .0168). In the PS-matched cohort, RT patients had a significantly higher risk of bladder cancer during follow-up (10-year cumulative incidence of 1.1% vs. 0.6% in NRT). The direction of the RT effects in men and women and different tumor sites may cancel each other. CONCLUSION A protective effect of RT in rectal cancer patients on developing prostate SC by half is reproduced. Further analyses studying the long-term SC risks of RT should essentially focus on stratification by sex, and focus on more recent data.
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Affiliation(s)
- Anne Schlesinger-Raab
- Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Faculty of Medicine, Ludwig-Maximilians-University Munich (LMU), Munich, Germany.
| | - Gabriele Schubert-Fritschle
- Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Faculty of Medicine, Ludwig-Maximilians-University Munich (LMU), Munich, Germany
| | - Mia Kim
- Department of Surgery, Clinic Munich-Neuperlach Hospital, Munich, Germany
| | - Jens Werner
- Department of General, Visceral, and Transplantation Surgery, University Hospital, Ludwig-Maximilians-University (LMU), Munich, Germany
| | - Claus Belka
- Department of Radiation Oncology, University Hospital, Ludwig-Maximilians-University (LMU), Munich, Germany
| | - Hendrik Wolff
- Department of Radiology, Nuclear Medicine and Radiotherapy, Radiology Munich, Munich, Germany
| | - Ayman Agha
- Department of General, Visceral, Endocrine and Minimal-Invasive Surgery, Clinic Munich-Bogenhausen, Munich, Germany
| | - Martin Fuchs
- Department of Gastroenterology, Hepatology, and Gastrointestinal-Oncology, Clinic Munich-Bogenhausen, Munich, Germany
| | - Helmut Friess
- Department of General Surgery, Klinikum rechts der Isar, Technical University Munich (TUM), School of Medicine, Munich, Germany
| | - Stefanie Combs
- Department of Radiation Oncology, Klinikum rechts der Isar, Technical University Munich (TUM), School of Medicine, Munich, Germany
| | | | - Jutta Engel
- Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Faculty of Medicine, Ludwig-Maximilians-University Munich (LMU), Munich, Germany
| | - Kathrin Halfter
- Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Faculty of Medicine, Ludwig-Maximilians-University Munich (LMU), Munich, Germany
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Zhou MJ, Singh G, Hwang JH, Ladabaum U. Risk of Proximal Gastrointestinal Cancer After Positive Fecal Immunochemical Test. Clin Gastroenterol Hepatol 2023; 21:3179-3181.e3. [PMID: 36464140 DOI: 10.1016/j.cgh.2022.11.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 11/22/2022] [Accepted: 11/22/2022] [Indexed: 12/03/2022]
Affiliation(s)
- Margaret J Zhou
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Gurkirpal Singh
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, Stanford, California; Institute of Clinical Outcomes Research and Education, Woodside, California
| | - Joo Ha Hwang
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Uri Ladabaum
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, Stanford, California.
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Liang LA, Tseng YJ, Tanaka LF, Klug SJ. Second primary cancer among 217702 colorectal cancer survivors: An analysis of national German cancer registry data. Int J Cancer 2023; 153:1459-1471. [PMID: 37392091 DOI: 10.1002/ijc.34638] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 05/19/2023] [Accepted: 06/01/2023] [Indexed: 07/02/2023]
Abstract
With improvements in survival after colorectal cancer (CRC), more survivors are at risk of developing a second cancer, particularly in younger populations where CRC incidence is increasing. We estimated the incidence of second primary cancer (SPC) in CRC survivors and its potential risk factors. We identified CRC cases diagnosed between 1990 and 2011 and SPCs until 2013 from nine German cancer registries. Standardized incidence ratios (SIR) and absolute excess risk (AER) per 10 000 person-years were calculated and were stratified by index site: colon cancer (CC) and rectal cancer (RC), age and sex. Cox regression assessed potential SPC risk factors, including primary tumor-related therapy considering death as a competing risk. We included 217 202 primary CRC cases. SPC occurred in 18 751 CRC survivors (8.6%; median age: 69 years). Risk of cancer was significantly higher in CRC survivors than in the general population (SIR males 1.14, 95% confidence interval [CI] 1.12-1.17, AER = 24.7; SIR females 1.20, 95% CI 1.17-1.23, AER = 22.8). Increased risks of SPCs were observed for the digestive system, urinary system and female and male reproductive organs. CRC incidence increased in younger persons (<50 years) and SPC incidence was 4-fold in this group (SIR males 4.51, 95% CI 4.04-5.01, AER = 64.2; SIR females 4.03, 95% CI 3.62-4.48, AER = 77.0). Primary tumor-related factors associated with SPC risk were right-sided cancer and smaller primary tumor size. Treatment and risk of SPC differed for CC (no effect) and RC (lower risk after chemotherapy). CRC survivors have excess risk of developing SPC, with particular characteristics that could guide targeted surveillance.
