No abstract available.
Adenocarcinoma, Mucinous/*diagnosis ; Carcinoma, Pancreatic Ductal/*diagnosis ; Carcinoma, Papillary/*diagnosis ; Humans ; Neoplasms, Multiple Primary/diagnosis/*epidemiology ; Neoplasms, Second Primary/diagnosis/epidemiology ; Pancreatic Neoplasms/*diagnosis

We wanted to present the results of our experience with bilateral testis tumor and to suggest the effects of chemotherapy in suppressing the development of second primary testicular tumors. Between 1978 and 1997, 2,345 patients were treated for testicular tumor at The University of Texas M. D. Anderson Cancer Center. Of these, 2,107 had germ cell cancers. There were 22 (0.94%) cases of bilateral testicular tumor in the overall patient population and 21 (1.0%) cases among patients with germ cell cancer. We reviewed the medical records to determine the incidence of the histological subtype, the incidence of metachronous versus synchronous formation of contralateral tumors, and tumor stage in this patient population. We also examined the effect of chemotherapy in treating the first tumor and preventing the occurrence of a second tumor. Finally, we compared the effect of ultrasonography, serum tumor marker elevation, and physical examination in detecting second tumors. Only one contralateral germ cell tumor developed synchronously; all others developed metachronously. Fifty percent of first tumors were seminomas, compared to 55% of second tumors. The histologic concordance rate for first and second tumors was 35%. Tumor stage was higher among first tumors than second tumors. The majority of second tumors in patients who received chemotherapy for first malignancies tended to be metachronous seminomas. Ultrasonography detected 6 of 21 (28.6%) contralateral tumors before they were evident by physical examination or serum tumor marker elevation. Seminomas were more prevalent among patients with bilateral germ cell disease than patients with unilateral disease. Chemotherapy, when used as treatment for first tumors, may have some effect in preventing the development of nonseminomatous germ cell tumors in the contralateral testicle. Close follow-up of the contralateral testis with ultrasonography is essential for early detection of second tumors. The outcome for patients with bilateral testicular germ cell cancer is excellent, secondary to early detection.
Adolescence ; Adult ; Antineoplastic Agents/therapeutic use* ; Human ; Incidence ; Male ; Neoplasms, Multiple Primary/epidemiology ; Neoplasms, Second Primary/prevention & control* ; Neoplasms, Second Primary/epidemiology ; Testicular Neoplasms/pathology ; Testicular Neoplasms/drug therapy*

No abstract available.
Adenocarcinoma, Mucinous/*diagnosis ; Carcinoma, Pancreatic Ductal/*diagnosis ; Carcinoma, Papillary/*diagnosis ; Humans ; Neoplasms, Multiple Primary/diagnosis/*epidemiology ; Pancreatic Neoplasms/*diagnosis ; Prevalence

OBJECTIVETo report the clinical and pathological characteristics of bilateral primary breast cancer (BPBC) in comparison with unilateral primary breast cancer (UPBC).

METHODSA retrospect database of primary breast cancer patients admitted to the Cancer Hospital from March 1967 through May 2003 was analyzed.

RESULTSA total of 10,470 primary breast cancer patients were treated, among which 271 patients had bilateral primary tumors with an incidence of 2.1%. Most of the BPBC, developed both synchronously (sBPBC, incidence rate: 0.6%) and metachronously (mBPBC, incidence rate: 1.5%), were diagnosed in premenopausal women with an average age of 48. In the latter cases, the median time interval between their occurrences was 57.6 months. The median survival time for patients with sBPBC and mBPBC was 29.6 months and 27.8 months, respectively. There was no statistical difference in survival rate between the 2 groups of patients. Nor was menopausal status related to survival. In mBPBC patients, when the occurrence of the second breast cancer was taken as the beginning of prognostic analysis, the prognosis of BPBC patients was worse than those with unilateral involvement.

