1.The Risk and Survival Analysis of Multiple Malignancies in Hematologic Malignancy Patients: A Single Chinese Center Retrospective Study, 2009 through 2017.
Xu-Chang ZHANG ; Lei FAN ; Hua LU ; Si-Xuan QIAN ; Li-Juan CHEN ; Wei XU ; Jian-Yong LI ; Xiao-Yan QU ; Xiao-Li ZHAO
Journal of Experimental Hematology 2023;31(2):389-395
		                        		
		                        			OBJECTIVE:
		                        			To explore the risk and location of multiple malignancies in patients with hematologic malignancies who were followed up for 9 years in Jiangsu Province Hospital and to evaluate the impact of the second primary malignancy on survival of patients.
		                        		
		                        			METHODS:
		                        			The incidence and survival of multiple malignancies in 7 921 patients with hematologic malignancies from 2009 to 2017 were analyzed retrospectively.
		                        		
		                        			RESULTS:
		                        			A total of 180 (2.3%, 180/7 921) patients developed second malignancy, of whom 58 patients were diagnosed with hematologic malignancies as the first primary malignancy, and 98 patients developed hematologic malignancies as second primary malignancy, and the other 24 cases were diagnosed with the second malignancy within 6 months after the first primary malignancy was diagnosed, which was difined as multiple malignancies occurring simultaneously. In 180 patients, 18 cases developed two hematologic malignancies successively, and 11 patients developed more than 3 primary cancers (among them, 2 female patients were diagnosed with 4 primary cancers). Patients with lymphoma and multiple myeloma (MM) as the second primary malignancy had poorer survival than patients with lymphoma and MM as the first primary malignancy. Patients with chronic myeloid leukemia as the second primary malignancy were also associated with inferior overall survival.
		                        		
		                        			CONCLUSION
		                        			In this study, 2.3% of hematologic malignancy patients had multiple mali-gnancies, lymphoma and MM as the second primary malignancy had poor survival.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			East Asian People
		                        			;
		                        		
		                        			Hematologic Neoplasms/complications*
		                        			;
		                        		
		                        			Lymphoma/complications*
		                        			;
		                        		
		                        			Multiple Myeloma/complications*
		                        			;
		                        		
		                        			Neoplasms, Second Primary
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			Survival Analysis
		                        			
		                        		
		                        	
2.Clinical Features and Prognosis of Multiple Myeloma Patients with Secondary Primary Malignancies.
Ling-Ling LI ; Meng-Lin LI ; Yu ZHANG ; Yu LIU ; Yan-Fang LIU ; Zhong-Xing JIANG ; Shao-Qian CHEN ; Shu-Juan WANG ; Chong WANG
Journal of Experimental Hematology 2023;31(2):429-434
		                        		
		                        			OBJECTIVE:
		                        			To explore the clinical characteristics and prognosis of multiple myeloma(MM) patients with secondary primary malignancies.
		                        		
		                        			METHODS:
		                        			The clinical data of newly diagnosed MM patients admitted to the First Affiliated Hospital of Zhengzhou University from January 2011 to December 2019 were retrospectively analyzed. The patients with secondary primary malignancies were retrieved, and their clinical features and prognosis were evaluated.
		                        		
		                        			RESULTS:
		                        			A total of 1 935 patients with newly diagnosed MM were admitted in this period, with a median age of 62 (18-94) years old, of which 1 049 cases were hospitalized twice or more. There were eleven cases with secondary primary malignancies (the incidence rate was 1.05%), including three cases of hematological malignancies (2 cases of acute myelomonocytic leukemia and 1 case of acute promyelocytic leukemia) and eight cases of solid tumors (2 cases of lung adenocarcinoma, and 1 case each of endometrial cancer, esophageal squamous cell carcinoma, primary liver cancer, bladder cancer, cervical squamous cell carcinoma, and meningioma). The median age of onset was 57 years old. The median time between diagnosis of secondary primary malignancies and diagnosis of MM was 39.4 months. There were seven cases with primary or secondary plasma cell leukemia, the incidence rate was 0.67%, and the median age of onset was 52 years old. Compared with the randomized control group, the β2-microglobulin level in the secondary primary malignancies group was lower (P=0.028), and more patients were in stage I/II of ISS (P=0.029). Among the 11 patients with secondary primary malignancies, one survived, ten died, and the median survival time was 40 months. The median survival time of MM patients after the secondary primary malignancies was only seven months. All seven patients with primary or secondary plasma cell leukemia died, with a median survival time of 14 months. The median overall survival time of MM patients with secondary primary malignancies was longer than that of the patients with plasma cell leukemia (P=0.027).
		                        		
