Clinical characteristics and efficacy of second primary malignancies in hypopharyngeal carcinoma: an analysis of 216 real-world cases / 中华放射肿瘤学杂志

Objective:To evaluate the incidence, clinical characteristics and prognosis of second primary malignancies (SPMs) among patients with hypopharyngeal carcinoma (HPC) in real-world analysis.Methods:A total of 594 HPC patients admitted to Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College from 2010 to 2018 were retrospectively analyzed.The incidence and clinical characteristics of HPC patients complicated with SPMs were analyzed. Clinical efficacy was compared among different groups.Results:With a median follow-up time of 66.9 months, SPMs were present in 36.4% (216/594) of HPC patients: 22.2% (132/594) were synchronous and 14.1% (84/594) were metachronous. The upper aerodigestive tract was the most common involved region. Compared with patients without SPMs, patients with synchronous and metachronous carcinoma in situ had similar 5-year overall survival (OS) of 42.2% vs. 44.5% ( P=0.958) and 62.2% vs. 44.5% ( P=0.240), respectively. Patients with synchronous invasive SPMs had a worse 5-year OS of 27.2% vs. 44.5% in their counterparts without SPMs ( P=0.001). Patients with metachronous invasive SPMs had similar 5-year OS of 50.2% vs. 44.5% in their counterparts without SPMs ( P=0.587). SPMs accounted for 42.5% of total death in metachronous invasive SPMs group. Conclusions:Patients with HPC have a high probability of developing SPMs. Moreover, the incidence of complicated with esophageal/gastric carcinoma in situ or metachronous SPMs exerts no effect on prognosis, while the occurrence of synchronous SPMs significantly affectes the prognosis of patients. However, the incidence of SPMs is still one of the main death causes in metachronous invasive SPMs group.

Influencing factors of secondary primary cancer in patients with acute lymphoid leukemia / 公共卫生与预防医学

Objective To analyze the influencing factors of second primary cancer (SPC) in patients with acute lymphoblastic leukemia (ALL). Methods The Surveillance, Epidemiology and End Results database of the National Cancer Institute was used to extract data, and SEER*Stat program 8.4.0 was used to calculate the standardized incidence rate ratio (SIR) and absolute excess rate (AER). In addition, Cox regression models were used to estimate the hazard ratio (HR) of different age, race, sex, chemotherapy, and radiation and other factors for secondary tumors by R 4.2.1, and Kaplan-Meier method was used to plot the cumulative incidence. Results A total of 22 407 cases were included, and the person-years of follow-up were 142780.82. There was a total of 436 SPC cases, 32 of which developed multiple cancers. The median time of secondary cancers was 47.5 months. Patients with ALL had a higher risk of SPC than the general population (SIR=2.27; 95% , CI:2.07-2.50), and the most observed SPC was lymphatic and hematopoietic system, with an SIR of 6.96 (95% CI:5.94-8.11). The risk of SPC in ALL patients diagnosed in different time periods showed an upward trend, from 1.98 in 2000 to 2.38 in 2019. With the increase of age, the risk of SPC in ALL patients gradually decreased. Chemotherapy reduced the risk of SPC (HR=0.26; 95%CI: 0.19-0.36), while radiotherapy increased the risk of SPC by 59.60% (HR=1.57; 95% CI: 1.23-2.00). Conclusion In the future, chemotherapy is recommended for ALL patients to reduce radiation exposure during radiotherapy, and more attention should be paid to the health status of ALL patients within 1-5 years after their onset.

Clinical characteristics and efficacy of oropharyngeal carcinoma with secondary primary tumor / 临床耳鼻咽喉头颈外科杂志

