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Truong VT, Al-Shakfa F, Newman N, Roberge D, Masucci GL, Tran TPY, Boubez G, Shedid D, Yuh SJ, Wang Z. Spinal Metastasis in Multiple Primary Malignancies Involving Lung Cancer: Clinical Characteristics and Survival. World Neurosurg 2022; 167:e726-e731. [PMID: 36030008 DOI: 10.1016/j.wneu.2022.08.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 08/16/2022] [Accepted: 08/17/2022] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The incidence of multiple primary malignancies (MPM) has increased in recent decades. Our aim was to evaluate incidence, clinical features, and survival in cases of spinal metastases from MPM in which one of the malignancies is lung cancer. METHODS We retrospectively reviewed an institutional database of lung cancer patients with spinal metastasis and extracted all cases of MPM. RESULTS Among 275 patients who had spinal metastasis with lung cancer as one of the diagnoses, 21 (7.6%) patients with MPM were identified. Mean patient age was 68.5 years (95% confidence interval [CI], 65.3-71.7). The most common cancers diagnosed in addition to lung cancer were breast cancer (5 patients, 24%), upper aerodigestive tract cancer (4 patients, 19%), and prostate cancer (4 patients, 19%). Eighteen (86%) patients walked independently, and 3 (14%) patients walked with help. Seventeen (80.9%) patients had a good Karnofsky performance scale score. The median survivals from the date of first cancer diagnosis, last cancer diagnosis, and spinal metastasis diagnosis were 109.8 months (95% CI, 23.5-196.1), 17.8 months (95% CI, 5.8-29.8), and 10.3 months (95% CI, 5.4-15.2), respectively. Actual rates of survival at 6 months, 12 months, and 24 months from the date of spinal metastasis diagnosis were 81%, 42.9%, and 23.8%, respectively. CONCLUSIONS The present study is the first series to our knowledge to show that survival of patients with spinal metastasis and MPM involving lung cancer is not clearly inferior to that of patients with spinal metastasis and lung cancer alone.
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Affiliation(s)
- Van Tri Truong
- Division of Orthopedics, Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal, Québec, Canada; Department of Neurosurgery, Vinmec Central Park International Hospital, Vinmec Healthcare System, Ho Chi Minh City, Vietnam.
| | - Fidaa Al-Shakfa
- Division of Orthopedics, Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal, Québec, Canada
| | - Nicholas Newman
- Division of Orthopedics, Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal, Québec, Canada
| | - David Roberge
- Division of Radiation Oncology, Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal, Québec, Canada
| | - Giuseppina Laura Masucci
- Division of Radiation Oncology, Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal, Québec, Canada
| | - Thi Phuoc Yen Tran
- Department of Neurosurgery, Vinmec Central Park International Hospital, Vinmec Healthcare System, Ho Chi Minh City, Vietnam; Research Center, Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal, Québec, Canada
| | - Ghassan Boubez
- Division of Orthopedics, Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal, Québec, Canada
| | - Daniel Shedid
- Division of Neurosurgery, Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal, Québec, Canada
| | - Sung-Joo Yuh
- Division of Neurosurgery, Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal, Québec, Canada
| | - Zhi Wang
- Division of Orthopedics, Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal, Québec, Canada
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de Alencar VTL, Formiga MN, de Lima VCC. Inherited lung cancer: a review. Ecancermedicalscience 2020; 14:1008. [PMID: 32104210 PMCID: PMC7039693 DOI: 10.3332/ecancer.2020.1008] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Indexed: 12/17/2022] Open
Abstract
Lung cancer is the most common cancer worldwide and has high rates of mortality. The major risk factor associated with this disease is tobacco smoke, but approximately 10%-25% of all lung cancer cases occur in patients who have never smoked. Data suggest that lung cancer in never-smokers has a different molecular profile, tumour microenvironment and epidemiology than that in smokers. Several risk factors have been associated with its occurrence, and the possibility of inherited predisposition is becoming clearer. A better understanding of this disease is essential for the future development of personalised screening, diagnosis and treatment approaches, with consequent reduction of mortality. In this review, we discuss historical studies of lung cancer in never-smokers and the currently available evidence of inherited predisposition to this disease.
