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Jena SS, Nundy S. Synchronous multiple primary neoplasms of the esophagus, rectosigmoid and central nervous system. Int J Surg Case Rep 2024; 117:109566. [PMID: 38518470 PMCID: PMC10973714 DOI: 10.1016/j.ijscr.2024.109566] [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: 02/05/2024] [Revised: 03/14/2024] [Accepted: 03/16/2024] [Indexed: 03/24/2024] Open
Abstract
INTRODUCTION Multiple primary neoplasms (MPN) are rare and can affect any system especially the upper aero-digestive system. They can be simultaneous, synchronous or metachronous. Their management depends on the individual organ system affected and simultaneous resection is possible as shown by T. Suzuki. PRESENTATION OF CASE We encountered a 77-year-old male who had had malena and constipation for 2 months and on investigation was found to have a rectosigmoid and an esophageal adenocarcinoma as well as a calcified lesion in the brain. He underwent surgery for the rectosigmoid growth only (according to the patient's preference) and received chemotherapy. Unfortunately, he developed acute intestinal obstruction after 2 cycles of chemotherapy and died. DISCUSSION MPNS are defined as presence of two or more histologically distinct tumours in the same individual. It can be synchronous or metachronous. Various factors like genetic and environmental play crucial role in its development. Management of these depends up on the status of the patient, stage of disease. CONCLUSION MPNS are rare but their rising trend suggests it should be kept in mind while working up a patient with any malignancy.
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Affiliation(s)
- Suvendu Sekhar Jena
- Institute of Surgical Gastroenterology, GI and HPB Oncosurgery and Liver Transplantation, Sir Ganga Ram Hospital, New Delhi 110060, India.
| | - Samiran Nundy
- Institute of Surgical Gastroenterology, GI and HPB Oncosurgery and Liver Transplantation, Sir Ganga Ram Hospital, New Delhi 110060, India
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Lin LH, Chang KW, Cheng HW, Liu CJ. Identification of Somatic Mutations in Plasma Cell-Free DNA from Patients with Metastatic Oral Squamous Cell Carcinoma. Int J Mol Sci 2023; 24:10408. [PMID: 37373553 DOI: 10.3390/ijms241210408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/01/2023] [Accepted: 06/15/2023] [Indexed: 06/29/2023] Open
Abstract
The accurate diagnosis and treatment of oral squamous cell carcinoma (OSCC) requires an understanding of its genomic alterations. Liquid biopsies, especially cell-free DNA (cfDNA) analysis, are a minimally invasive technique used for genomic profiling. We conducted comprehensive whole-exome sequencing (WES) of 50 paired OSCC cell-free plasma with whole blood samples using multiple mutation calling pipelines and filtering criteria. Integrative Genomics Viewer (IGV) was used to validate somatic mutations. Mutation burden and mutant genes were correlated to clinico-pathological parameters. The plasma mutation burden of cfDNA was significantly associated with clinical staging and distant metastasis status. The genes TTN, PLEC, SYNE1, and USH2A were most frequently mutated in OSCC, and known driver genes, including KMT2D, LRP1B, TRRAP, and FLNA, were also significantly and frequently mutated. Additionally, the novel mutated genes CCDC168, HMCN2, STARD9, and CRAMP1 were significantly and frequently present in patients with OSCC. The mutated genes most frequently found in patients with metastatic OSCC were RORC, SLC49A3, and NUMBL. Further analysis revealed that branched-chain amino acid (BCAA) catabolism, extracellular matrix-receptor interaction, and the hypoxia-related pathway were associated with OSCC prognosis. Choline metabolism in cancer, O-glycan biosynthesis, and protein processing in the endoplasmic reticulum pathway were associated with distant metastatic status. About 20% of tumors carried at least one aberrant event in BCAA catabolism signaling that could possibly be targeted by an approved therapeutic agent. We identified molecular-level OSCC that were correlated with etiology and prognosis while defining the landscape of major altered events of the OSCC plasma genome. These findings will be useful in the design of clinical trials for targeted therapies and the stratification of patients with OSCC according to therapeutic efficacy.
