Patterns of multiple primaries in fortyfour cancer patients: a single-center clinical experience

Introduction. Multiple primaries are defined as the existence of more than one synchronous or metachronous cancer type in the same individual. Due to a longer follow-up time after a primary cancer diagnosis, the likelihood of detection of a second primary is also increased. We report on patterns of multiple primaries in a cohort of cancer patients from a single institution.  Material and methods. We identified 44 patients with multiple primaries that were diagnosed, treated, and followed up between March 2011 and January 2022 from our prospectively maintained database at the Hatay Education and Research Hospital Cancer Unit.  Results. The median follow-up time was 60 months (range; 3–103). The median time between the diagnosis of the first primary and the second primary was 29 months (range; 0–94). The median OS was 76 months (95% Cl 26.6–125.4) from the first diagnosis and 27 months (95% Cl 0.65–53.4) from the diagnosis of the second primary for the entire cohort. The first diagnosed tumor was localized in the gastrointestinal system in 43.2% of patients and 65.9% of all tumors were adenocarcinoma. The first diagnosed cancer was at an early stage (Stages I and II) in 63.6% of patients. At the staging evaluation of the second primary, 54.5% of patients were found to be in the early stage (Stages I and II) and 45.5% were found to be in the late stage (Stages III and IV).  Conclusions. Our study is important as this is the largest cohort study about practical implications of managing multiple primaries. The risk of second and further primaries should be kept in mind in the active follow-up Introduction and surveillance of cancer patients

Osteogenesis Imperfecta, Pseudoachalasia, and Gastric Cancer

Osteogenesis imperfecta (OI) is a rare, inherited skeletal disorder characterized by abnormalities of type 1 collagen. Malignancy is rarely reported in patients with OI and it was suggested that this disease can protect against cancer. Here, we report a 41-year-old woman with symptoms of achalasia where repeated treatment of pneumatic dilation and stent replacement was unsuccessful; therefore, surgery was performed. Pathology showed gastric adenocarcinoma unexpectedly. Chemotherapy was given after assessing dihydropyrimidine dehydrogenase (DPD) enzyme activity, which can be deficient in OI patients. This is the first report of gastric cancer mimicking achalasia in a patient with OI

Recent advances in preoperative management of esophageal adenocarcinoma [version 1; referees: 2 approved]

Esophageal cancer is an aggressive malignancy with increasing incidence, and the prognosis of patients treated by surgery alone remains dismal. Preoperative treatment can modestly prolong overall survival. Preoperative chemotherapy or chemoradiation is the standard of care for resectable esophageal cancer (greater than clinical stage I and less than clinical stage IV). One of the challenges is to predict complete response in the surgical specimen from preoperative therapy and to avoid surgery in some patients but also predict ineffectiveness of preoperative therapy if the tumor is resistant and avoid such therapies altogether. In-depth understanding of the molecular biology could lead to personalized therapy, and in the future, clinical trials designed according to molecular features are expected. Here, we summarize preoperative treatment for esophageal adenocarcinoma and their potential

Customization of therapy for gastroesophageal adenocarcinoma patients

Gastroesophageal adenocarcinomas (GEACs) remain a global health problem. These are most often diagnosed at advanced stage and the estimated 5-year relative survival rate is about 5%. Although cure is not possible for patients with advanced GEAC, systemic therapy (chemotherapy or biochemotherapy) can palliate symptoms, improve survival and provide a better quality of life. One of the most promising options for some patients with advanced stage GEAC is immunotherapy, which can result in durable responses. Numerous phase III trials evaluating targeted therapies in different lines are ongoing and it is hoped that better biomarkers will emerge to identify patients who can benefit from targeted agents and immunotherapy in the future. Surgery remains as the corner stone for localized GEAC and adjunctive therapies can increase the survival rates by about 10%. The high toxicity and low completion rates of adjuvant therapy led to the strategies of preoperative treatment. With the results of ongoing pre-operative therapy trials we will be able to determine the optimal adjunctive approach for resectable GEAC. Keywords: Therapy, Gastroesophageal adenocarcinoma, Esophageal adenocarcinoma, Gastric adenocarcinom

Efficacy of preoperative neutrophil-to-lymphocyte ratio in determining lymph node metastases in testicular cancer

Purpose: Testicular cancer is the most common solid tumor in young men between the ages of 20-35 and has excellent clinical outcomes with appropriate treatment. Neutrophil-to-lymphocyte-ratio (NLR) is related with prognosis and relapse in different solid tumors. We aimed to investigate the relation of presence and size of regional lymph node metastasis with NLR in testicular cancer. Materials and Methods: A total of 72 testicular cancer patients were included in the study. All medical records were retrospectively collected. NLR was calculated as the count of neutrophil divided by the count of lymphocyte. Chest and abdomen computed tomograpy (CT) scans of all patients were evaluated for metastases. Results: The mean age was 32.18 +/- 8.89 years. The pathologic classification was seminoma in 43% and nonseminoma in 57% of patients. Of 72 patients, 32 (44.4%) had lymph node positivity and 40 (55.6%) hadnot. The mean NLR value was 2.63 +/- 1.79 for all cohort. The mean NLR was significantly lower in patients with lymph node negative disease (for lymph node positive and negative disease 3.19 +/- 2.32 and 2.25 +/- 1.06, respectively.). In the ROC analysis, 2.5 was determined as the cut-off value for NLR to assess lymph node status. Conclusion NLR is a cheap and readily available index that can be used to determine lymph node metastases in testicular GCTs.WOS:00069527270002

Efficacy of preoperative neutrophil-to-lymphocyte ratio in determining lymph node metastases in testicular cancer

Purpose: Testicular cancer is the most common solid tumor in young men between the ages of 20-35 and has excellent clinical outcomes with appropriate treatment. Neutrophil-to-lymphocyte-ratio (NLR) is related with prognosis and relapse in different solid tumors. We aimed to investigate the relation of presence and size of regional lymph node metastasis with NLR in testicular cancer. Materials and Methods: A total of 72 testicular cancer patients were included in the study. All medical records were retrospectively collected. NLR was calculated as the count of neutrophil divided by the count of lymphocyte. Chest and abdomen computed tomograpy (CT) scans of all patients were evaluated for metastases. Results: The mean age was 32.18 +/- 8.89 years. The pathologic classification was seminoma in 43% and nonseminoma in 57% of patients. Of 72 patients, 32 (44.4%) had lymph node positivity and 40 (55.6%) hadnot. The mean NLR value was 2.63 +/- 1.79 for all cohort. The mean NLR was significantly lower in patients with lymph node negative disease (for lymph node positive and negative disease 3.19 +/- 2.32 and 2.25 +/- 1.06, respectively.). In the ROC analysis, 2.5 was determined as the cut-off value for NLR to assess lymph node status. Conclusion NLR is a cheap and readily available index that can be used to determine lymph node metastases in testicular GCTs.WOS:00069527270002

An unexpected cause of hyponatremia in a cancer patient: Trimethoprim-sulfamethoxazole

Background: Hyponatremia is one of the most common electrolyte abnormalities seen in hospitalized patients. In cancer patients, it's generally related to syndrome of inappropriate ADH secretion (SIADH). Case Report: Here, we report a breast cancer patient with hyponatremia related to high dose trimethoprim-sulfamethoxazole use for pneumonitis cariini pneumonia. Conclusion: It is important to be aware that all hyponatremias are not related to SIADH in cancer patients. For proper treatment strategies, a proper differential diagnosis is needed