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Features of synchronous and Metachronous dual primary gastric and colorectal cancer

World Journal of Gastrointestinal Oncology 2023年第11期15卷 1864-1873页

作者： Yi-Jia Lin Hua-Xian Chen Feng-Xiang Zhang Xian-Sheng Hu Hai-Juan Huang Jian-Hua Lu Ye-Zi Cheng Jun-Sheng Peng Lei Lian Department of General Surgery(Gastrointestinal Surgery) The Sixth Affiliated HospitalSun Yat-sen UniversityGuangzhou 510655Guangdong ProvinceChina Department of General Surgery(Colorectal Surgery) The Sixth Affiliated HospitalSun Yat-sen UniversityGuangzhou 510655Guangdong ProvinceChina Follow-up office The Sixth Affiliated HospitalSun Yat-sen UniversityGuangzhou 510655Guangdong ProvinceChina

BACKGROUND Studies evaluating the characteristics of dual primary gastric and colorectal cancer(CRC)(DPGCC)are limited.AIM To analyze the clinicopathologic characteristics and prognosis of synchronous and Metachronous cancers in patients with DPGCC.METHODS From October 2010 to August 2021,patients with DPGCC were retrospectively reviewed.The patients with DPGCC were divided into two groups(synchronous and Metachronous).We compared the overall survival(OS)between the groups using Kaplan-Meier survival methods.Univariate and multivariate analyses were performed using Cox’s proportional hazards model to identify the independent prognostic factors for OS.RESULTS Of the 76 patients with DPGCC,46 and 30 had synchronous and Metachronous cancers,respectively.The proportion of unresectable CRC in patients with synchronous cancers was higher than that in patients with Metachronous cancers(28.3%vs 3.3%,P=0.015).The majority of the second primary cancers had occurred within 5 years.Kaplan-Meier survival analysis showed that the patients with Metachronous cancers had a better prognosis than patients with synchronous cancers(P=0.010).The patients who had undergone gastrectomy(PMetachronous cancer is necessary during postoperative follow-up.Surgical resection is the mainstay of therapy to improve the prognosis of DPGCC.The prognosis appears to be influenced by the stage of GC rather than the stage of CRC.Patients with synchronous cancer have a worse prognosis,and its treatment strategy is worth further exploration.

关键词： Synchronous Metachronous Prognosis Gastric cancer Colorectal cancer

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Association between Helicobacter pylori status and Metachronous gastric cancer after endoscopic resection

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World Journal of Gastroenterology 2016年第44期22卷 9794-9802页

作者： Sung Bum Kim Si Hyung Lee Seung Il Bae Yo Han Jeong Se Hoon Sohn Kyeong Ok Kim Byung Ik Jang Tae Nyeun Kim Department of Internal Medicine Yeungnam University College of Medicine

AIM To investigate the effect of Helicobacter pylori(H. pylori) status test and H. pylori eradication on the occurrence of Metachronous gastric cancer(MGC) after endoscopic submucosal dissection(ESD) of early gastric cancer(EGC) and risk factors of MGC. METHODS The authors retrospectively reviewed the medical records of 433 patients(441 lesions) who underwent ESD for EGC from January 2005 to January 2015 in Yeungnam University Hospital. Patients were categorized into two groups; the H. pylori tested group(n = 257) and the H. pylori non-tested group(n = 176) based on performance of H. pylori status test after ESD of EGC. The H. pylori tested group was further categorized into three subgroups based on H. pylori status; the H. pylori-eradicated subgroup(n = 120), the H. pylori-persistent subgroup(n = 42), and the H. pylori-negative subgroup(n = 95). Incidences of MGC and risk factors of MGC were identified.RESULTS Median follow-up duration after ESD was 30.00 mo(range, 6-107 mo). Total 15 patients developed MGC during follow-up. MGC developed in 11 patients of the H. pylori tested group(7 in the H. pylori-negative subgroup, 3 in the H. pylori-eradicated subgroup, and 1 in the H. pylori-persistent subgroup) and 4 patients of the H. pylori non-tested group(P > 0.05). The risk factors of MGC were endoscopic mucosal atrophy in the H. pylori tested group and intestinal metaplasia in all patients. CONCLUSION H. pylori eradication and H. pylori status test seems to have no preventive effect on the development of MGC after ESD for EGC. The risk factors of MGC development were endoscopic mucosal atrophy in the H. pylori tested group alone and intestinal metaplasia in all patients.