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Affiliation(s)
- Li-Han Lin
- Department of Medical Research, MacKay Memorial Hospital No. 92, Sec. 2, Chung San N. Rd., Taipei 10449, Taiwan
| | - Kuo-Wei Chang
- Institute of Oral Biology, School of Dentistry, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
- Department of Stomatology, Taipei Veterans General Hospital, Taipei 11121, Taiwan
| | - Hui-Wen Cheng
- Department of Medical Research, MacKay Memorial Hospital No. 92, Sec. 2, Chung San N. Rd., Taipei 10449, Taiwan
| | - Chung-Ji Liu
- Department of Medical Research, MacKay Memorial Hospital No. 92, Sec. 2, Chung San N. Rd., Taipei 10449, Taiwan
- Institute of Oral Biology, School of Dentistry, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
- Department of Oral and Maxillofacial Surgery, Taipei MacKay Memorial Hospital, Taipei 10449, Taiwan
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Adeel M, Andaleeb H, Shakil S, Akhtar SE, Almas T, AlSubai AK, AlNajdi S, Alenizi AM, Aldhaheri KSO, Aqil S. Bilateral simultaneous primary Oral Squamous Cell Carcinoma: A rare presentation. Ann Med Surg (Lond) 2022; 82:104573. [PMID: 36268450 PMCID: PMC9577514 DOI: 10.1016/j.amsu.2022.104573] [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: 07/21/2022] [Revised: 09/01/2022] [Accepted: 09/04/2022] [Indexed: 12/01/2022] Open
Abstract
Introduction and Importance: Oral Squamous Cell Carcinoma (OSSC) is one of the most common malignancies of the oral cavity and is one of the ten most prevalent tumours in the world. Control of this tumor is difficult and challenging as its propensity to spread is embedded in the cancer field of epithelial cells which alter these cells and induce a malignant potential within them. Simultaneous bilateral primary tumours are a rare presentation in the oral cavity which highlights the significance of early diagnosis and treatment. Case presentation Here we present a case of 50-year-old gentleman known case of diabetes, hypertension and chronic history of beetle nut chewing who developed a simultaneously growing bilateral primary OSSC in the buccal mucosa. CT scan revealed a heterogeneous enhancing thickening in the bilateral buccogingival mucosa. A wide local excision of bilateral buccal mucosa with bilateral marginal mandibulectomy with neck dissection was planned. Clinical discussion The majority of the case report emphasises the relevance of simultaneously developing bilateral primary oral cavity tumours in a patient who had a history of consuming beetle nuts. The independent incidence of bilateral primary OSSC in individuals without a history of tobacco, beetle nut, or alcohol use has also been documented in a small body of research. Due to the considerable clinical variety in its presentation, it is necessary to include bilateral primary OSSC when making a differential diagnosis of OSSC. Conclusion Multiple bilateral primary tumours of the oral cavity are typically on the rise. The prognosis and survival of these individuals are considerably improved by close surveillance and early, expectant management of these cancers. This case study emphasises the value of thorough screening techniques used at an early stage to find these lesions and treat them appropriately. Oral Squamous Cell Carcinoma is one of the most prevalent malignancies in the world. The case presented is a bilaterally occurring simultaneous primary OSCC of the buccal mucosa in a 50-year-old patient. This is especially significant because bilateral primaries occurring concurrently are an uncommon occurrence in the oral cavity. Detecting and treating bilateral primaries timely is of utmost importance for better prognosis in view of surgical complications.