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Affiliation(s)
| | - Maria Nirvana Formiga
- AC Camargo Cancer Center, R Prof Antônio Prudente, 211 São Paulo, SP 01509-010, Brazil
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Fujita S, Masago K, Takeshita J, Togashi Y, Hata A, Kaji R, Kokubo M, Katakami N. Multiple primary malignancies in patients with non-small cell lung cancer. Intern Med 2015; 54:325-31. [PMID: 25748742 DOI: 10.2169/internalmedicine.54.2921] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE Information regarding multiple primary malignancies is important, as it has the potential to clarify etiological factors and may indicate the need to refine patient follow-up to include screening for associated malignancies. Upper aerodigestive tract cancer often develops in patients with smoking-related lung cancer; however, little is known about the frequencies or types of other primary malignancies in patients with non-small cell lung cancer (NSCLC) without a history of smoking. METHODS We retrospectively evaluated the records of patients examined and/or treated for NSCLC at the Institute of Biomedical Research and Innovation between January 2007 and June 2012. Patients In total, 938 patients, including 599 men (never-smoker/ever-smoker: 35/564) and 339 women (never-smoker/ever-smoker: 236/103), were analyzed. RESULTS Among the 209 patients (22.3%) with multiple primary malignancies, 151 had a history of smoking and 58 were never-smokers. The most common cancers were gastric (43 cases), colorectal (33 cases), and prostate (29 cases) cancer. Smoking-related cancer was more common in current smokers and ex-smokers for both men and women. Among women with NSCLC, never-smokers were more likely to have thyroid cancer than those with a history of smoking (5.1% vs. 0%, p=0.021). CONCLUSION In this study, several differences in malignancies were observed between never-smokers and patients with a history of smoking. Thyroid cancer and NSCLC co-existed in some women without a history of smoking, implicating predisposing factors other than tobacco smoke in the onset of these cancers.
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Affiliation(s)
- Shiro Fujita
- Division of Integrated Oncology, Institute of Biomedical Research and Innovation, Japan
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Unusual synchronous lung tumors: mucoepidermoid carcinoma and mucinous adenocarcinoma. Case Rep Oncol Med 2014; 2014:183617. [PMID: 24707420 PMCID: PMC3970349 DOI: 10.1155/2014/183617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Accepted: 01/09/2014] [Indexed: 12/04/2022] Open
Abstract
Primary mucoepidermoid tumors of the lung are rare entities. Synchronous primary malignancies of the lung involving mucoepidermoid carcinoma and mucinous adenocarcinoma are even rarer and constitute a unique set of patient population. The presentation, diagnosis and treatment strategies for this patient population are not well described. In most cases, the diagnosis of synchronous primary lung malignancy is made after pathological examination of the resected lung specimen. Molecular and genetic analysis is now being used to supplement the diagnosis of synchronous primary lung malignancies. In this work, we briefly discuss the current state of knowledge of this unique combination of primary lung malignancies and describe the clinical presentation and management of a patient with a rare combination of synchronous primary lung malignancies.
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Shen C, Xu H, Liu L, Zhou Y, Chen D, Du H, Han Z, Che G. "Unique trend" and "contradictory trend" in discrimination of primary synchronous lung cancer and metastatic lung cancer. BMC Cancer 2013; 13:467. [PMID: 24106770 PMCID: PMC3852048 DOI: 10.1186/1471-2407-13-467] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Accepted: 10/01/2013] [Indexed: 02/05/2023] Open
Abstract
Background Distinguishing between multiple primary lung cancers and metastatic tumors is often difficult when the tumor histology is same. Since genomic instability is a common feature of cancer, we hypothesized that independently arising neoplasms in an individual patient would exhibit measurable genomic variation, enabling discrimination of tumor lineage and relatedness. The feasibility of analyzing genomic instability expression profiles to distinguish multiple primary lung cancers from metastatic tumors was evaluated. Methods This study enrolled 13 patients, with multiple primary lung cancers demonstrating with the histology, who underwent surgery between April 2003 and December 2012 at the Department of the Thoracic Surgery at West China Hospital in Sichuan province of China and 10 patients who were diagnosed as metastasis disease during the same period for comparison purposes. Genomic DNA from lung cancers from individual patients was analyzed by six microsatellites (D2S1363, D6S1056, D7S1824, D10S1239, D15S822, and D22S689) with PCR to identify discordant allelic variation. The experiments were approved by the West China Hospital Ethics committee (No.2013 (33)) and all patients agreed to participate in the study and signed an informed consent form. Results All of the 10 patients with distant metastasis showed a consistent consequence that we called “unique trend” between primary tumor and distant metastasis. The “trend” is representive in this study, which means that all alleles corresponding to six microsatellite markers were detected in DNA from primary tumors but were reduced or not observed in DNA from metastatic tumors. In the group of synchronous lung tumor with different histological types, the result showed a “contradictory trend”. Some alleles were detected in DNA from primary tumors but were reduced or not observed in DNA from metastatic tumors and other alleles corresponding to six microsatellite markers were detected in DNA from metastatic tumors but were reduced or not observed in DNA from primary tumors. In the third group (synchronous lung tumor with same histological types), 2 of 8 patients showed “unique trend” and the others showed “contradictory trend”. Conclusions With polymorphic microsatellite markers, the “unique trend” that represents metastasis cancers and the “contradictory trend” that represents primary multiple tumors are useful in the diagnosis between tumors found at the same time in the pulmonary even diagnosed with the histopathological evaluation from a single patient.
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Affiliation(s)
- Cheng Shen
- Department of Cardiovascular and Thoracic Surgery, West-China Hospital, Sichuan University, Chengdu 610041, China.
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