关键词： Metachronous gastric cancer Endoscopic submucosal dissection Helicobacter pylori

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Case of Metachronous bilateral isolated adrenal metastasis from colorectal adenocarcinoma and review of the literature

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World Journal of Gastroenterology 2016年第14期22卷 3879-3884页

作者： Yu-Yi Liu Zhi-hui Chen Er-tao Zhai Jie Yang Jian-bo Xu Shi-rong Cai Wu Song Department of Gastrointestinal Surgery the First Affiliated Hospital Sun Yat-sen University

rarely has a solitary, Metachronous bilateral adrenal metastasis of colorectal cancer been reported. We depict a 41-year-old man who underwent sigmoid colon cancer radical surgery followed by adjuvant chemotherapy for alocally ulcerative sigmoid adenocarcinoma with Metachronous bilateral adrenal metastasis revealed by a computed tomography scan. histopathological examination showed adenocarcinoma, compatible with metastasis from the rectal cancer. the level of serum carcinoembryonic antigen had indicative significance for the presence of adrenal metastasis in the reported series. We performed a literature analysis related to this pathological characteristic and attach importance to consistent, vigilant radiological surveillance of the adrenal glands in the patients' follow up for colorectal cancer with or without subsequent adrenal metastasis.

关键词： Adrenal gland bilateral Colorectal cancer metastasis Metachronous

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Different clinical presentations of Metachronous pulmonary metastases after resection of pancreatic ductal adenocarcinoma: Retrospective study and review of the literature

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World Journal of Gastroenterology 2017年第35期23卷 6420-6428页

作者： Martin Lovecek Pavel Skalicky Josef Chudacek Marek Szkorupa Hana Svebisova Radmila Lemstrova Jiri Ehrmann Bohuslav Melichar Tharani Yogeswara Dusan Klos Radek Vrba Roman Havlik Beatrice Mohelnikova-Duchonova Department of Surgery I University Hospital Olomouc and Faculty of Medicine and DentistryPalacky University Department of Oncology University Hospital Olomouc and Faculty of Medicine and DentistryPalacky University Department of Molecular Pathology Faculty of Medicine and DentistryPalacky University OlomoucUniversity Hospital Olomouc Institute of Molecular and Translational Medicine Faculty of Medicine and DentistryPalacky University Department of Oncology Faculty of Medicine and DentistryPalacky University OlomoucUniversity Hospital Olomouc Department of Surgery I Faculty of Medicine and DentistryPalacky University

AIM To analyze pancreatic cancer patients who developed Metachronous pulmonary metastases(MPM) as a first site of recurrence after the curative-intent surgery.METHODS One-hundred-fifty-nine consecutive pancreatic ductal adenocarcinoma(PDAC) patients who underwent radical pancreatic surgery between 2006 and 2013 were included in this retrospective analysis. The clinical data including age, sex, grade, primary tumor location, p TNM stage, lymph node infiltration, microangioinvasion, perineural invasion, lymphovascular invasion, the therapy administered, and follow-up were all obtained from medical records. Further analysis covered only patients with Metachronous metastases. Clinical and histopathological data(age, sex, grade, primary tumor location, p TNM stage, lymph node infiltration, microangioinvasion, perineural invasion, lymphovascular invasion, the therapy administered and follow-up) of patients with Metachronous non-pulmonary metastases and patients with Metachronous pulmonary metastases were statistically assessed. Disease-free survival(DFS) from pancreas resection until metastases onset and overall survival(OS) were calculated. Wilcoxon test, χ~2 test and survival functions computed by the KaplanMeier method were used. Statistical significance was evaluated by the log-rank test using SPSS. A P-value of less than 0.05 was considered statistically significant.RESULTS Metachronous pulmonary metastases were observed in 20(16.9%) and were operable in 3(2.5%) of PDAC patients after a prior curative-intent surgery. Patients with isolated pulmonary metastases(oligometastases and multiple metastases) had estimated prior DFS and OS of 35.4 and 81.4 mo, respectively, and those with Metachronous pulmonary metastases accompanied by other metastases had prior DFS and OS of 17.3 and 23.4 mo, respectively. Patients with non-pulmonary metastases had prior DFS and OS of 9.4 and 15.8 mo, respectively. Different clinical scenarios according to the presentation of MPM were observed and patients could be divided to three subgr

关键词： Pancreatic cancer Pulmonary metastases Metachronous metastases Surgical resection Overall survival Chemotherapy

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Metachronous isolated penile metastasis from sigmoid colon adenocarcinoma:A case report

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World Journal of Clinical Cases 2022年第31期10卷 11658-11664页

作者： Guo-Lin Yin Jiang-Bo Zhu Cheng-Lin Fu Ru-Liang Ding Jun-Miao Zhang Qian Lin Department of Urology Taizhou First People's HospitalTaizhou 318020Zhejiang ProvinceChina Department of Pathology Taizhou First People's HospitalTaizhou 318020Zhejiang ProvinceChina Department of Anorectology Taizhou First People's HospitalTaizhou 318020Zhejiang ProvinceChina