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Affiliation(s)
- Maira Adeel
- Department of Otorhinolaryngology - Head and Neck Surgery, Liaquat National Hospital and Medical College, Pakistan
| | - Hira Andaleeb
- Department of Otorhinolaryngology - Head and Neck Surgery, Liaquat National Hospital and Medical College, Pakistan
| | - Saad Shakil
- Ziauddin Medical College, Karachi, Pakistan
- Corresponding author. Ziauddin Medical College, Karachi, Pakistan.
| | | | - Talal Almas
- RCSI University of Medicine and Health Sciences, 123 St. Stephen's Green, Dublin 2, Ireland
| | - Abdulla K. AlSubai
- RCSI University of Medicine and Health Sciences, 123 St. Stephen's Green, Dublin 2, Ireland
| | - Sara AlNajdi
- RCSI University of Medicine and Health Sciences, 123 St. Stephen's Green, Dublin 2, Ireland
| | - Aryam Mohammed Alenizi
- RCSI University of Medicine and Health Sciences, 123 St. Stephen's Green, Dublin 2, Ireland
| | | | - Shakil Aqil
- Department of Otorhinolaryngology - Head and Neck Surgery, Liaquat National Hospital and Medical College, Pakistan
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Mita J, Iguchi T, Iseda N, Takada K, Hirose K, Miura N, Honboh T, Emi Y, Akashi T, Kato S, Sadanaga N, Matsuura H. A case of successful conversion surgery for locally advanced pancreatic cancer with synchronous triple cancer of the lung and esophagus: a case report. Surg Case Rep 2022; 8:19. [PMID: 35067787 PMCID: PMC8784582 DOI: 10.1186/s40792-022-01377-x] [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: 11/04/2021] [Accepted: 01/20/2022] [Indexed: 11/11/2022] Open
Abstract
Background The number of reports of multiple primary cancer (MPC) is increasing because of the advancement in diagnostic imaging technology. However, the treatment strategy for MPCs involving pancreatic cancer is controversial because of the extremely poor prognosis. We herein report a patient with synchronous triple cancer involving the pancreas, esophagus, and lung who underwent conversion surgery after intensive chemotherapy for unresectable locally advanced pancreatic cancer. Case presentation A 59-year-old man was admitted to our hospital with epigastric pain, anorexia, and weight loss. Computed tomography and upper gastrointestinal endoscopy revealed that the patient had synchronous triple cancer of the pancreas, esophagus, and lung. While the esophageal and lung cancer were relatively non-progressive, the pancreatic tail cancer had invaded the aorta, celiac axis, and left kidney, and the patient was diagnosed with unresectable locally advanced disease. Because the described lesion could have been the prognostic determinant for this patient, we initiated intensive chemotherapy (gemcitabine plus nab-paclitaxel) for pancreatic cancer. After six courses of chemotherapy, the tumor size shrank remarkably and no invasion to the aorta or celiac axis was observed. No significant changes were observed in the esophageal and lung cancers; endoscopic submucosal dissection could be still a curative treatment for the esophageal cancer. Therefore, we performed curative resection for pancreatic cancer (distal pancreatomy, splenectomy, and left nephrectomy; ypT3N0cM0, ypStage IIA, UICC 8th). Pathologically, complete resection was achieved. The patient then underwent endoscopic submucosal dissection for early esophageal cancer (pT1a[M]-LPM) and video-assisted thoracoscopic right upper lobectomy in combination with right lower partial resection for early lung cancer (pT2aN0M0, pStage IB, UICC 8th). Eight months after pancreatic cancer surgery, the patient is alive and has no sign of recurrence; as a result of the successful treatment, the patient has a good quality of life. Conclusions Treatment of MPC is challenging, especially for cases with unresectable tumors. Although synchronous triple cancer can involve unresectable pancreatic cancer, radical resection may be possible after careful assessment of the appropriate treatment strategy and downstaging of unresectable tumors.
