Humans ; Carcinoma, Hepatocellular/secondary* ; Liver Neoplasms/surgery* ; Thyroid Neoplasms/surgery* ; Neoplasms, Second Primary

Currently, surgery-based comprehensive therapy plays an important role in the treatment of local advanced gastric cancer (LAGC), and standard lymph node dissection is a mainstay of gastric surgery. Radical gastrectomy with D2 lymph node dissection is widely accepted based on the international publications of randomized clinical trials, but the extent of lymph node dissection is controversial. An adequate lymph node dissection may improve prognosis and reduce complications, and D2+ lymphadenectomy may improve surgical outcomes in some selected patients. To improve the efficacy of LAGC therapies, the Gastric Cancer Association, China Anti Cancer Association took the lead and organized experts to discuss and vote, and finally formulated this expert consensus. It is hoped that this consensus can provide reference for clinicians and further improve the diagnosis and treatment level of LAGC in China.
Consensus ; Gastrectomy ; Humans ; Lymph Node Excision ; Neoplasms, Second Primary/surgery* ; Prognosis ; Stomach Neoplasms/pathology*

INTRODUCTIONMetastatic disease to the liver in colorectal cancer is a common entity that may present synchronously or metachronously. While increasing surgical experience has improved survival outcomes, some evidence suggest that synchronous lesions should be managed differently. This review aims to update current literature on differences between the outcomes and management of synchronous and metachronous disease.

MATERIALS AND METHODSSystematic review of MEDLINE database up till November 2008.

RESULTSDiscrete differences in tumour biology have been identified in separate studies. Twenty-one articles comparing outcomes were reviewed. Definitions of metachronicity varied from anytime after primary tumour evaluation to 1 year after surgery for primary tumour. Most studies reported that synchronous lesions were associated with poorer survival rates (8% to 16% reduction over 5 years). Sixteen articles comparing combined vs staged resections for synchronous tumour showed comparable morbidity and mortality. Benefits over staged resections included shorter hospital stays and earlier initiation of chemotherapy. Suitability for combined resection depended on patient age and constitution, primary tumour characteristics, size and the number of liver metastases, and the extent of liver involvement.

CONCLUSIONSSurgery remains the only treatment option that offers a chance of long-term survival for patients amenable to curative resection. Synchronicity suggests more aggressive disease although a unifying theory for biological differences explaining the disparity in tumour behaviour has not been found. Combined resection of primary tumour and synchronous metastases is a viable option pending careful patient selection and institutional experience. Given the current evidence, management of synchronous and metachronous colorectal liver metastases needs to be individualised to the needs of each patient.

Biomarkers, Tumor ; Colorectal Neoplasms ; mortality ; pathology ; surgery ; Humans ; Liver Neoplasms ; mortality ; secondary ; surgery ; Neoplasms, Multiple Primary ; mortality ; pathology ; surgery ; Neoplasms, Second Primary ; mortality ; pathology ; surgery ; Prognosis

