Senkron ve Metakron Hematolojik ve Onkolojik Tümörlerin Tek Merkez Deneyimi

Yıl 2023, Cilt: 45 Sayı: 6, 853 - 861, 24.10.2023

Filiz Yavaşoğlu , Çiğdem Özdemir , Yiğit Şenol , Hacer Demir , Meltem Baykara

https://doi.org/10.20515/otd.1291816

Öz

Dünyada kanser görülme sıklığı giderek artmaktadır. Kanser tedavisindeki gelişmelerle birlikte hastaların ortalama yaşam süreleri uzamakta ve sekonder malignitelerin görülme sıklığı artmaktadır. Yeni kurulan bir hematoloji merkezinde hematolojik malignitelere eşlik eden senkron / metakron maligniteleri retrospektif olarak inceledik.Veriler tıbbi kayıtlardan elde edildi.Hastaların demografik verileri, tedavileri ve genel sağ kalımları değerlendirildi. Hematolojik maligniteli 433 hastanın 28’i (%6) çalışmaya devam edildi. 12 hasta (%42,9) senkron, 16 (%57,1) hasta ise metakron hematolojik-onkolojik tümör tanısı almıştır. Hastaların 16’sı erkek, 12’si kadındı. Senkron tümörlerde en sık görülen hematolojik malignite non-hodgkın lenfoma (NHL), en sık görülen onkolojik maligniteler ise tiroid papiller kanseri ve kolon kanseri idi. Metakron tümörlerde en sık görülen maligniteler NHL ve meme kanseri idi. Metakron tümörlerin tanısı arasındaki medyan süre 49,5 aydı (8-192 ay). Senkron malignitesi olan hastalrın medyan sağkalımı 19 aydı (SE=12,19) )%95 CI 0-42,89), metakron maligniteleri olan hastaların medyan sağkalımı 22 aydı (SE=14,9= (%95 CI 0-49,44). Senkron ve metakron maligniteleri olan hastaların sağkalım eğrilerinin karşılaştırılmasında istatistiksel olarak anlanmlı fark saptanmadı (p=0,382). Hematolojik malignitelere eşlik eden onkolojik maligniteler nadir değildir. Senkron / metakron hematolojik maligniteler için standart bir tedavi yoktur. Senkron multipl malignite varlığında, malignitelerin her biri ayrı ayrı değerlendirilmelidir.

Anahtar Kelimeler

Multipl primer tümörler, Senkronize tümörler, Hematolojik maligniteler

A Single-center Experience of Synchronous and Metachronous Hematologic and Oncologic Tumors

Öz

The incidence of cancer is increasing in the world. With the developments in cancer treatment, the life expectancy of patients is prolonged and the incidence of secondary malignancies is increasing. We retrospetively patients with syncronous / metachronous oncological malignancies accompanying hematological malignancies in a newly established hematology center. Data were obtained from the medical records. Demographic data, treatments and overall survival of the patients were evaluated. Twenty eight (6%) of 433 patients hematological malignancies were included in the study. 12 patients (42.9) were diagnosed with syncronous and 16 (57.1%) patients with metachronous hematologic-oncologic tumors. Sixteen of the patients were male,twelve were female. In syncronous tumors, the most common hematologic malignancy was Non-hodgkın lymphoma (NHL), while the most common oncologic malignancies were thyroid papillary cancer and colon cancer. In metachronous tumors, the most common malignancies were NHL and breast cancer. The median time between diagnosis of metachronous tumors was 49.5 months (8-192 months). The median survival of patients with syncronous malignancies was 19 months (SE=12.19) (95% CI 0-42.89), with metachronous malignancies was 22 months (SE=14.0) (95% CI 0-49.44). There was no statistically significant difference in the comparison of survival curves of patients with syncronous and metachronous malignancies (p=0.382). Oncological malignancies accompanying hematological malignancies are not uncommon. There is no standart treatment for syncronous / metachronous hematologic malignancies. In the presence of syncronous multipl malignancies should be evaluated individually.