		                        			CONCLUSION
		                        			The incidence rate of MM with secondary primary malignancies is 1.05%. MM patients with secondary primary malignancies have poor prognosis and short median survival time, but the median survival time is longer than that of patients with plasma cell leukemia.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Aged
		                        			;
		                        		
		                        			Aged, 80 and over
		                        			;
		                        		
		                        			Multiple Myeloma/complications*
		                        			;
		                        		
		                        			Leukemia, Plasma Cell
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			Esophageal Neoplasms/complications*
		                        			;
		                        		
		                        			Esophageal Squamous Cell Carcinoma/complications*
		                        			;
		                        		
		                        			Prognosis
		                        			;
		                        		
		                        			Neoplasms, Second Primary
		                        			
		                        		
		                        	
5.Recent Advances in Diagnosis and Treatment Strategies for Multiple Primary Lung Cancer.
Bangsheng LI ; Zhenghong YANG ; Yingding ZHAO ; Ying CHEN ; Yunchao HUANG
Chinese Journal of Lung Cancer 2023;26(11):863-873
		                        		
		                        			
		                        			As the utilization of computed tomography in lung cancer screening becomes more prevalent in the post-pandemic era, the incidence of multiple primary lung cancer (MPLC) has surged in various countries and regions. Despite the continued application of advanced histologic and sequencing technologies in this research field, the differentiation between MPLC and intrapulmonary metastasis (IM) remains challenging. In recent years, the specific mechanisms of genetic and environmental factors in MPLC have gradually come to light. Lobectomy still predominates in the treatment of MPLC, but the observation that tumor-specific sublobar resection has not detrimentally impacted survival appears to be a viable option. With the evolution of paradigms, the amalgamated treatment, primarily surgical, is an emerging trend. Among these, stereotactic ablative radiotherapy (SABR) and lung ablation techniques have emerged as efficacious treatments for early unresectable tumors and control of residual lesions. Furthermore, targeted therapies for driver-positive mutations and immunotherapy have demonstrated promising outcomes in the postoperative adjuvant phase. In this manuscript, we intend to provide an overview of the management of MPLC based on the latest discoveries.
.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Lung Neoplasms/therapy*
		                        			;
		                        		
		                        			Early Detection of Cancer
		                        			;
		                        		
		                        			Lung/surgery*
		                        			;
		                        		
		                        			Treatment Outcome
		                        			;
		                        		
		                        			Radiosurgery/methods*
		                        			;
		                        		
		                        			Neoplasms, Multiple Primary/pathology*
		                        			
		                        		
		                        	
7.Treatment and prognosis of multiple primary malignant neoplasms complicated with renal cell carcinoma.
Min QIU ; Yan Yan LIAN ; Min LU ; Bin Shuai WANG ; Xiao Jun TIAN ; Jian LU ; Cheng LIU ; Shu Dong ZHANG ; Min JIANG ; Lu Lin MA
Journal of Peking University(Health Sciences) 2022;54(4):680-685
		                        		
		                        			OBJECTIVE:
		                        			To investigate the treatment and prognosis of multiple primary malignant neoplasms (MPMN) complicated with renal cell carcinoma (RCC), and to make risk stratification.
		                        		