BACKGROUND: With the wide application of endoscopic submucosal dissection (ESD) for early gastric neoplasms, metachronous gastric neoplasms (MGN) have gradually become a concern. This study aimed to analyze the characteristics of MGN and evaluate the treatment and follow-up outcomes of MGN patients. METHODS: A total of 814 patients were retrospectively enrolled. All these patients were treated by ESD for early gastric cancer or gastric dysplasia between November 2006 and September 2019 at The First Medical Center of Chinese People's Liberation Army General Hospital. The risk factors for MGN were analyzed using Cox hazard proportional model. Moreover, the cumulative incidence, the correlation of initial lesions and MGN lesions, and the treatment and follow-up outcomes of MGN patients were analyzed. RESULTS: A total of 4.5% (37/814) of patients had MGN after curative ESD. The 3-, 5-, and 7-year cumulative incidences of MGN were 3.5%, 5.1%, and 6.9%, respectively, and ultimately reaching a plateau of 11.3% at 99 months after ESD. There was no significant correlation between initial lesions and MGN lesions in terms of gross type (P = 0.178), location (long axis: P = 0.470; short axis: P = 0.125), and histological type (P = 0.832). Cox multivariable analysis found that initial multiplicity was the only independent risk factor of MGN (hazard ratio: 4.3, 95% confidence interval: 2.0-9.4, P < 0.001). Seventy-three percent of patients with MGN were treated by endoscopic resection. During follow-up, two patients with MGN died of gastric cancer with lymph node metastasis. The disease-specific survival rate was significantly lower in patients with MGN than that in patients without MGN (94.6% vs. 99.6%, P = 0.006). CONCLUSIONS The MGN rate gradually increased with follow-up time within 99 months after curative gastric ESD. Thus, regular and long-term surveillance endoscopy may be helpful, especially for patients with initial multiple neoplasms.
Endoscopic Mucosal Resection ; Gastric Mucosa/surgery* ; Humans ; Neoplasms, Second Primary/surgery* ; Retrospective Studies ; Stomach Neoplasms/surgery* ; Treatment Outcome

The application of pelviscopic surgery for the management of ovarian tumors has increased dramatically in the last few years. Of particular concern is the pelviscopic excision of malignant ovarian tumors. One of the important potential problems with this approach is disseminating malignant cells to peritoneal surface. The aim of this report is to draw attention to the possibility of the occurrence of a tumor implantation at the pelviscopic port site in patients with malignant ovarian tumors. A case is presented here in which a localized tumor implant occurred in the abdominal trocar site after pelviscopic removal of ovarian mass subsequently found to be squamous cell carcinoma arising in mature cystic teratoma with brief review of literatures.
Abdomen ; Adult ; Carcinoma, Squamous Cell/*pathology/surgery ; Case Report ; Female ; Human ; *Neoplasms, Second Primary ; Ovarian Neoplasms/*pathology/surgery ; Pelvis

Gastrectomy is known to be a risk factor for adenocarcinoma in remnant stomach. It is suggested that reflux of bile juice or duodenal secretion to remnant stomach induces atrophic gastritis, intestinal metaplasia, and gastric adenocarcinoma. Malignant lymphoma in remnant stomach after gastrectomy is very rare. Only about thirty cases are reported in the world, and there is no case report in Korea. Gastric MALT (mucosa-associated lymphoid tissue) lymphoma is associated with Helicobacter pylori infection but the mechanism of lymphoma development in remnant stomach is still unknown. We report a case of low grade gastric MALT lymphoma of gastric stump after 10 years from partial gastrectomy.
Aged ; *Gastrectomy ; *Gastric Stump ; Humans ; *Lymphoma, B-Cell, Marginal Zone/pathology ; Male ; *Neoplasms, Second Primary ; Stomach Neoplasms/pathology/*surgery

BACKGROUND/AIMS: After colorectal cancer surgery, colonoscopic surveillance should be done for prevention and early detection of secondary cancer. This study aimed to identify the group with high risk of developing colorectal adenoma after curative surgery of colorectal cancer. METHODS: We retrospectively investigated the medical records of the subjects of 130 patients who had been examined using colonoscopy before and after the curative surgery. RESULTS: The average age was 59.4 years. Synchronous adenomas were in 42 patients (32.3%). The occurrence rate was significantly high in men (38.8%) than women (22.0%). After the operation, the mean interval of examining colonoscopy was 11.6 months (3-24 months) and metachronous adenomas were detected in 26 patients (20.0%). The patients who have both metachronous and synchronous adenomas were observed in 13/42 (30.9%) and the patients of metachronous adenomas without synchronous adenomas were observed in 13/88 (14.8%). The occurrence rate of metachronous adenomas with synchronous adenomas was significantly high. The frequency of synchronous adenomas didn't increase with age. However, the frequency of metachronous adenomas increased with age: 0/9 (0%) under 40 years, 7/49 (14.3%) in 41-61 years and 19/72 (26.4%) over 61 years. The occurrence rate was higher in men (26.3%) than women (10.0%). CONCLUSIONS: The occurrence rate of metachronous adenomas after colorectal cancer surgery was higher in the patients with synchronous adenomas, male gender and old aged patients.
Adenoma/*diagnosis ; Adult ; Aged ; Colonoscopy ; Colorectal Neoplasms/*surgery ; English Abstract ; Female ; Humans ; Male ; Middle Aged ; Neoplasms, Multiple Primary/diagnosis ; Neoplasms, Second Primary/*diagnosis ; Risk Factors