CONCLUSIONPrognosis of patients with bilateral primary breast cancer is poor. In mBPBC patients whose breast cancers appear one after the other, meticulous follow-up is needed after resection of tumor on one side to early detect development of cancer of the countralateral breast especially within 5 years.

Adult ; Breast Neoplasms ; epidemiology ; pathology ; surgery ; China ; Female ; Follow-Up Studies ; Humans ; Incidence ; Lymphatic Metastasis ; Mastectomy ; Middle Aged ; Neoplasm Staging ; Neoplasms, Multiple Primary ; epidemiology ; pathology ; surgery ; Neoplasms, Second Primary ; epidemiology ; pathology ; surgery ; Premenopause ; Prognosis ; Retrospective Studies

OBJECTIVETo explore the prevalence, clinical features and prognosis of multiple primary neoplasms in patients with colorectal carcinoma (CRC).

METHODSData of colorectal cancer patients admitted to our hospital from June 1994 to June 2002 were analyzed retrospectively. Patients were divided into multiple-cancer group (MCG) and single- cancer group (SCG). Clinical features and prognosis were compared between two groups.

RESULTSThe incidence of multiple cancers was 7.4 % (83/ 1125). Forty- seven patients had multiple colorectal cancers metachronous CRC(S) in 12 and synchronous CRC(S) in 35. Thirty- six patients 5 patients with synchronous cancers had malignant tumors outside colorectal tract,12 of whom were gastric carcinomas. No significant differences were found between MCG and SCG regarding gender, onset age, Dukes stage and differentiation of index CRC. Cancer family history (P=0.002) and colorectal adenoma (P=0.036) were significantly more common in MCG than those in SCG. The local recurrence or distant metastasis in MCG was significantly higher than that in SCG (P=0.047), though there was no significant difference in survival between the two groups. Forty- one percent of index tumors were located in right colon in MCG, significantly higher than that in SCG (P=0.048). The secondary tumors were mainly adenoma cancerization in MCG.

CONCLUSIONCancer family history and colorectal adenoma seems to be at high risk for developing multiple cancers in CRC patients. Gastric cancer and colorectal adenoma cancerization were common secondary tumors of multiple primary neoplasms in patients with colorectal carcinoma.

Adenomatous Polyps ; genetics ; Adult ; Aged ; Colorectal Neoplasms ; diagnosis ; epidemiology ; pathology ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Neoplasms, Multiple Primary ; diagnosis ; epidemiology ; pathology ; Prognosis ; Retrospective Studies ; Risk Factors

Sixteen cases of male breast cancer seen over a 20-year period were reviewed. The causes of cancer of the male breast are no better understood, but major alterations in hormonal environment could be a significant factor. Some clinical characteristics correspond well with the results of other series. The median age at presentation was 61.7 years. The most frequent initial symptom was a painless mass, and the incidences of nipple discharge, central tumor location, and axillary node involvement were high. Males also had a higher incidence of local advancement which was associated with a longer delay in seeking treatment and small breast tissue. The pathologic type was infiltrating ductal type in all cases except one, and all cases showed favorable nuclear grade. Estrogen receptor analysis was performed from the tumor of 2 patients. Both of them showed a high receptor level. There was no locoregional relapse in 5 patients who received adjuvant radiotherapy in contrast to the 2 relapses in 3 patients who underwent surgery alone. And three of the five patients who received radiotherapy suffered from systemic metastasis which suggested the important role of adjuvant chemotherapy as well as radiotherapy. In light of the encouraging results about adjuvant chemotherapy in the treatment for female breast cancer with axillary lymph node involvement, it would be desirable to extend this policy to male breast cancer.
Adenocarcinoma/epidemiology ; Adult ; Aged ; Breast Neoplasms/*epidemiology/pathology/therapy ; Carcinoma, Intraductal, Noninfiltrating/*epidemiology/pathology/therapy ; Combined Modality Therapy ; Human ; Korea/epidemiology ; Lymphatic Metastasis ; Male ; Middle Age ; Neoplasms, Multiple Primary ; Retrospective Studies