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Lin LH, Chou CH, Cheng HW, Chang KW, Liu CJ. Precise Identification of Recurrent Somatic Mutations in Oral Cancer Through Whole-Exome Sequencing Using Multiple Mutation Calling Pipelines. Front Oncol 2021; 11:741626. [PMID: 34912705 PMCID: PMC8666431 DOI: 10.3389/fonc.2021.741626] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 11/11/2021] [Indexed: 01/18/2023] Open
Abstract
Understanding the genomic alterations in oral carcinogenesis remains crucial for the appropriate diagnosis and treatment of oral squamous cell carcinoma (OSCC). To unveil the mutational spectrum, in this study, we conducted whole-exome sequencing (WES), using six mutation calling pipelines and multiple filtering criteria applied to 50 paired OSCC samples. The tumor mutation burden extracted from the data set of somatic variations was significantly associated with age, tumor staging, and survival. Several genes (MUC16, MUC19, KMT2D, TTN, HERC2) with a high frequency of false positive mutations were identified. Moreover, known (TP53, FAT1, EPHA2, NOTCH1, CASP8, and PIK3CA) and novel (HYDIN, ALPK3, ASXL1, USP9X, SKOR2, CPLANE1, STARD9, and NSD2) genes have been found to be significantly and frequently mutated in OSCC. Further analysis of gene alteration status with clinical parameters revealed that canonical pathways, including clathrin-mediated endocytotic signaling, NFκB signaling, PEDF signaling, and calcium signaling were associated with OSCC prognosis. Defining a catalog of targetable genomic alterations showed that 58% of the tumors carried at least one aberrant event that may potentially be targeted by approved therapeutic agents. We found molecular OSCC subgroups which were correlated with etiology and prognosis while defining the landscape of major altered events in the coding regions of OSCC genomes. These findings provide information that will be helpful in the design of clinical trials on targeted therapies and in the stratification of patients with OSCC according to therapeutic efficacy.
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Affiliation(s)
- Li-Han Lin
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan
| | - Chung-Hsien Chou
- Institute of Oral Biology, School of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Hui-Wen Cheng
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan
| | - Kuo-Wei Chang
- Institute of Oral Biology, School of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chung-Ji Liu
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan.,Department of Oral and Maxillofacial Surgery, Taipei MacKay Memorial Hospital, Taipei, Taiwan
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Imamura H, Hirose H, Endo S, Hashimoto Y, Takeda M, Kidogami S, Mokutani Y, Kishimoto T, Yoshioka S, Tamura S, Sasaki Y. Simultaneous triple cancer of the esophagus, pancreas and rectum treated with multimodal strategies: a case report. Surg Case Rep 2020; 6:259. [PMID: 33006693 PMCID: PMC7532257 DOI: 10.1186/s40792-020-01035-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 09/25/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Due to the development of diagnostic imaging technology, we have increased chance of detecting multiple primary cancers. However, simultaneous triple cancer is still a very rare finding whose frequency is not yet known. Treatment of simultaneous triple cancer is a clinical challenge because it requires multimodal strategies including surgery, chemotherapy and radiotherapy. CASE PRESENTATION Here, we present the case of a 74-year-old male with triple cancer involving esophageal and pancreatic cancer, and rectal carcinoma. Each cancer was surgically resectable, but simultaneous resection of all cancers seemed to cause too much surgical stress for the patient. First, we performed a laparoscopic Hartmann's operation for rectal cancer to minimize the risk of postoperative complications. Then treatment for pancreatic cancer was initiated by administering neoadjuvant chemotherapy with gemcitabine plus nab-paclitaxel. The pancreatic tumor shrank in size, so pancreatoduodenectomy was performed. We chose S-1 as adjuvant chemotherapy. The esophageal cancer showed regression during the treatment of the other two cancers, likely because the chemotherapeutic agents administered for pancreatic cancer had some effect on the esophageal cancer. Definitive chemoradiotherapy was selected instead of esophagectomy because the patient had already undergone two major surgeries. The patient is still alive nine months after the whole course of treatment with no sign of recurrence. CONCLUSIONS The treatment of triple cancer requires an elaborate strategy to determine which cancer has to be dealt with first and which can be treated later. An aggressive multimodal treatment strategy may be an important option for a patient with triple cancer.