Objective:To analysis the clinical features and prognosis in oropharyngeal carcinoma with secondary primary tumor. Methods:A retrospective analysis was performed on 468 pathologically confirmed oropharyngeal cancer as the primary tumor patients with p16 status, excluded distant metastasis, and admitted to the Chinese Academy of Medical Sciences from January 2010 to December 2020. The clinical features and prognosis of the secondary primary tumor were analyzed. Results:Among 468 patients with oropharyngeal cancer treated at initial diagnosed, 222 cases were P16-negative. With a median follow-up time of 64.3 months, 66 cases developed second primary cancer, with an incidence of 29.3%, among which 63.6%（42/66） were synchronous and 36.4%（24/66） were heterochronous, esophagus was the most commonly involved site. The 5-year OS of p16-negative oropharyngeal carcinoma with synchronous second primary cancer, without second primary cancer and with heterogeneous second primary cancer were 26.3% and 57.3% and 73.2%（P=0.001）; The second primary cancer accounted for 11.2%（12/107） of the deaths in the whole group, among them, the heterochronous second primary accounted for 75.0%（9/12）. There were 246 patients with p16 positive, with a median follow-up time of 52.4 months, 20 patients developed second primary cancer（8.1%）. Among them, 65.0%（13/20） were synchronous and 35.0%（7/20） were heterochronous. Esophagus was the most commonly involved site. The 4-year OS of p16-positive with synchronous, heterochronous and non-second primary cancer group were 51.9%, 80.7% and 83.3%. Secondary primary cancer accounted for 3.8%（2/52） of all deaths in p16 positvie group. Conclusion:The incidence of second primary cancer of p16 positive and negative oropharyngeal carcinoma were different. The esophagus was the most commonly involved site regardless of p16 status. Regardless of p16 status, the survival of patients with synchronous second primary cancer was worse than those without second primary cancer. For p16-negative oropharyngeal carcinoma, the prognosis was better in patients with heterogeneous second primary cancer, the second primary cancer is one of the main causes of death.

The Risk and Survival Analysis of Multiple Malignancies in Hematologic Malignancy Patients: A Single Chinese Center Retrospective Study, 2009 through 2017 / 中国实验血液学杂志

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.

Síndrome del psoas maligno secundario a cáncer de cuello uterino / Malignant psoas syndrome secondary to uterine cervical carcinoma

Resumen Una mujer de 40 años se internó de forma programada para recibir quimioterapia por una leucemia linfoblástica aguda (LLA) B común de alto riesgo, diagnosticada 10 meses antes a raíz de hemato mas y petequias en los miembros inferiores, y metrorragia. En ese momento, presentaba trombocitopenia y una ecografía ginecológica transvaginal normal. Al ingreso de la internación programada, se quejó de dolor inguinal izquierdo con irradiación al muslo e impotencia funcional de 3 meses de evolución, dolor en fosa ilíaca derecha y diarrea. En el examen físico tenía dolor a la palpación profunda en la fosa ilíaca derecha y signo del psoas positivo a la izquierda. La tomografía de abdomen y pelvis reveló una imagen compatible con un absceso del psoas izquierdo y signos de tiflitis. La biopsia del psoas izquierdo demostró infiltración por nidos y cordones de carcinoma escamoso queratinizante moderadamente diferenciado. El examen ginecológico dirigido evidenció anomalías macroscópicas del cuello uterino correlacionadas con el mismo diagnóstico histopatológico. Los se gundos cánceres primarios más frecuentemente asociados a LLA son linfoma de Hodgkin, cáncer escamoso de piel, tumores endocrinos, cáncer renal, linfoma no-Hodgkin y cáncer de mama. Las metástasis musculares de tumores sólidos son infrecuentes, y habitualmente provienen del pulmón, riñón, tiroides y melanoma. El síndrome del psoas maligno es causado por infiltración neoplásica del músculo. El diagnóstico diferencial debe realizarse con el absceso del psoas, que puede originarse en una tiflitis si es secundario. No hemos podido encontrar registros de cáncer de cuello uterino como segundo cáncer primario luego de LLA.

Abstract A 40-year-old woman was scheduled to receive chemotherapy for a high-risk common B-cell acute lymphoblastic leukemia (ALL), diagnosed 10 months earlier in the wake of lower limb bruising and petechiae, and metrorrhagia. At that time, she had thrombocytopenia and a normal transvaginal gynecological ultrasound. Upon admission, she complained of a 3-month history of incapacitating left groin pain radiated to the thigh, and right lower quadrant abdominal pain associated with diarrhea. On physical examination, she had tenderness in the right iliac fossa and a positive psoas sign on the left. Computerized scan of the abdomen and pelvis reported an image compatible with a left psoas abscess and signs of typhlitis. The biopsy of the left psoas muscle demonstrated infiltration by nests and cords of moderately differentiated keratinizing squamous carcinoma. Gynecological examination revealed macroscopic abnormalities of the cervix correlated with the same histopathological diagnosis. The second primary cancers most frequently associated with ALL are Hodgkin lymphoma, squamous skin cancer, endocrine tumors, kidney cancer, non-Hodgkin lymphoma, and breast cancer. Muscle metastases from solid tumors are rare, and usually arise from the lung, kidney, thyroid, and melanoma. Malignant psoas syndrome is caused by neoplastic infiltration of the muscle. The differential diagnosis should be made with a psoas abscess, which may arise from typhlitis if secondary. We have not been able to find records of cervical cancer as second primary cancer after ALL.