Anahtar Kelimeler

Multipl primary neoplasms, Syncronous neoplasms, Hematologic malignancies

Kaynakça

• 1. https://www.wcrf.org/cancer-trends/worldwide-cancer-data/ Accessed on March 20,2023).
• 2. Warren CS, Gates O. Multiple primary malignant tumors: a survey of the literature and a statistical study. Am J Cancer 1932;16:1358-1414.
• 3. Demandante CG, Troyer DA, Miles TP. Multiple primary malignant neoplasms: case report and a comprehensive review of the literature. Am J Clin Oncol 2003;26:79–83.
• 4. Copur MS, Manapuram S. Multiple primary tumors over a lifetime. Oncology (Williston Park) 2019;33:629384.
• 5. Chaudhary P, Gupta S, Leekha N, Tandon R, Nandy M, De S. Pattern of occurrence and treatment outcome of second primary malignancies: A single center experience. South Asian J. Cancer 2017;6:137–8.
• 6. Wei JL, Jiang YZ, Shao ZM. Survival and chemotherapy-related risk of second primary malignancy in breast cancer patients: A SEER-based study. Int. J. Clin. Oncol. 2019;24, 934–40.
• 7. Horii A, Han HJ, Shimada M, Yanagisawa A, Kato Y, Ohta H, Yasui W, Tahara E, Nakamura Y. Frequent replication errors at microsatellite loci in tumors of patients with multiple primary cancers. Cancer Res. 1994;54:3373-5.
• 8. NIH National Cancer Institute Division on Cancer Epidemiology & Genetics. Available online: https://dceg.cancer.gov/research/what-we-study/second-cancers (accessed on 1 March 2022).
• 9. Kılçıksız SÇ, Kaynak C, Eşki E, Yersal Ö, Ünlü İ, Çallı A, Sarı A, Baloğlu A, Nalbantoğlu G, Yiğitbaş H. Çok primerli ve tek primerli kanser olguları: İzmir kanser kayıt merkezi verilerinden hastane tabanlı bir inceleme. Türk Onkoloji Dergisi 2007;22:55-62.
• 10. Aytan P, Yeral Mİ, Gereklioğlu Ç, Kasar M, Korur A, Buyukkurt N, Asma S, Kozanoglu I, Ozdogu H, & Boğa C. The clinicopathologic features of multiple primary malignancies in hematology: A cross sectional descriptive study. Medicine Science | International Medical Journal. 2020; 9, 94.
• 11. Nishiwaki S, Okuno S, Suzuki K, Kurahashi S, Sugiura I. Impact of Synchronous Multiple Primary Malignant Tumors on Newly Diagnosed Hematological Malignancies. Clin Lymphoma Myeloma Leuk. 2017;17(12):e79-e85.
• 12. Deveci B, Yildiz A, Yilmaz S, Ozcan B, Kargi A, Saba R, Sahin Z, Ozdogan M. Evaluation of the Patients with Hematological Malignancies along with Synchronous or Metachronous Solid Tumors. International Journal of Hematology and Oncology.2021;32(4), 214-220.
• 13. Liu S, Wei X, Xiong Y, Mi R,Yin Q. Thirty-two case reports of synchronous hematological malignancy and solid tumor. Turk J Haematol 2019; 36: 291-4.
• 14. GLOBOCAN 2020: New global cancer data. https://www.uicc.org/news/globocan-2020-new-global-cancer-data (Accessed on November 24, 2021).
• 15. Shah BK, Khanal A. second primary malignancies in mantle cell lymphoma: A US population-based study. Anticancer Res. 2015;35: 3437–40.
• 16. Solomon BM, Chaffee KG, Moreira J, Schwager SM, Cerhan JR, Call TG, Kay NE, Slager SL, Shanafelt TD. Risk of non-hematologic cancer in individuals with highcount monoclonal B-cell lymphocytosis. Leukemia. 30, 331–6 (2016).