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Affiliation(s)
- Hiroki Imamura
- Department of Surgery, Yao Municipal Hospital, 1-3-1, Ryuge-cho, Yao-shi, Osaka, Japan
| | - Hajime Hirose
- Department of Surgery, Yao Municipal Hospital, 1-3-1, Ryuge-cho, Yao-shi, Osaka, Japan
| | - Shunji Endo
- Department of Surgery, Yao Municipal Hospital, 1-3-1, Ryuge-cho, Yao-shi, Osaka, Japan
| | - Yasuji Hashimoto
- Department of Surgery, Yao Municipal Hospital, 1-3-1, Ryuge-cho, Yao-shi, Osaka, Japan
| | - Masashi Takeda
- Department of Pathology, Yao Municipal Hospital, 1-3-1, Ryuge-cho, Yao-shi, Osaka, Japan
| | - Shinya Kidogami
- Department of Surgery, Yao Municipal Hospital, 1-3-1, Ryuge-cho, Yao-shi, Osaka, Japan
| | - Yukako Mokutani
- Department of Surgery, Yao Municipal Hospital, 1-3-1, Ryuge-cho, Yao-shi, Osaka, Japan
| | - Tomoya Kishimoto
- Department of Surgery, Yao Municipal Hospital, 1-3-1, Ryuge-cho, Yao-shi, Osaka, Japan
| | - Shinichi Yoshioka
- Department of Surgery, Yao Municipal Hospital, 1-3-1, Ryuge-cho, Yao-shi, Osaka, Japan
| | - Shigeyuki Tamura
- Department of Surgery, Yao Municipal Hospital, 1-3-1, Ryuge-cho, Yao-shi, Osaka, Japan
| | - Yo Sasaki
- Department of Surgery, Yao Municipal Hospital, 1-3-1, Ryuge-cho, Yao-shi, Osaka, Japan
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Kim MS, Song IS, Oh KH, Cho JG, Baek SK, Woo JS, Jung KY, Kwon SY. The Utility of Gastrointestinal Endoscopic Examination Versus Positron Emission Tomography-Computed Tomography in the Detection of Second Primary Lesions in Korean Patients With Head and Neck Cancer. EAR, NOSE & THROAT JOURNAL 2020; 101:NP50-NP57. [PMID: 32749871 DOI: 10.1177/0145561320940089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Head and neck cancer often accompany a synchronous secondary primary lesion in the digestive tract. The aim of this study was to compare detection rates between positron emission tomography-computed tomography (PET-CT) and esophagogastroduodenoscopy (G-fiber) or colonoscopy (C-fiber) in the initial staging and to analyze risk factors for premalignant, malignant, and total synchronous secondary primary lesions. METHODS A total of 739 patients with head and neck cancer who underwent PET-CT, G-fiber, or C-fiber were analyzed retrospectively. RESULTS Positron emission tomography-CT did not definitely detect any premalignant synchronous secondary primary lesions (0 [0%] of 739) but definitely detected 10 malignant synchronous secondary primary lesions (10 [1.35%] of 739). Esophagogastroduodenoscopy or C-fiber detected all 20 premalignant synchronous secondary primary lesions (20 [2.71%] of 739) and all 37 malignant synchronous secondary primary lesions (37 [5.00%] of 739). The patients with nasopharynx cancer tended to have premalignant synchronous secondary primary lesions (odds ratio [OR]: 3.793; 95% CI: 1.414-10.171; P = .008). Those with distant metastasis tended to have premalignant (OR: 4.743; 95% CI: 1.508-14.916; P = .009), malignant (OR: 3.803; 95% CI: 1.486-9.731; P = .005), and total synchronous secondary primary lesions (OR: 2.753; 95% CI: 1.159-6.538; P = .022). CONCLUSIONS Premalignant or malignant synchronous secondary primary lesions that were not definitely detected by PET-CT could be found in the endoscopic examination.