Whether radiotherapy for pelvic tumor increases the risk of second primary cancer / 中华放射肿瘤学杂志

Second primary cancer (SPC) is one of the main late toxicities of tumor therapy. According to statistics, one out of every 12 cancer survivors will develop SPC, and more than half of the cancer survivors will die of SPC. At present, approximately 70% of cancer patients receive radiotherapy (RT) throughout the course of disease. Whether high-dose radiation will increase the risk of SPC has captivated widespread attention. Among them, most pelvic tumor patients should receive RT because of the high incidence. In this article, relevant studies of potential pathogenesis of SPC, impact of different RT techniques, selection of RT timing, and RT for male, female and pediatric pelvic tumors were reviewed, aiming to investigate whether pelvic RT will increase the risk of SPC.

Secondary primary tumor mimicking osteoradionecrosis

ABSTRACT Nasopharyngeal carcinoma (NPC) is a malignant tumor rarely found in the head and neck, representing about 1% of all malignancies. The main treatment for NPC is radiation therapy, which is often given in combination with chemotherapy. However, such treatment may lead to long‐term complications, including second primary tumors (SPTs) and osteoradionecrosis (ORN). Both complications have similar radiological characteristics, which can lead to erroneous diagnoses. This paper describes a case of a second primary tumor in a patient after 20 years of radiotherapy in the area where a previous extraction was performed, mimicking an osteoradionecrosis process.

Routine follow-up after surgical treatment of lung cancer: is chest CT useful? / Acompanhamento de rotina após tratamento cirúrgico de câncer de pulmão: a TC de tórax é útil?

ABSTRACT Objective: To report the experience of a routine follow-up program based on medical visits and chest CT. Methods: This was a retrospective study involving patients followed after complete surgical resection of non-small cell lung cancer between April of 2007 and December of 2015. The follow-up program consisted of clinical examination and chest CT. Each follow-up visit was classified as a routine or non-routine consultation, and patients were considered symptomatic or asymptomatic. The outcomes of the follow-up program were no evidence of cancer, recurrence, or second primary lung cancer. Results: The sample comprised 148 patients. The median time of follow-up was 40.1 months, and 74.3% of the patients underwent fewer chest CTs than those recommended in our follow-up program. Recurrence and second primary lung cancer were found in 17.6% and 11.5% of the patients, respectively. Recurrence was diagnosed in a routine medical consultation in 69.2% of the cases, 57.7% of the patients being asymptomatic. Second primary lung cancer was diagnosed in a routine medical appointment in 94.1% of the cases, 88.2% of the patients being asymptomatic. Of the 53 patients who presented with abnormalities on chest CT, 41 (77.3%) were diagnosed with cancer. Conclusion: Most of the cases of recurrence, especially those of second primary lung cancer, were confirmed by chest CT in asymptomatic patients, indicating the importance of a strict follow-up program that includes chest CTs after surgical resection of lung cancer.