PURPOSE: Newly developed extra-mammary multiple primary cancers (MPCs) are an issue of concern when considering the management of breast cancer survivors. This study aimed to investigate the prevalence of MPCs and to evaluate the implications of MPCs on the survival of breast cancer patients. MATERIALS AND METHODS: A total of 8204 patients who underwent surgery at Severance Hospital between 1990 and 2012 were retrospectively selected. Clinicopathologic features and survival over follow-up periods of < or =5 and >5 years were investigated using univariate and multivariate analyses. RESULTS: During a mean follow-up of 67.3 months, 962 MPCs in 858 patients (10.5%) were detected. Synchronous and metachronous MPCs were identified in 23.8% and 79.0% of patients, respectively. Thyroid cancer was the most prevalent, and the second most common was gynecologic cancer. At < or =5 years, patients with MPCs were older and demonstrated significantly worse survival despite a higher proportion of patients with lower-stage MPCs. Nevertheless, an increased risk of death in patients with MPCs did not reach statistical significance at >5 years. The causes of death in many of the patients with MPCs were not related to breast cancer. Stage-matched analysis revealed that the implications of MPCs on survival were more evident in the early stages of breast disease. CONCLUSION: Breast cancer patients with MPCs showed worse survival, especially when early-stage disease was identified. Therefore, it is necessary to follow screening programs in breast cancer survivors and to establish guidelines for improving prognosis and quality of life.
Adult ; Aged ; Breast/pathology ; Breast Neoplasms/diagnosis/*mortality ; Female ; Humans ; Middle Aged ; Multivariate Analysis ; Neoplasm Metastasis ; Neoplasm Staging ; Neoplasms, Multiple Primary/diagnosis/*mortality ; Neoplasms, Second Primary/diagnosis/*mortality ; Prognosis ; *Quality of Life ; Republic of Korea/epidemiology ; Retrospective Studies ; Survival Analysis

OBJECTIVETo investigate the epidemiological and clinical features of multiple primary malignant neoplasms (MPMNs).

METHODSOne hundred and twenty-five cases of more than or equal to three primary malignant neoplasms detected in the period of 1958 to 2001 were studied retrospectively in terms of frequency, age of onset, sex ratio, tumor location and the interval between sequential tumors.

RESULTSThe overall incidence of MPMNs was 0.090%; for three, four and five MPMNs was 0.078%, 0.009% and 0.001%. The mean age of onset of MPMNs was 64 years. The sex ratio, of male to female, was 1.0:1.2. The mean time interval was 7.1 years, and it reduced from 5.7 to 2.4 years in a descending order of the first, second, third, forth and fifth primary tumors. Three, four and five primary malignant neoplasms were predicated respectively in the large intestine, breast, lung, esophagus, uterus, skin; the large intestine, breast, skin stomach, urinary bladder, uterus; and the large intestine, breast, skin, parotid glands.

CONCLUSIONSThe overall incidence of multiple primary malignant neoplasms seems to ascend. The age of onset of MPMNs tends to be increase. The incidence of in women is higher than in men. The time interval from the first to fifth primary tumor is decreasing. The susceptible organs are identical organ, bigeminal organs or organs of the same system.

Adult ; Age of Onset ; Aged ; Aged, 80 and over ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Neoplasms, Multiple Primary ; epidemiology ; Retrospective Studies ; Sex Factors

