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Alhamadh MS, Alanazi RB, Algarni ST, Alhuntushi AAR, Alshehri MQ, Chachar YS, Alkaiyat M, Sabatin F. A Descriptive Study of the Types and Survival Patterns of Saudi Patients with Multiple Primary Solid Malignancies: A 30-Year Tertiary Care Center Experience. Curr Oncol 2022; 29:4941-4955. [PMID: 35877253 PMCID: PMC9315520 DOI: 10.3390/curroncol29070393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/30/2022] [Accepted: 07/07/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Objective: Cancer survival has improved significantly, which reflects the achievements in screening, diagnosis, and treatment. As a consequence, multiple primary malignancies are diagnosed more frequently, with an incidence ranging from 0.52–11.7%. The types of malignancy that coexist and survival patterns vary notably in different countries and geographical areas. Due to the limited literature in Saudi Arabia, a baseline of prevalent malignancy combinations and their survival patterns would support early detection and disease management. Method: This was a retrospective descriptive study conducted from 1993–2022 at King Abdulaziz Medical City, Department of Medical Oncology, Riyadh, Saudi Arabia. Patients with at least two biopsy-proven solid malignancies were included. Patients with hematological malignancies, missing data, or an uncertain or indecisive pathology report were excluded. Result: In total, 321 patients were analyzed. More than half (57.3%) of the patients were female. A third (33%) of the cases were synchronous, and 67% were metachronous. The most frequent site of the first primary malignancy was breast cancer, followed by colorectal, skin, and thyroid cancers. The most frequent site of the second primary malignancy was colorectal cancer, followed by thyroid, breast, and liver cancers. Only 4% of the cases had a third primary malignancy, with colorectal and appendiceal cancers being the most frequent. The most frequently observed histopathology in the synchronous and metachronous malignancies was adenocarcinoma. Breast–colorectal, breast–thyroid, and kidney–colorectal were the most frequently observed malignancy combinations. Conclusion: The current study offers a baseline of multiple primary malignancies in Saudi Arabia and provides supporting evidence that the pattern of multiple primary malignancies varies among different countries and ethnicities. The possibility of developing another primary malignancy should be considered when treating and monitoring cancer patients.
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Affiliation(s)
- Moustafa S. Alhamadh
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of the National Guard—Health Affairs, Riyadh 14611, Saudi Arabia; (R.B.A.); (S.T.A.); (A.A.R.A.); (M.Q.A.)
- King Abdullah International Medical Research Center, Ministry of the National Guard—Health Affairs, Riyadh 11481, Saudi Arabia; (Y.S.C.); (M.A.); (F.S.)
- Correspondence: ; Tel.: +96-656-333-4984
| | - Rakan B. Alanazi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of the National Guard—Health Affairs, Riyadh 14611, Saudi Arabia; (R.B.A.); (S.T.A.); (A.A.R.A.); (M.Q.A.)
- King Abdullah International Medical Research Center, Ministry of the National Guard—Health Affairs, Riyadh 11481, Saudi Arabia; (Y.S.C.); (M.A.); (F.S.)
| | - Sultan T. Algarni
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of the National Guard—Health Affairs, Riyadh 14611, Saudi Arabia; (R.B.A.); (S.T.A.); (A.A.R.A.); (M.Q.A.)
- King Abdullah International Medical Research Center, Ministry of the National Guard—Health Affairs, Riyadh 11481, Saudi Arabia; (Y.S.C.); (M.A.); (F.S.)
| | - Ahmed Abdullah R. Alhuntushi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of the National Guard—Health Affairs, Riyadh 14611, Saudi Arabia; (R.B.A.); (S.T.A.); (A.A.R.A.); (M.Q.A.)
- King Abdullah International Medical Research Center, Ministry of the National Guard—Health Affairs, Riyadh 11481, Saudi Arabia; (Y.S.C.); (M.A.); (F.S.)
| | - Mohammed Qasim Alshehri
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of the National Guard—Health Affairs, Riyadh 14611, Saudi Arabia; (R.B.A.); (S.T.A.); (A.A.R.A.); (M.Q.A.)