RESUMO Objetivo: Relatar a experiência de um programa de acompanhamento de rotina baseado em consultas médicas e TC de tórax. Métodos: Estudo retrospectivo envolvendo pacientes acompanhados após ressecção cirúrgica completa de câncer de pulmão de células não pequenas entre abril de 2007 e dezembro de 2015. O programa de acompanhamento consistiu em exame clínico e TC de tórax. Cada visita de acompanhamento foi classificada como uma consulta de rotina ou fora da rotina, e os pacientes foram considerados sintomáticos ou assintomáticos. Os desfechos do programa de acompanhamento foram ausência de evidência de câncer, recidiva ou segundo câncer de pulmão primário. Resultados: A amostra foi composta por 148 pacientes. A mediana do tempo de acompanhamento foi de 40,1 meses, e 74,3% dos pacientes realizaram menos TCs do que as recomendadas em nosso programa de acompanhamento. Recidiva e segundo câncer de pulmão primário foram encontrados em 17,6% e 11,5% dos pacientes, respectivamente. A recidiva foi diagnosticada em uma consulta médica de rotina em 69,2% dos casos, sendo 57,7% dos pacientes assintomáticos. O segundo câncer de pulmão primário foi diagnosticado em consulta médica de rotina em 94,1% dos casos, sendo 88,2% dos pacientes assintomáticos. Dos 53 pacientes que apresentaram anormalidades na TC de tórax, 41 (77,3%) foram diagnosticados com câncer. Conclusões: A maioria dos casos de recidiva, principalmente os de segundo câncer de pulmão primário, foi confirmada por TC de tórax em pacientes assintomáticos, indicando a importância de um programa de acompanhamento rigoroso que inclua TC de tórax após ressecção cirúrgica de câncer de pulmão.

Synchronous malignancy of stomach and kidney: an unusual combination: a case report

Synchronous occurrence of primary gastric cancer with primary renal cell carcinoma (RCC) is exceedingly rare. We report a case of a 70 years old gentleman who presented with a history of epigastric fullness and tarry stools from 1 month, along with significant weight loss which he was unable to quantify. Esophagogastroduodenoscopy showed ulceroproliferative growth in the antropyloric region of stomach causing complete outlet obstruction. Histopathology revealed poorly differentiated mucinous adenocarcinoma. Contrast enhanced computed tomography (CECT) abdomen showed an asymmetrical circumferential growth in the antropyloric region leading to obstruction. A heterogeneously enhancing hypervascular mass was also visualized over the lower pole of left kidney with an initial impression of metastasis. A concomitant radical subtotal gastrectomy and radical left nephrectomy was performed. Pathological examination confirmed gastric adenocarcinoma (T4a) and renal cell carcinoma-RCC (T3a). Most of the operable synchronously occurring second primary malignancy (SPM) can be resected in a single stage.

Double synchronous primary gastric and thyroid cancer

Second or multiple primary malignancies is very rare and the number of patients diagnosed with multiple primary cancers has recently been increasing due to the improved diagnostic techniques. Herein we report a very rare case of synchronous double primary cancer of the stomach and thyroid gland for the 39 years old lady who presented with a short period of abdominal pain were diagnosed to have an invasive adenocarcinoma with signet ring differentiation of the stomach by gastroscopy and biopsy. Computed tomography and positron emission tomography scan showed high fludeoxyglucose uptake of the thyroid gland were biopsied to confirm the malignancy. underwent initially for radical distal gastrectomy followed by adjuvant chemotherapy and interval total thyroidectomy. Although Synchronous tumors are defined as ≥2 primary tumors occurring within 6 months of diagnosis of the first primary tumor, our case was discovered concomitantly at the first presentation of the patient. The prognosis of patients with multiple primary cancers can be determined independently by the stage of each cancer.

Using positron emission tomography - computed tomography imaging to distinguish of metastatic disease from second primary lung tumours in patients with non-small cell lung cancer

Background: In NSCLC patients with multiple lesions, the differentiation between metastases and second primary tumours has significant therapeutic and prognostic implications. The aim of this retrospective study was to investigate the potential of 18F-FDG PET to discriminate metastatic disease from second primary lung tumours.Methods: Of 318 NSCLC patients between November 2015 and October 2018 at Bach Mai hospital, patients with a synchronous second primary lung cancer were selected. Patients with metastatic disease involving the lungs served as the control group. Maximum standardized uptake values (SUVs) measured with 18F-FDG PET were determined for two tumours in each patient. The SUVmax was determined and compared between the second primary group and metastatic disease group. Receiver-operating characteristic (ROC) curve analysis was performed to determine the sensitivity and specificity of the SUVmax for an optimal cut-off value.Results: A total of 81 NSCLC patients (44 metastatic disease, 37 second primary cancer) were included for analysis. The SUVmax was significantly higher in patients with second primary cancer than in those with metastatic disease (7.53±4.33 vs 4.35±2.58, respectively, p<0.001). The area under the ROC curve was 0.81 and the odds ratio for the optimal cut-off was 7.52.Conclusions: SUVmax from 18F-FDG PET images can be helpful in differentiating metastatic disease from second primary tumours in patients with synchronous pulmonary lesions. Further studies are warranted to confirm the consistency of these results.