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Affiliation(s)
- Min-Su Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Gyeonggi-do, Republic of Korea
| | - In Sik Song
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Ansan Hospital, Ansan, Gyeonggi-do, Republic of Korea
| | - Kyoung Ho Oh
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Ansan Hospital, Ansan, Gyeonggi-do, Republic of Korea
| | - Jae-Gu Cho
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Seung-Kuk Baek
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Jeong-Soo Woo
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Kwang-Yoon Jung
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Soon Young Kwon
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Ansan Hospital, Ansan, Gyeonggi-do, Republic of Korea
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Matsui T, Okada T, Kawada K, Okuda M, Ogo T, Nakajima Y, Kume Y, Ryotokuji T, Hoshino A, Tokairin Y, Michi Y, Harada H, Nakajima Y, Kawano T. Detection of Second Primary Malignancies of the Esophagus and Hypophraynx in Oral Squamous Cell Carcinoma Patients. Laryngoscope Investig Otolaryngol 2018; 3:263-267. [PMID: 30186956 PMCID: PMC6119782 DOI: 10.1002/lio2.179] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 05/06/2018] [Accepted: 05/25/2018] [Indexed: 12/11/2022] Open
Abstract
Objective To assess the usefulness of modified esophagogastroduodenoscopy (EGD) for the detection of second primary malignancies of the esophagus or hypopharynx in patients with oral squamous cell carcinoma and determine the association between the oral lesion subsite and esophageal or hypopharyngeal lesion occurrence. Study Design Retrospective review. Methods In total, 166 patients with oral squamous cell carcinoma without any established symptoms of esophageal or hypopharyngeal squamous cell carcinoma underwent modified EGD based on the Valsalva maneuver and U-turn method, image-enhanced endoscopy, and chromoendoscopy using Lugol's iodine for diagnosis. All suspected lesions were biopsied to determine the clinical stages and duplication rates. Odds ratios for the occurrence of duplicate lesions according to the oral lesion subsite were determined. Results In total, 37 esophageal and 16 hypopharyngeal lesions were detected. According to the Union for International Cancer Control/American Joint Committee on Cancer classification (2009), 75.7% and 5.4% esophageal lesions were classified as stage IA and IB, respectively, and 50% and 18.8% hypopharyngeal lesions as stage II and stage I, respectively. Approximately 59.1% and 50% esophageal and hypopharyngeal lesions, respectively, were successfully treated by endoscopic resection. Oral lesions involving the floor of the mouth were more frequently accompanied by second primary malignancies of the esophagus or hypopharynx. Conclusions Modified EGD is an effective noninvasive technique for early diagnosis and treatment of second primary malignancies of the esophagus and hypopharynx in patients with oral squamous cell carcinoma. In particular, patients with floor of the mouth lesions need close monitoring for hypopharyngeal and esophageal lesions. Level of Evidence 3b.
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Affiliation(s)
- Toshihiro Matsui
- Department of Gastrointestinal Surgery Tokyo Medical and Dental University Tokyo Japan
| | - Takuya Okada
- Department of Gastrointestinal Surgery Tokyo Medical and Dental University Tokyo Japan
| | - Kenro Kawada
- Department of Gastrointestinal Surgery Tokyo Medical and Dental University Tokyo Japan
| | - Masahumi Okuda
- Department of Gastrointestinal Surgery Tokyo Medical and Dental University Tokyo Japan
| | - Taichi Ogo
- Department of Gastrointestinal Surgery Tokyo Medical and Dental University Tokyo Japan
| | - Yutaka Nakajima
- Department of Gastrointestinal Surgery Tokyo Medical and Dental University Tokyo Japan
| | - Yuichiro Kume
- Department of Gastrointestinal Surgery Tokyo Medical and Dental University Tokyo Japan
| | - Tairo Ryotokuji
- Department of Gastrointestinal Surgery Tokyo Medical and Dental University Tokyo Japan
| | - Akihiro Hoshino
- Department of Gastrointestinal Surgery Tokyo Medical and Dental University Tokyo Japan
| | - Yutaka Tokairin
- Department of Gastrointestinal Surgery Tokyo Medical and Dental University Tokyo Japan
| | - Yasuyuki Michi
- Department of Maxillofacial Surgery Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University Tokyo Japan
| | - Hiroyuki Harada
- Department of Oral & Maxillofacial Surgery Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University Tokyo Japan
| | - Yasuaki Nakajima
- Department of Gastrointestinal Surgery Tokyo Medical and Dental University Tokyo Japan
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Liao CT, Fan KH, Kang CJ, Lin CY, Chang JTC, Tsang NM, Huang BS, Chao YK, Lee LY, Hsueh C, Wang HM, Liau CT, Hsu CL, Hsieh CH, Ng SH, Lin CH, Tsao CK, Fang TJ, Huang SF, Chang KP, Yen TC. Clinical Outcomes of Patients with Resected Oral Cavity Cancer and Simultaneous Second Primary Malignancies. PLoS One 2015; 10:e0136918. [PMID: 26335067 PMCID: PMC4559414 DOI: 10.1371/journal.pone.0136918] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 08/10/2015] [Indexed: 11/23/2022] Open