		                        			METHODS:
		                        			A retrospective study of 27 cases of MPMN with RCC in two centers, including the different tumors of MPMN, specific treatment methods, and the interval between primary cancers. At the same time, the survival conditions, including recurrence, metastasis and survival, were followed up for statistical analysis. The interval between the two kinds of primary cancer within 6 months was simultaneous MPMNs, and more than 6 months was metachronous MPMNs. For simple risk stratification of cases, as long as one of the MPMNs had a stage Ⅲ or higher malignancy, which was defined as high risk.
		                        		
		                        			RESULTS:
		                        			Among the 27 patients, 20 were male and 7 were female, with age at the time of diagnosis was 42-82 years, with an average age of (61.3±11.7) years. The age at the diagnosis of renal cancer was 43-87 years, with an average age of (66.0±11.3) years. There were 21 cases with duplex primary malignant neoplasms, 4 cases with triple primary malignant neoplasms, and 2 cases with quadruple primary malignant neoplasms. The interval between first cancer and second cancer was 0-360 months, with a median of 18 months. There were 17 cases of metachronous multiple primary malignant neoplasms and 10 cases of simultaneous multiple primary malignant neoplasms. The most common system of MPMN with comorbid RCC involved urologic system, digestive system and respiratory system. The most common locations of MPMN with comorbid RCC were bladder cancer, lung cancer and colon cancer. Follow-up time calcu- lated from the last cancer was 2-156 months, with a median of 32 months. And 14 cases survived and 13 cases died, with 11 cases being tumor related. Tumor stage was the risk factor of prognosis. Any kind of tumor stage in stage Ⅲ or above had a relatively poor prognosis.
		                        		
		                        			CONCLUSION
		                        			MPMN complicated with RCC is relatively rare. Standard treatment should be used for each cancer type during the treatment process. The prognosis mainly depends on the highest stage of each tumor. Simple risk stratification shows that the prognosis of the high-risk group is worse. This simple stratification method may be helpful to predict the prognosis.
		                        		
		                        		
		                        		
		                        			Aged
		                        			;
		                        		
		                        			Carcinoma, Renal Cell/therapy*
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Kidney Neoplasms/therapy*
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Neoplasms, Multiple Primary/therapy*
		                        			;
		                        		
		                        			Prognosis
		                        			;
		                        		
		                        			Retrospective Studies
		                        			
		                        		
		                        	
10.Interpretation of the 2020 American society of colon and rectal surgeons clinical practice guidelines for the management of rectal cancer.
Chinese Journal of Gastrointestinal Surgery 2021;24(1):27-34
		                        		
		                        			
		                        			Located in the pelvic cavity and contiguous to the anal sphincter complex and urogenital organs, the rectum has more intricate anatomical features compared with the colon. Consequently, the treatment of rectal cancer involves more consideration, including pelvic radiation, lateral lymph node dissection, transanal access, postoperative function, sphincter preservation, and nonoperative management. Based on the last set of American society of colon and rectal surgeons (ASCRS) practice parameters for the management of rectal cancer published in 2013, the 2020 guidelines present evidence-based updates for both long-existing and emerging controversies on surgical management of rectal cancer. These updates include the indication for local resection, lymph node dissection for radical proctectomy, minimally invasive surgery, the "watch and wait" strategy for patients with clinical complete response, and prevention of anastomotic leak. Meanwhile, the guidelines recommend a risk-stratified approach for perioperative therapies for non-metastatic disease, and an individualized multimodality treatment based on treatment intent for synchronous metastatic disease.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Lymph Node Excision
		                        			;
		                        		
		                        			Neoplasms, Multiple Primary/therapy*
		                        			;
		                        		
		                        			Practice Guidelines as Topic
		                        			;
		                        		
		                        			Proctectomy
		                        			;
		                        		
		                        			Rectal Neoplasms/therapy*
		                        			;
		                        		
		                        			Rectum/surgery*
		                        			;
		                        		
		                        			United States
		                        			
		                        		
		                        	
            
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