OBJECTIVETo verify the outcome and long-term survival of surgical management for double primary lung cancers.

METHODSThe clinical data of 98 patients with double primary lung cancers admitted between January 1999 and June 2009 was analyzed retrospectively. There were 72 cases of synchronous double primary lung cancers, including 54 males and 18 females with median age of onset of 66 years (37 to 79 years). Thoracic surgical procedures for 144 tumor lesions included lobectomy for 9 cases, bilobectomy for 14 cases, pneumonectomy for 6 cases, lobectomy plus wedge resection for 33 cases, double wedge resection for 9 cases, and bilobectomy plus wedge resection for 1 case. There were 26 cases of metachronous double primary lung cancers, including 20 males and 6 females. The median age for the first primary cancer was 59.5 years (38 to 73 years), for second primary cancer was 66 years (47 to 77 years). Thoracic surgical procedures for 52 tumor lesions included lobectomy for 31 cases, bilobectomy for 1 cases, wedge resection for 10 cases, and pneumonectomy for 8 cases.

RESULTSThe overall 30-day mortality was 0. Postoperative complications rate was 13.3%. All patients were followed up after the operation. Until December 2009, follow-up rate was over 90%. Five-year survival for all the patients from the time of initial diagnosis of cancer was 66.4%. Five-year survival for patients with metachronous and synchronous disease from the time of initial diagnosis of cancer was 96.2% and 43.0% (P = 0.000), respectively. Survival at 5 years for the second cancer of metachronous disease and synchronous disease was 45.9% and 43.0% (P = 0.634), respectively.

CONCLUSIONSurgical treatment for double primary lung cancer is reasonable, and the patients can make long-term survival.

Adenocarcinoma ; surgery ; Adult ; Aged ; Female ; Humans ; Lung Neoplasms ; surgery ; Male ; Middle Aged ; Neoplasms, Second Primary ; surgery ; Pneumonectomy ; Retrospective Studies ; Survival Rate

OBJECTIVETo review the experience of the diagnosis, surgical treatment and prognosis of metachronous second primary lung cancers.

METHODSBetween January 1983 and April 2004, 32 patients with metachronous second primary lung cancers were operated in our department. Clinical data of all these patients were reviewed retrospectively.

RESULTSThe initial procedures for their first primary lung cancers were lobectomy or pneumonectomy. Lobectomy or completion pneumonectomy for the second primary lung cancers were performed in 17 cases, limited pulmonary resection was done in 14 cases and exploration was in 1 case. The postoperative morbidity and mortality were 12% (4/32) and 3% (1/32), respectively. The 1-, 3-, and 5-year survival rate after second operation were 66% (19/29), 32% (9/28) and 19% (4/21), respectively.

CONCLUSIONSThe incidence of metachronous second primary lung cancers has been increasing gradually during recent years. The closely follow-up for patients undergoing resection for their first primary lung cancers is most important factor for improvement of the diagnosis of metachronous second primary lung cancers. Limited resection and incomplete lymph node dissection might be the factors contributing to the poor prognosis.

Adult ; Aged ; Female ; Humans ; Lung Neoplasms ; diagnosis ; mortality ; pathology ; surgery ; Lymph Node Excision ; Male ; Middle Aged ; Neoplasms, Second Primary ; diagnosis ; mortality ; pathology ; surgery ; Pneumonectomy ; methods ; Prognosis ; Retrospective Studies

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