BACKGROUND: In recent decades, there has been an increase in the incidence of multiple malignancies. The incidence of this type of cancer ranges from 4.6 to 8.0 %. Subsequent tumors are detected between 1.5 and 42 years. The average interval between the primary and secondary processes is 6 years. More than 80 % of cases of primary multiple cancer (PMC) occur in people over 60 years of age. AIM: To generalize the patterns of development of PMC associated with breast cancer (BC), and to predict risk factors. METHODS: We retrospectively reviewed the medical records of 62 women with VUR, examined and treated at the Sverdlovsk Regional Oncology Center (Yekaterinburg) from 2020 to 2022. VUR associated with breast cancer was detected in 2 % of cases. Three women were excluded from the study according to the Warren–Gates criteria: two with metastases and one with mammary tuberculosis. The average time to secondary tumor detection was 5.4 years (range, 2 to 10 years). PMC was detected in the other breast in 29 % of cases, endometrial lesions were diagnosed in 17.7 % of patients, and malignant ovarian and renal neoplasms were diagnosed in 9.6 %. Disease progression in the form of metastases was observed in 14.5% of cases in patients over 55 years of age. Family history was a significant risk factor in 36 % of cases, gene mutations in 18.5 %, hormonal status in 49.4 %, obesity in 45.6 %, lymph node status in 48.4 %, previous treatment (chemotherapy or radiation therapy) in 5 %, and environmental factors in 24.5 %. A shallow learning neural network was used to predict risk factors for the development of PMC. The input data (diagnostic features) were converted to binary form: a value of “1” for a feature indicated its presence, a value of “0” indicated its absence. When training and testing the neural network, the target function was the time of secondary tumor onset and, in the presence of known breast cancer, also the time of progression. RESULTS: The risk of developing PMC within 5 years with a sensitivity of 86%, a specificity of 100 %, and an AUC of 0.929 (AUC – area under the receiver operating characteristic curve) was observed in patients over 60 years of age with stage T1–2N1 disease and luminal B and luminal/HER2-positive breast cancer (HER2 – human epidermal growth factor receptor 2). The development of PMC more than 5 years after the primary process, with a sensitivity of 64 %, a specificity of 86 %, and an AUC of 0.714, is possible in patients under 60 years of age with the luminal B molecular subtype of breast cancer and a primary tumor with a malignancy grade of G2. CONCLUSION: There is no consensus on the causes of PMC development (single tumors are not an exception). Increased survival after the onset of the first malignancy leads to an increased frequency of detection of second and subsequent tumors. Patients diagnosed with PMC, especially those with a strong family history and early onset of the disease, should be referred to a geneticist for consultation.
Introduction: Gastric cancer in young patients is of particular interest due to a number of clinical and endoscopic features. Despite of the general downward trend in gastric cancer incidence, in recent years there has been a steady increase in cases among young patients, which determines the relevance of studying the characteristics of this pathology. Objective: Evaluation of the results of endoscopic diagnostics of cases of gastric cancer detected in patients under 30 years of age in the endoscopy department of the P.A. Hertsen Moscow Oncology Research Institute. Materials and methods: A retrospective analysis of 27 cases of gastric cancer in patients under 30 years of age examined at the P.A. Hertsen Moscow Oncology Research Institute in the period 2012-2024 was conducted. Expert-class endoscopic equipment with near-focus endoscopy technology (NBI Near Focus) was used. Results: Infiltrative forms were observed in 100% of cases (70% - type III according to Borrmann classification, 30% - type IV). Total gastric involvement was detected in 41% of cases, with extension to the esophagus and/or duodenum in 45% of them. 60% of cases were diagnosed at stage IV. Histologically - poorly differentiated adenocarcinoma with a signet ring cell component predominated (89%). A case of association with Lynch syndrome was identified. Conclusion: Gastric cancer in young patients is characterized by an aggressive course and a predominance of infiltrative forms, which requires the development of special algorithms for early diagnosis and increased oncological alertness.
Data on multinational 90-day mortality and morbidity rates after surgery for gastric cancer is limited in the literature. This study aimed to understand the 90-day mortality and morbidity outcomes among patients undergoing elective gastric cancer surgery, as in the GASTRODATA Registry, and to identify associated risk factors. We conducted an international prospective study on patients aged ≥ 18 years undergoing elective surgery for gastric cancer with curative intent from January 4 to September 30, 2022. Known metastatic disease, concurrent secondary cancers, gastrointestinal stromal tumour (GIST) and Siewert type I/II oesophagogastric junction malignancies were excluded. Univariate and multivariate logistic regression were used to identify variables associated with the 90-day outcome. 380 collaborators from 47 countries submitted data on 1538 patients. Median age was 65 years (IQR: 19–94), and 58.5
A clinical case of intraoperative contrast-enhanced ultrasound (ICUSI) of a brain tumor using the contrast agent «Sonovyu» is described. The method allowed to clarify the boundaries of the tumor lesion and to evaluate the angioarchitectonics of glioblastoma revealed by intraoperative ultrasound (IOUSI).