BACKGROUND/AIMS: Endoscopic submucosal dissection (ESD) has become accepted as a minimally invasive treatment for gastric neoplasms. However, the development of synchronous or metachronous gastric lesions after endoscopic resection has become a major problem. We investigated the characteristics of multiple gastric neoplasms in patients with early gastric cancer (EGC) or gastric adenoma after ESD. METHODS: In total, 512 patients with EGC or gastric adenoma who had undergone ESD between January 2008 and December 2011 participated in this study. The incidence of and factors associated with synchronous and metachronous gastric tumors were investigated in this retrospective study. RESULTS: In total, 66 patients (12.9%) had synchronous lesions, and 13 patients (2.5%) had metachronous lesions. Older (> 65 years) subjects had an increased risk of multiple gastric neoplasms (p = 0.012). About two-thirds of the multiple lesions were similar in macroscopic and histological type to the primary lesions. The median interval from the initial lesions to the diagnosis of metachronous lesions was 31 months. The annual incidence rate of metachronous lesions was approximately 3%. CONCLUSIONS: We recommend careful follow-up in patients of advanced age (> 65 years) after initial ESD because multiple lesions could be detected in the remnant stomach. Annual surveillance might aid in the detection of metachronous lesions. Large-scale, multicenter, and longer prospective studies of appropriate surveillance programs are needed.
Adenoma/epidemiology/pathology/*surgery ; Age Factors ; Aged ; *Dissection ; Female ; Gastrectomy/*methods ; Gastric Mucosa/pathology/*surgery ; *Gastroscopy ; Humans ; Incidence ; Male ; Middle Aged ; Neoplasms, Multiple Primary/epidemiology/pathology/*surgery ; Neoplasms, Second Primary/epidemiology/pathology/*surgery ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms/epidemiology/pathology/*surgery ; Time Factors ; Treatment Outcome

BACKGROUNDIn China, esophageal squamous cell carcinoma (ESCC) and gastric cardia adenocarcinoma (GCA) share susceptibility loci, but different rates of multiple primary cancer and male/female ratio suggest the proportion of familial cancer is not equal.

METHODSThe percent of cases with a positive family history, median onset age, rate of multiple primary cancer, and male/female ratio associated with upper, middle, lower third ESCC and GCA were compared to reveal the proportion of familial cancer. The 7267 subjects analyzed constituted all ESCC and GCA cases in whom the cancer was resected with cure intention between 1970 and 1994 at the 4th Hospital of Hebei Medical University.

RESULTSA positive family history for cancer was most often associated with the multiple primary ESCC and/or GCA cases, e.g. with 42% of the males and 59% of the females. For upper, middle, lower third ESCC and GCA, the percent of cases with a positive family history decreased by 38.5%, 26.3%, 26.5%, and 11.2% in males (P < 0.000) and 25.0%, 22.3%, 23.9%, and 9.8% in females (P < 0.0001). Median onset age increased from 49, 52, 55, to 56 years old in males and from 50, 53, 55, to 56 years old in females ( both P < 0.0001) for upper, middle, lower third ESCC and GCA. Male/female ratio increased from 2.2, 2.1, 2.2, to 6.2:1 for upper, middle, lower third ESCC and GCA (P < 0.0001). For upper, middle, lower third ESCC and GCA, the percent of multiple primary cancers decreased from 21.2%, 2.3%, 2.2%, to 1.5% in males and from 14.3%, 2.4%, 3.4%, to 3.1% in females. The preponderance of males, smoking, drinking, or onset-age ≥ 50 years was significantly higher in GCA than in ESCC, and the difference in the rates of multiple primary cancers between the preponderant and the non-preponderant cases was significant in GCA, but not in ESCC, suggesting non-equal requirement for genetic susceptibility when environmental hazards did not exist.

CONCLUSIONSThe proportion of familial cancer in upper gastrointestinal carcinomas decreases by the primary site of upper, middle, lower third esophagus and gastric cardia. Considering familial and sporadic cancers differ in preventability, screening strategy and recurrence, our findings have basic and clinical implications.

Adenocarcinoma ; genetics ; Age of Onset ; Carcinoma, Squamous Cell ; genetics ; Cardia ; China ; Esophageal Neoplasms ; genetics ; Female ; Genetic Loci ; Genetic Predisposition to Disease ; Humans ; Male ; Middle Aged ; Neoplasms, Multiple Primary ; epidemiology ; Risk Factors ; Stomach Neoplasms ; genetics