Abstract
Objectives Simultaneous second primary tumors (SSPT) are not uncommon in patients with oral cavity squamous cell carcinoma (OSCC) living in areas where the habit of betel quid chewing is widespread. We sought to identify the main prognostic factors in OSCC patients with SSPT and incorporate them into a risk stratification scheme. Methods A total of 1822 consecutive patients with primary OSCC treated between January 1996 and February 2014 were analyzed for the presence of SSPT. The 18-month and 5-year overall survival (OS) rates served as the main outcome measures. Results Of the 1822 patients, 77 (4%) were found to have SSPT (i.e, two malignancies identified within one month of each other). The 18-month and 5-year OS rates in patients without SSPT and with SSPT were 82% and 69%, and 72% and 53%, respectively (p = 0.0063). Patients with SSPT were further divided into patients with either esophageal cancer or hepatocellular carcinoma (eso-HCC subgroup, n = 8) and other tumors (NO eso-HCC subgroup, n = 69). After multivariate analysis, neck nodal extracapsular spread (ECS, n = 18) and the presence of eso-HCC were identified as independent adverse prognostic factors. The 18-month OS rates of SSPT patients with both eso-HCC and ECS (n = 5) vs. the remaining patients (n = 72) were 0% and 78%, respectively (p < 0.0001). Conclusion OSCC patients with neck nodal ECS and esophageal cancer or hepatocellular carcinoma as SSPT have a dismal short-term prognosis.
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Affiliation(s)
- Chun-Ta Liao
- Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
- Head and Neck Oncology Group, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Kang-Hsing Fan
- Head and Neck Oncology Group, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
- Department of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Chung-Jan Kang
- Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
- Head and Neck Oncology Group, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Chien-Yu Lin
- Head and Neck Oncology Group, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
- Department of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Joseph Tung-Chieh Chang
- Head and Neck Oncology Group, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
- Department of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Ngan-Ming Tsang
- Head and Neck Oncology Group, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
- Department of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Bing-Shen Huang
- Head and Neck Oncology Group, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
- Department of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Yin-Kai Chao
- Head and Neck Oncology Group, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
- Department of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Li-Yu Lee
- Head and Neck Oncology Group, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
- Department of Pathology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Chuen Hsueh
- Head and Neck Oncology Group, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
- Department of Pathology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Hung-Ming Wang
- Head and Neck Oncology Group, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
- Department of Medical Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Chi-Ting Liau
- Head and Neck Oncology Group, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
- Department of Medical Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Cheng-Lung Hsu
- Head and Neck Oncology Group, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
- Department of Medical Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Chia-Hsun Hsieh
- Head and Neck Oncology Group, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
- Department of Medical Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Shu-Hang Ng
- Head and Neck Oncology Group, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Chih-Hung Lin
- Head and Neck Oncology Group, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Chung-Kan Tsao
- Head and Neck Oncology Group, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Tuan-Jen Fang
- Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
- Head and Neck Oncology Group, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Shiang-Fu Huang
- Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
- Head and Neck Oncology Group, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Kai-Ping Chang
- Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
- Head and Neck Oncology Group, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
| | - Tzu-Chen Yen
- Head and Neck Oncology Group, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
- Department of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
- * E-mail:
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