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Affiliation(s)
- Linda A Liang
- Chair of Epidemiology, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Ying-Ju Tseng
- Chair of Epidemiology, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Luana F Tanaka
- Chair of Epidemiology, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Stefanie J Klug
- Chair of Epidemiology, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
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Collatuzzo G, Ferrante M, Ippolito A, Di Prima A, Colarossi C, Scarpulla S, Boffetta P, Sciacca S. Second Primary Cancers following Colorectal Cancer in Sicily, Italy. Cancers (Basel) 2022; 14:cancers14215204. [PMID: 36358623 PMCID: PMC9657763 DOI: 10.3390/cancers14215204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/19/2022] [Accepted: 10/20/2022] [Indexed: 11/26/2022] Open
Abstract
Simple Summary This study addressed the under-investigated issue of second primary cancer occurring in colorectal cancer survivors. Our aim was to explore whether patients recovered from a first colorectal cancer were at higher risk of developing a subsequent primary cancer. The hypothesis was that exposure to cancer treatment, enhanced health surveillance and shared risk factors may lead to an excess risk of second primary cancer in this population. The number of cases of second primary cancer exceeded the expected in this population, mainly driven by female genital cancers, and especially observed in the first years after colorectal cancer diagnosis. Our findings are overall consistent with previous studies, providing valuable information to better characterize and predict mortality from second primary cancer in subjects who suffered from first colorectal cancer. Abstract Background: Cancer survivors are at risk of developing second primary cancers (SPC). We investigated the risk of SPC in colorectal cancer (CRC) survivors in Sicily, Southern Italy. Methods: We analyzed data from the Eastern Sicily cancer registry covering 2.5 million people diagnosed and followed up between 2003 and 2017. We calculated the standardized incidence ratio (SIR) and 95% confidence interval (CI) of SPC overall and by cancer type, using the general Sicily population rates as reference. Results: A total of 19,040 cases of CRC and 1453 cases of SPC were included in the analysis. Mean age of occurrence of SPC was 68.1. The SIR for any SPC was 1.11 (95% CI 1.05–1.17); it was higher in women (1.18; 95% CI 1.08–1.29) than in men (1.07; 95% CI 0.97–1.14, p-value of difference 0.07). The SIR was increased for SPC from the ovary (SIR 2.01; 95% CI 1.33–2.95), kidney (SIR 2.00; 95% CI 1.54–2.56), endometrium (SIR 1.94; 95% CI 1.45–2.54), bladder (SIR 1.22, 95% CI 1.04–1.43) and stomach (1.29; 95% CI 0.98–1.66). The SIR for CRC as SPC was 0.84 (95% CI 0.70–1.01). No increased incidence was found for lung, prostate, breast, thyroid and liver cancer. The SIR for SPC overall and several cancers decreased with time of follow-up. Conclusions: In this population, CRC survivors have an 11% higher risk of developing a SPC than the general population, particularly cancers of the ovary, kidney, endometrium, bladder and stomach. Follow-up for SPC is required, especially during the first 5 years from CRC diagnosis.
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Affiliation(s)
- Giulia Collatuzzo
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
| | - Margherita Ferrante
- Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, Via Santa Sofia 87, 95123 Catania, Italy
- Cancer Registry of Catania, Messina, Syracuse and Enna, Via Santa Sofia 87, 95123 Catania, Italy
| | - Antonella Ippolito
- Cancer Registry of Catania, Messina, Syracuse and Enna, Via Santa Sofia 87, 95123 Catania, Italy
| | - Alessia Di Prima
- Cancer Registry of Catania, Messina, Syracuse and Enna, Via Santa Sofia 87, 95123 Catania, Italy
| | - Cristina Colarossi
- Mediterranean Institute of Oncology (IOM), Viagrande, 95029 Catania, Italy
| | | | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY 11794, USA
- Correspondence:
| | - Salvatore Sciacca
- Mediterranean Institute of Oncology (IOM), Viagrande, 95029 Catania, Italy
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