BACKGROUND Sigmoid colon adenocarcinoma has a high incidence among gastrointestinal tumors,and it very rarely metastasizes to the penis.The literature reports that the prognosis after penile metastasis is generally poor,with a median survival of about 9 mo.Metachronous isolated metastasis to the penis originating from sigmoid colon adenocarcinoma has not been reported so far.Here,we report a case of sigmoid colon adenocarcinoma with isolated penile metastasis occurring 2 years after surgery.The mass was pathologically confirmed as metastatic adenocarcinoma,and oral chemotherapy with capecitabine was given after surgery.The tumor did not recur during the 2-year follow-up period.CASE SUMMARY A 79-year-old man presented to the urology department with"a mass located at the root of the penis since 1 mo".Enhanced computed tomography(CT)examination suggested a 12 mm×10 mm×9 mm nodule at the root of the right penile corpus cavernosum.Cranial,pulmonary,and abdominal CT;and bone scan did not show any tumorigenic lesions.The carcinoembryonic antigen(CEA)level was slightly elevated(6.01 ng/mL,reference value 0-5 ng/mL).The patient had undergone laparoscopic radical sigmoidectomy for sigmoid colon cancer 2 years ago.The postoperative pathology showed moderately differentiated adenocarcinoma of the sigmoid colon,and the stage was PT2N0M0.The penile mass was removed under general anesthesia.The postoperative pathology showed adenocarcinoma,and immunohistochemistry showed CDX2(+),CK20(+),and Villin(+).Based on the medical history,he was diagnosed with penile metastasis from sigmoid colon adenocarcinoma.The CEA level returned to normal(3.34 ng/mL)4 d after surgery.Oral chemotherapy with capecitabine was given subsequently,and tumor recurrence was not found during the 2-year follow-up period.CONCLUSION To our knowledge,this is a rare case of Metachronous isolated penile metastasis from sigmoid colon adenocarcinoma.The penis is a potential site of metastasis of colon adenocarcinoma,and the possibility of metastasis should be consid

关键词： Colon adenocarcinoma Penis Metastases Metachronous Adenocarcinoma Case report

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Metachronous squamous cell carcinoma of pancreas and stomach in an elderly female patient:A case report

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World Journal of Clinical Cases 2021年第31期9卷 9680-9685页

作者： Ji Hyun Kim Chang Don Kang Kyungyul Lee Kyu-Hyoung Lim Department of Internal Medicine Kangwon National University School of MedicineChuncheon 24341Kangwon DoSouth Korea Department of Pathology Kangwon National University School of MedicineChuncheon 24341Kangwon DoSouth Korea

BACKGROUND Squamous cell carcinoma(SCC)in pancreas and stomach is a rare histologic subtype with aggressive behavior,poor prognosis,and no standardized therapy.Pancreatic SCC or gastric SCC has been previously reported.However,case of SCC occurring in both the pancreas and the stomach has not been reported yet.CASE SUMMARY A 75-year-old female with prior history of hypertension and diabetes mellitus visited our hospital with complaint of abdominal pain that started three months ago.Computed tomography(CT)scan of the abdomen showed 3.3 cm mass at the distal pancreas.She received surgical resection which was histologically found to be SCC of the pancreas with clear resection margins.After she was discharged,she no longer visited the hospital.Three years later,she was referred to our hospital after showing abnormal findings on a gastroscopy performed at another hospital.Gastroscopy revealed a single,2cm sized,ill-defined irregular flat and hyperemic mass at high body.Histologic finding of the mass was SCC.CT scan and positive emission tomography CT showed metastatic lesions to the liver and the peritoneum.She received combination chemotherapy with capecitabine and oxaliplatin.However,she passed away 6 mo after diagnosis of gastric SCC.CONCLUSION To the best of our knowledge,this is the first case of Metachronous SCC of stomach occurring after diagnosis of pancreatic SCC.

关键词： Squamous cell carcinoma Pancreas Stomach Metachronous Pancreatectomy Case report

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Isolated Metachronous splenic multiple metastases after colon cancer surgery: A case report and literature review

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World Journal of Clinical Cases 2020年第15期8卷 3320-3328页

作者： Li Hu Ji-Yun Zhu Lei Fang Xiu-Chong Yu Zhi-Long Yan Department of Gastrointestinal Surgery Ningbo First HospitalNingbo 315000Zhejiang ProvinceChina