- King Abdullah International Medical Research Center, Ministry of the National Guard—Health Affairs, Riyadh 11481, Saudi Arabia; (Y.S.C.); (M.A.); (F.S.)
| | - Yusra Sajid Chachar
- King Abdullah International Medical Research Center, Ministry of the National Guard—Health Affairs, Riyadh 11481, Saudi Arabia; (Y.S.C.); (M.A.); (F.S.)
- College of Sciences and Health Professions, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of the National Guard—Health Affairs, Riyadh 14611, Saudi Arabia
| | - Mohammad Alkaiyat
- King Abdullah International Medical Research Center, Ministry of the National Guard—Health Affairs, Riyadh 11481, Saudi Arabia; (Y.S.C.); (M.A.); (F.S.)
- Department of Medical Oncology, King Abdulaziz Medical City, Ministry of the National Guard—Health Affairs, Riyadh 12713, Saudi Arabia
| | - Fouad Sabatin
- King Abdullah International Medical Research Center, Ministry of the National Guard—Health Affairs, Riyadh 11481, Saudi Arabia; (Y.S.C.); (M.A.); (F.S.)
- Department of Medical Oncology, King Abdulaziz Medical City, Ministry of the National Guard—Health Affairs, Riyadh 12713, Saudi Arabia
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Unexplained neoplastic anastomotic recurrence after right hemicolectomy: a case report. J Med Case Rep 2020; 14:196. [PMID: 33076984 PMCID: PMC7574449 DOI: 10.1186/s13256-020-02529-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 09/11/2020] [Indexed: 11/17/2022] Open
Abstract
Background Anastomotic recurrences of the colon are postulated to arise due to inadequate margins, tumor implantation by exfoliated cells, altered biological properties of bowel anastomosis, and missed synchronous lesions. In this paper, a case of unexpected early local recurrence after surgery for colon cancer is presented. Case presentation A 68-year-old Caucasian man underwent right hemicolectomy for invasive G2 adenocarcinoma. Two months later, endoscopy revealed a wide and well-functioning anastomosis with a hyperemic, hard, and thickened mucosal area of about 2 cm in diameter. Biopsies showed the presence of an adenocarcinoma with the same grading of the previous lesion. Ten days later, the patient underwent a new intervention; the last 10 cm of the ileum and half of the remaining transverse colon were resected, and the patient started adjuvant therapy. Specimen examination confirmed the presence of an adenocarcinoma (G2) penetrating the muscular layer of the wall; also, in this case, resection edges were free from tumoral invasion, and the removed lymph nodes were exempt from neoplastic colonization. The patient was seen in follow-up for about 5 years, and he did not show local or systemic manifestations. Conclusions Whenever a neoplastic recurrence on the anastomotic line occurs, in the presence of negative intestinal margins, as usual in right colectomies, the implantation of neoplastic cells could be the possible cause.
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The Immune System in Cancer Pathogenesis: Potential Therapeutic Approaches. J Immunol Res 2016; 2016:4273943. [PMID: 28116316 PMCID: PMC5220497 DOI: 10.1155/2016/4273943] [Citation(s) in RCA: 128] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 10/09/2016] [Indexed: 12/13/2022] Open
Abstract
Interplay among immune activation and cancer pathogenesis provides the framework for a novel subspecialty known as immunooncology. In the rapidly evolving field of immunooncology, understanding the tumor-specific immune response enhances understanding of cancer resistance. This review highlights the fundamentals of incorporating precision medicine to discover new immune biomarkers and predictive signatures. Using a personalized approach may have a significant, positive impact on the use of oncolytics to better guide safer and more effective therapies.
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Sastry A, Wayne M, Steele J, Iskandar M, Yuan S, Cooperman AM. Three synchronous, sporadic and separate periampullary and pancreatic tumors: more than a coincidence? World J Surg Oncol 2014; 12:382. [PMID: 25494951 PMCID: PMC4301858 DOI: 10.1186/1477-7819-12-382] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Accepted: 11/18/2014] [Indexed: 12/27/2022] Open
Abstract
Three sporadic, synchronous, and separate lesions in the ampulla of Vater and the head of the pancreas presented in an 81-year-old male. One was symptomatic and two were incidental. One was detected preoperatively (the ampullary lesion) and two by examination of the resected specimen (the neuroendocrine and pancreatic carcinomas). The case is summarized and the literature and the issue of commonality are reviewed.