• 17. Kripa Ahuja, Ranjit Goudar. Castleman Disease: A Population Based Study Using the National Cancer Institute's Surveillance, Epidemiology, and End Results Program. Blood 2022; 140 (Supplement 1): 12114–12115.
• 18. Young NS. Aplastic Anemia. N Engl J Med. 2018 Oct 25;379(17):1643-1656.
• 19. Ruan Jing, Han Bing. Effective treatment of aplastic anemia secondary to chemoradiotherapy using cyclosporine A. Chinese Medical Journal 134(19):p 2356-8, October 5, 2021.
• 20. Siegel RL, Miller KD and Jemal A. CA A Cancer J Clin. 2019;69: 7-34.
• 21. Dong C, Hemminki K. Second primary neoplasms among 53 159 haematolymphoproliferative malignancy patients in Sweden, 1958-1996: a search for common mechanisms. Br J Cancer 2001;85:997–1005.
• 22. Poh, Christina, Theresa Keegan, and Aaron Seth Rosenberg. "Second primary malignancies in multiple myeloma: A review." Blood reviews 46 (2021):100757.
• 23. Xu H, Wei X, Yin Q, et al. Zhonghua Xue Ye Xue Za Zhi. 2014;35(11):1018-1021.
• 24. W Ch, Y H, Y M. Acute Myeloid Leukemia Complicated With Granulocytic Sarcoma After Chemotherapy for Malignant Fibrous Histiocytoma: A Case Report. Chongqing Med J (2018) 47(27):3602–4.
• 25. Aldoss I, Stiller T, Tsai NC, Song J Y, Cao T, Bandara N A, Salhotra A, Khaled S, Aribi A, Malki MMA, Mei M, Ali H, Spielberger R, O’Donnell M, Snyder D, Slavin T, Nakamura R, Stein AS, Forman SJ, Marcucci G, Pullarkat, V. Therapy-related acute lymphoblastic leukemia has distinct clinical and cytogenetic features compared to de novo acute lymphoblastic leukemia, but outcomes are comparable in transplanted patients. Hematologica, 2018;103(10), 1662.
• 26. Barbui T, Ghirardi A, Masciulli A, Carobbio A, Palandri F, Vianelli N, De Stefano V, Betti S, Di Veroli A, Iurlo A, Cattaneo D, Delaini F, Bonifacio M, Scaffidi L, Patriarca A, Rumi E, Casetti IC, Stephenson C, Guglielmelli P, Elli EM, Palova M, Bertolotti L, Erez D, Gomez M, Wille K, Perez-Encinas M, Lunghi F, Angona A, Fox ML, Beggiato E, Benevolo G, Carli G, Cacciola R, McMullin MF, Tieghi A, Recasens V, Marchetti M, Griesshammer M, Alvarez-Larran A, Vannuchi AM, Finazzi G. Second cancer in Philadelphia negative myeloproliferative neoplasms (MPN-K). A nested case-control study. Leukemia. 2019;33,1996–2005.
• 27. Masarova L, Cherry M, Newberry KJ, Estrov Z, Cortes JE, Kantarjian HM, et al. Secondary solid tumors and lymphoma in patients with essential thrombocythemia and polycythemia vera—single center experience. Leuk Lymphoma. 2016;57:237–9.
• 28. Marcheselli L, Polliack A, Tadmor T. Impact of therapy on the development of second malignancies in essential thrombocythemia and polycythemia vera: are we comfortable about this? Leuk Lymphoma. 2016;57:6–7.
• 29. Skelton WP 4th, Ali A, Skelton MN, Federico R, Bosse R, Nguyen TC, et al. Analysis of overall survival in patients with multiple primary malignancies: a single-center experience. Cureus. 2019 Apr;11(4):e4552.
• 30. Chowdary T, Sivaraj S, Rao G, Thirunavukkarasu S. Dual malignancies: do they have a worse prognosis than their individual counterparts. Arch Int Surg. 2015;5(1):29–32.
• 31. Singh A, Khare IC, Dixit AK, Pandey KC, Mittal DK, Singh P. Successfully treated synchronous double malignancy of the breast and esophagus: a case report. J Med Case Rep. 4.2010;1-4.