BACKGROUND Isolated splenic metastasis is a rare clinical entity.Multiple metastases in the spleen after radical colon resection in a patient who subsequently underwent a second local resection for isolated Metachronous splenic metastasis are exceedingly rare.CASE SUMMARY We report a colon cancer patient who underwent laparoscopic radical colon resection 14 mo previously,and subsequently underwent a second local resection due to local recurrence detected by elevated serum carcinoembryonic antigen(CEA)and positron emission tomography(PET).However,multiple metastases in the spleen were found 7 mo later by elevated serum CEA and PET-magnetic resonance imaging.Then the patient underwent total laparoscopic splenectomy.Local tumor recurrence and splenic metastasis from colorectal cancer(CRC)were found by postoperative pathology.Genetic analysis of these recurrent and metastatic tissues showed KRAS exon2,APC exon16 and TP53 exon6 missense mutations,but no mutations of NRAS,KRAF,EGFR,ERBB2,MET,MLH1,MSH2 and MSH6 were detected.Chemotherapy and target therapy were administered after multiple disciplinary team(MDT)consultation,and no tumor recurrence has been observed to date.We also reviewed the literature by conducting a search of the PubMed database using the following key words:CRC,splenic metastasis,isolated,and review.We identified 34 relevant papers,which included 28 cases of Metachronous metastasis and 6 cases of simultaneous metastasis.CONCLUSION Close monitoring of serum CEA levels is crucial for the detection of isolated splenic metastases after colon surgery.In terms of overall survival and progression-free survival,MDT plays an important role in the entire process of disease management.

关键词： Colon cancer Isolated Metachronous Splenic metastasis Literature review Case report

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Classifying extrahepatic bile duct Metachronous carcinoma by de novo neoplasia site

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World Journal of Gastroenterology 2014年第11期20卷 3050-3055页

作者： Hyung Jun Kwon Sang Geol Kim Jae Min Chun Yoon Jin Hwang Department of Surgery Kyungpook National University Medical CenterDaegu 702-210South Korea

Extrahepatic bile duct(EHBD)cancer may occur Metachronously,and these cancers are resectable with a favorable prognosis.We aimed to identify the pattern of Metachronous EHBD cancer.We classified the cases of Metachronous EHBD cancer reported in the literature thus far and investigated two new cases of Metachronous EHBD cancer.A 70-year-old female underwent R0 bile duct resection for a type 1 Klatskin tumor(pT-1N0M0).A 70-year-old male patient underwent R0 bile duct resection for a middle bile duct cancer(pT2N1M0).Imaging studies of both patients taken at 14 and 24mo after first surgery respectively revealed a Metachronous cholangiocarcinoma that required pancreaticoduodenectomy(PD).Histopathology of the both tumors after PD revealed cholangiocarcinoma invading the pancreas(pT3N0M0).Both patients have been free from recurrence for 6 years and 16 mo respectively after the second surgery.Through a review of the literature on these cases,we classified the pattern of Metachronous EHBD cancer according to the site of de novo neoplasia.The proximal remnant bile duct was most commonly involved.Metachronous EHBD cancer should be distinguished from an unresectable recurrent tumor.Classifying Metachronous EHBD cancer may be helpful in identifying rare Metachronous tumors.

关键词： Metachronous Extrahepatic bile duct Cancer Prognos

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Triple Metachronous colon cancer

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World Journal of Gastroenterology 2013年第27期19卷 4443-4444页

作者： Hugh J Freeman Department of Gastroenterology School of MedicineUniversity of British Columbia

A 72-year-old male with an early stage "node-negative" sigmoid colon cancer developed 2 separate "node-negative" early stage colon cancers during a subsequent colonoscopy surveillance regimen, the first in the descending colon 7 years later, and the second in the cecum almost 14 years after the first cancer was resected. After the initial symptomatic cancer, all subsequent neoplastic disease, including malignant cancers were completely asymptomatic. This entity, multiple primary cancers, likely reflected the use of a colonoscopic surveillance regimen.

关键词： Colorectal cancer Surveillance colonoscopy Multiple primary cancer syndrome Metachronous colorectal cancer

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Metachronous intracystic and intraductal papillary neoplasms of the biliary tree

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World Journal of Gastroenterology 2013年第36期19卷 6125-6126页

作者： Hirohide Sato Yasunori Sato Kenichi Harada Motoko Sasaki Katsuyasu Hirano Yasuni Nakanuma Department of Human Pathology Kanazawa University Graduate School of Medicine Department of Surgery Wajima Hospital

A 77-year-old woman complained of epigastralgia,and a tumor(5 cm in diameter)of the gallbladder neck was detected by image analysis.Following cholecystectomy,the tumor was pathologically diagnosed as intraductal papillary neoplasm(IPN),gastric type,with associated invasive carcinoma.About 10 mo later,intraluminal multiple masses(3 foci,up to 1.8 cm)were noted in the extrahepatic bile duct,and the resected specimen showed that all tumors had similar gross and microscopic features as seen in gallbladder IPN without invasion,and they were synchronous multiple lesions.This case showed a papillary tumor of the gallbladder of gastric phenotype,and confirmed that the gallbladder is a target of IPN in addition to the bile ducts.

关键词： Intraductal papillary neoplasm Intracystic papillary neoplasm Gastric type Metachronous occurrence Synchronous occurrence

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