Analysis of the characteristics of second primary malignancy affecting the survival of lymphoma patients / 中华肿瘤杂志

Objective@#To analyze the characteristics of the second primary tumor affecting the survival of patients with lymphoma, and to explore the risk factors of death from the second primary tumor.@*Methods@#The medical records and related death information of 1 173 lymphoma patients who had already died with known causes were collected. The basic causes of death and the characteristics of patients who died of the second primary tumor were analyzed. Cox regression model was used to analyze the risk factors of lymphoma patients who died of the second primary tumor.@*Results@#Among the 1 173 patients who had died, 94 (8.0%) died of the second primary tumor, 935 (79.7%) died of the primary lymphoma and 144 (12.3%) died of other diseases. The second primary tumor accounted for 17.5% (38/217) of all causes of death in patients with the survival period of more than 5 years, and the second primary tumor accounted for 28.3% (17/60) of all causes of death in patients with the survival period of more than 10 years. Among 94 cases who died of second primary tumors, 31 died of lung cancer, 15 died of gastric cancer, 13 died of liver cancer, 9 died of pancreatic cancer, 6 died of colorectal cancer, 6 died of second primary lymphoma and 14 died of other types of tumors. Univariate Cox regression analysis showed that age, first-line treatment effect, and chest or mediastinal radiotherapy were associated with the death from second primary tumors for lymphoma patients (all P<0.05). Multivariate Cox regression analysis showed that the effect of first-line treatment (P=0.030) and the chest or mediastinal radiotherapy (P=0.039) were independent factors for the death of lymphoma patients from the second primary tumor.@*Conclusions@#The second primary tumor is an important factor affecting the survival of lymphoma patients, and the risk of death from second primary tumors increases significantly over time. The effect of first-line treatment and radiotherapy in the chest or mediastinum are independent factors for the death of lymphoma patients from the second primary tumor.

Detection of additional primary malignancies: the role of CT and PET/CT combined with multiple percutaneous biopsy / Detecção de malignidades primárias adicionais: papel da TC e PET/TC associadas a biópsias percutâneas múltiplas

Abstract Objective: To evaluate the imaging findings of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and computed tomography (CT) in patients with additional primary tumors, correlating the results with those of the method used in order to elucidate the diagnosis and of the pathology reports. Materials and Methods: We retrospectively analyzed the medical records, pathology reports and images of 11 patients who underwent CT, 18F-FDG PET/CT, or both. We included patients with at least two tumors, with confirmed distinct histopathological profiles, at different sites. Patients in whom there was no diagnostic confirmation were excluded, as were those in whom the additional lesion was suspected of being a metastasis of the first. Results: New primary malignancies were identified in 11 patients, one new tumor being found in 10 and two new tumors being found in 1. The confirmed sites of the additional malignancies were the lung, kidney, prostate, jejunum, and breast. Single or multiple percutaneous biopsies were performed in 10 patients, and 1 patient underwent a surgical procedure for diagnostic and therapeutic purposes. The tumors were metachronous in 6 cases and synchronous in 5. Conclusion: CT and 18F-FDG PET-CT combined with multiple percutaneous biopsy could facilitate the diagnosis of additional lesions, thus optimizing the treatment and follow-up of the affected patients.

Resumo Objetivo: Avaliar os achados de imagem da tomografia computadorizada por emissão de pósitrons com 18F-fluordesoxiglicose (18F-FDG PET/TC) e tomografia computadorizada (TC) em pacientes portadores de tumores primários adicionais, correlacionando com o método realizado para elucidação do diagnóstico e relatórios anatomopatológicos. Materiais e Métodos: Avaliamos, retrospectivamente, prontuários, relatórios anatomopatológicos e exames de 11 pacientes que realizaram 18F-FDG PET/TC e/ou TC. Foram incluídos pacientes que apresentaram pelo menos duas neoplasias, com histopatologia distinta confirmada nos diferentes locais. Foram excluídos pacientes sem confirmação diagnóstica e pacientes com suspeita de que a lesão adicional fosse uma metástase da primeira. Resultados: Lesões sugestivas de novas malignidades primárias foram encontradas em 11 pacientes, apresentando em 10 deles uma única nova lesão e em 1 caso dois novos tumores. Locais comprovados de lesão adicional foram pulmão, rim, próstata, jejuno e mama. Biópsia percutânea única ou múltipla foi realizada em 10 pacientes e 1 paciente foi submetido a procedimento cirúrgico para fins diagnósticos e terapêuticos. Os tumores eram metacrônicos em 6 casos e sincrônicos em 5 pacientes. Conclusão: A TC e a 18F-FDG PET/TC associadas a biópsias percutâneas múltiplas podem auxiliar no diagnóstico de lesões adicionais, otimizando o tratamento e acompanhamento desses pacientes.