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Affiliation(s)
| | | | | | | | | | - Avram M Cooperman
- Department of Surgery, Mount Sinai Beth Israel, 37 Union Square West, 4th floor, New York, NY 10003, USA.
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Gopalan S, Bose JC, Periasamy S. Anastomotic Recurrence of Colon Cancer-is it a Local Recurrence, a Second Primary, or a Metastatic Disease (Local Manifestation of Systemic Disease)? Indian J Surg 2014; 77:232-6. [PMID: 26246708 DOI: 10.1007/s12262-014-1074-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Accepted: 04/03/2014] [Indexed: 12/29/2022] Open
Abstract
The aim of this study is to review the literature to find out the exact etiology of anastomotic cancers of colon post resection and differentiate them between a recurrence, second primary, and metastatic disease (local manifestation of systemic disease). Web-based literature search was done, and datas collected. We searched PubMed for papers using the keywords colon cancer recurrence, anastomotic recurrence, and recurrent colon carcinoma. We also searched for systematic review in the same topic. In addition, we used our personal referrence archive. Anastomotic recurrences of colon are postulated to arise due to inadequate margins, tumor implantation by exfoliated cells, altered biological properties of bowel anastomosis, and missed synchronous lesions. Some tumors are unique with repeated recurrence after repeated resection. Duration after primary surgery plays a major role in differentiating recurrent and second primary lesions. Repeated recurrences after repeated resections have to be considered a manifestation of systemic disease or metastatic disease due to the virulence of the disease. A detailed analysis and study of patients with colonic anastomotic lesion are required to differentiate it between a recurrent, a second primary lesion, and a metastatic disease (local manifestation of a systemic disease). The nomenclature is significant to study the survival of these patients, as a second primary lesion will have different survival compared to that of recurrent lesions.
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Affiliation(s)
- Sathiyavelavan Gopalan
- Department of Surgical Oncology, Rajiv Gandhi Government General Hospital, Chennai, Tamilnadu India
| | - Jagadesh Chandra Bose
- Department of Surgical Oncology, Rajiv Gandhi Government General Hospital, Chennai, Tamilnadu India
| | - S Periasamy
- Department of Surgical Oncology, Rajiv Gandhi Government General Hospital, Chennai, Tamilnadu India
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Kilciksiz S, Gokce T, Baloglu A, Calli A, Kaynak C, Kilic B, Eski E, Nalbantoglu G, Yigitbas HA. Characteristics of synchronous- and metachronous-type multiple primary neoplasms: a study of hospital-based cancer registry in Turkey. Clin Genitourin Cancer 2008; 5:438-45. [PMID: 18272026 DOI: 10.3816/cgc.2007.n.032] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE The aim of this study was to evaluate the demographic, histologic, and topographic characteristics, and the association of synchronous and metachronous multiple primary neoplasms. PATIENTS AND METHODS Five hundred seventy-two multiple primary tumors (n = 286) of 20,895 tumors recorded from 1993 to 2005 by the office of Izmir Cancer Registry at the Izmir Ataturk Training and Research Hospital were analyzed. chi(2) and Student t test were performed. RESULTS One hundred fifty-eight patients had synchronous tumors whereas 128 had metachronous tumors. Both groups were more frequent among men and among patients aged > 50 years. The distribution of synchronous and metachronous tumors between sex and age groups was similar (P = .462 and P = .479, respectively). Carcinomas were more frequent and histologic compositions of both of the groups were significantly different (P = .009). Pairs of the same topographic origin were significantly more frequent in synchronous tumors (P = .019). The urogenital system was the most frequent location in all groups. The leading tumoral association was between urogenital-urogenital tumors, also. Detailed evaluation of the metachronous group revealed that the most frequent organ associations were of breast-ovary (n = 7) and bladder-larynx (n = 5). CONCLUSION Field cancerization in the epithelium, theory of a common clonal origin, or the screening effect might account for the relatively frequent association of urogenital tumors. The association of the tumors of breast-ovary might be related to the endocrine effect. Further studies complying with international rules and using data from different population-based tumor registries are necessary to elucidate site correlation.
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Affiliation(s)
- Sevil Kilciksiz
- Department of Radiation Oncology, Gaziantep University, Medical School, Gaziantep, Turkey.
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