Clinical features and prognosis of head and neck cancer in patients with esophagus cancer and triple primary carcinoma / 中国基层医药

Objective To investigate the clinical features and prognostic characteristics of head and neck cancer in patients with esophagus cancer and triple primary carcinoma(TPC).Methods A total of 30 patients with head and neck cancer with esophagus cancer TPC were collected in Zhejiang Cancer Hospital from January 2007 to December 2016.The distribution of cancer kinds and the incidence of synchronous and metachronous cancer were described.The clinical characteristics and prognosis were also compared in synchronous and metachronous cancer.The influence of number of hospitalization and different treatments on the survival time were analyzed.Results The TPC of "laryngeal pharynx + esophagus + lung" and "laryngeal pharynx + esophagus + oropharynx" had the highest incidence,that was 20.0％ in 30 patients (6/30).The second type was "laryngeal pharynx + esophagus + larynx".Fifteen cases were synchronous cancer and other 15 cases were metachronous cancer.The rate of surgery was 73.3％ (11/15),and the number of hospitalization who more or equal than 5 was 73.3％ (11/15) in the synchronous cancer.While the rate of surgery was 33.3％ (5/15),and the number of hospitalization who more or equal than 5 was 33.3％ (5/15) in the metachronous cancer.There were significant differences between synchronous and metachronous cancer (x2 =4.661,4.661,all P ＜ 0.05).The 1-year,3-year and 5-year survival rates were 39.9％,19.9％ and 0.0％ in patients with synchronous cancer.The mean survival time was (18.4 ± 6.2)months.In contrast,the survival rates were 78.7％,77.8％ and 59.1％ in metachronous cancer.The mean survival time was (122.2 ± 17.2) months.There were significant differences between the two groups (survival rate:x2 =10.934,P =0.001;mean survival time:t =3.201,P =0.003).The survival rate of the number of hospitalization more than or equal to 5 times had significant difference compared with those less than 5 times (x2 =10.574,P =0.001).There was no statistically significant difference in the improvement of OS between single operation,chemotherapy and target treatment (P ＞ 0.05).Conclusion Head and neck cancer in patients with esophagus cancer TPC can still has a high survival rate through active combined modality therapies,especially in metachronous carcinoma.

Causes of death in 1,173 patients with lymphoma / 中国肿瘤临床

Objective: To understand the causes of death and long-term prognosis of lymphoma patients. Methods: Data from 6 200 patients with lymphoma admitted to the Department of Lymphoma, Peking University Cancer Hospital, from January 1995 to Decem-ber 2017, were collected. Those who had died and whose causes of death were known were selected. Clinical records and information on death were collected. Results: A total of 1,173 patients were selected, 742 of whom were male (63.3% ), and 431 were female (36.7%). The median age was 56 (8-92) years. There were 77 cases (6.6%) of Hodgkin's lymphoma, 1,095 cases (93.4%) of non-Hodg-kin's lymphoma, and 1 case of unclear pathological classification. Overall population survival was 0-253 months, with a median surviv-al rate of 20 months. The direct causes of death included lymphoma in 688 (58.7%), various infectious diseases in 119 (10.1%), cardio-vascular diseases in 96 (8.2%), secondary primary tumors in 68 (5.8%), and other diseases in 202 cases (17.2%). The underlying causes of death included lymphoma in 936 (79.8%), secondary primary tumors in 94 (8.0%), cardiovascular diseases in 75 (6.4%), respiratory diseases in 32 (2.7%) and other diseases in 36 cases (3.1%). The underlying causes of death in cases wherein survival time exceeded 5 years included lymphoma in 129 (59.4%), secondary primary tumors in 38 (17.5%), cardiovascular diseases in 35 (16.1%), and other dis-eases in 15 cases (6.9%). The underlying causes of death in cases wherein survival time exceeded 10 years included lymphoma in 28 (46.7%), secondary primary tumors in 17 (28.3%), cardiovascular diseases in 7 (11.7%), and other diseases in 8 cases (13.3%). Conclu-sions: Primary tumors remain the main cause of death in patients with lymphoma. After primary tumors, secondary primary tumors and cardiovascular diseases are the most common causes of death, and with the prolongation of survival, the risk of death caused by these factors increases significantly.

Causes of death in patients with lymphoma during long-term follow-up / 中国肿瘤临床

The prognosis of lymphoma patients is relatively good, and most patients may survive for a long time after standard treatment. Long-term follow-up of lymphoma survivors may reveal some late complications related to the treatment. Analysis of the causes of death is helpful in further improving the prognosis of lymphoma patients. The purpose of this article is to review the causes of death in patients with lymphoma during long-term follow-up to generate new ideas for follow-up and treatment of lymphoma patients.

Clinicopathologic analysis of 38 male breast cancers / 中国实用外科杂志

OBJECTIVE: To analyze the clinicopathologic characteristics and molecular subtype in male breast cancer(MBC). METHODS: The clinical features, histological features and molecular subtype of 38 cases of male breast cancers admitted from January 2013 to March 2019 in Clinical Pathology Diagnostic Center of Ningbo were analyzed retrospectively. RESULTS: Thirty-eight patients were diagnosed with MBC, accounting for 0.83% of all the breast cancer in the same term. The median age was 68.5(range from 24 to 88). Tumor were located in left side in 20 cases, right side in 18 cases. Twenty-nine cases were diagnosed as invasive ductal carcinoma, two cases of secretory breast cancer, one case of invasive solid papillary carcinoma, two cases of intraductal papillary carcinoma with microinvasive, and four cases of encapsulated papillary carcinoma(two of them with microinvasive). Sixteen patients had lymphatic metastasis when the tumor was diagnosed. Imunohistochemically, ER was positive in 36 cases, while PR was positive in 35 cases.Eighteen cases were Luminal A type, while sixteen were Luminal B type and two cases were basal-like subtype.CONCLUSION: MBC is a rare malignant neoplasm, and most patients are diagnosed older and at advanced clinical stage,what is more, there is more possibility of second non-breast primary cancer. All suggesting that early diagnosis,treatment and more intensive surveillance are important. MBC needs further study.

Helicobacter pylori Eradication after Endoscopic Resection of Gastric Epithelial Neoplasms

Endoscopic submucosal dissection is widely accepted as standard treatment for early gastric cancer; however, long-term management of metachronous gastric cancer after endoscopic resection is an important issue that is gaining much attention. Several prospective and retrospective studies have reported that Helicobacter pylori (H. pylori) eradication can reduce the risk of metachronous gastric cancer after endoscopic resection. Although there is lack of sufficient data regarding this subject, a few studies have reported histologically proven improvement in atrophic gastritis and intestinal metaplasia following H. pylori eradication in patients undergoing endoscopic resection. Therefore, treatment for H. pylori eradication should be considered in this patient population to reduce the incidence of metachronous gastric cancer and improve long-term outcomes.(

Metachronous malignant tumors in ipsilateral salivary glands

Salivary gland tumors usually appear in solitary mass in single salivary gland. The coexistence of tumors with different histological types occurring within a unilateral parotid gland is an extremely rare event. We experienced a case which two different types of malignant tumors developed at different time points in same gland; metachronous tumors. The second tumor was excised widely and reconstruction was performed by free tissue transfer. Sensory and motor nerve to the left cheek appeared to be intact, and circulation was adequate. This rare case was presented in this article.

Space maintenance for the premature loss of the second primary molar / 中华口腔医学杂志

Space reduction after the premature loss of the second primary molars is one of the important factors affecting the occurrence of malocclusion, often increasing the demand for orthodontic treatment. It has great significance to select and apply appropriate appliances to maintainthe space soon after the premature loss of the second primary molars. The space should be maintained until the adjacent teeth and the successors erupt successfully. This review summarizes the selection and clinical application of the space maintainer for the premature loss of the second primary molars in different periods, to improve dentists′ awareness of the importance of space maintainers and to provide advises for clinical choices.