MDT discussion of a case of simultaneous multiple primary cancer–hepatocellular carcinoma and esophageal squamous cell carcinoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

QIN Zhi ¹ , QIN Yonghui ¹ , LIAO Jinyuan ² , YANG Hong ³ , ZENG Zhiming ⁴ , WANG Yongyong ⁵ , WANG Jilong ¹ , XU Banghao ¹ , GUO Ya ¹ , PENG Tao ¹ , PENG Minhao ¹ ,  WEN Zhang ¹

1. Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, P. R. China;
2. Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, P. R. China;
3. Department of Doppler Ultrasonic, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, P. R. China;
4. Department of Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, P. R. China;
5. Department of Thoracic Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, P. R. China;

Corresponding author：

WEN Zhang, Email: wenzgxmu@163.com

Keywords：

simultaneous multiple primary cancer; hepatocellular carcinoma; esophageal squamous cell carcinoma; MDT; surgery

DOI：

10.7507/1007-9424.202007091

Video：

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Objective To explore the safety and feasibility of surgical treatment of simultaneous multiple primary cancer–hepatocellular carcinoma and esophageal squamous cell carcinoma.Method The clinical data of one patient with simultaneous multiple primary cancer of hepatocellular carcinoma and esophageal squamous cell carcinoma, who treated in the First Affiliated Hospital of Guangxi Medical University in April 2019 was analyzed retrospectively. Results The patient was diagnosed as hepatocellular carcinoma and esophageal squamous cell carcinoma on admission. After MDT in the hospital, the patient underwent anterior right hepatectomy + cholecystectomy and radical resection of esophageal carcinoma in turn. The procedure of anterior right hepatectomy + cholecystectomy was smooth, the duration of the surgery was 270 min, and the total blood loss was 500 mL, and postoperative pathology showed that hepatocellular carcinoma was in grade Ⅱ. The operation process of radical resection of esophageal cancer was smooth too, the duration of the surgery was 176 min, and the total blood loss was 100 mL, and postoperative pathology showed moderately differentiated squamous cell carcinoma. No related surgical complications occurred after the operation. Thirteen months after the operation of liver cancer and 10 months after the operation of esophageal cancer, the patient was generally in good condition, well wound healing, and no clinical recurrence. The follow-up of the patient was continued.Conclusion In allusion to simultaneous multiple primary cancers, it is safe and feasible to evaluate the location, pathological stage, and general condition of the patient by combining multi-disciplinary diagnosis and treatment and then performing radical operations in turn.

Citation： QIN Zhi, QIN Yonghui, LIAO Jinyuan, YANG Hong, ZENG Zhiming, WANG Yongyong, WANG Jilong, XU Banghao, GUO Ya, PENG Tao, PENG Minhao, WEN Zhang. MDT discussion of a case of simultaneous multiple primary cancer–hepatocellular carcinoma and esophageal squamous cell carcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2020, 27(12): 1561-1567. doi: 10.7507/1007-9424.202007091 Copy

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2.	Caines A, Selim R, Salgia R. The changing global epidemiology of hepatocellular carcinoma. Clin Liver Dis, 2020, 24(4): 535-547.
3.	McGlynn KA, Petrick JL, El-Serag HB. Epidemiology of hepatocellular carcinoma. Hepatology, 2020, [Online ahead of print].
4.	Then EO, Lopez M, Saleem S, et al. Esophageal cancer: an updated surveillance epidemiology and end results database analysis. World J Oncol, 2020, 11(2): 55-64.
5.	Uhlenhopp DJ, Then EO, Sunkara T, et al. Epidemiology of esophageal cancer: update in global trends, etiology and risk factors. Clin J Gastroenterol, 2020, [Online ahead of print].
6.	Zhang L, Feng L, Cong H, et al. Multiple primary malignant neoplasms: a case report and literature review. Oncol Lett, 2019, 18(4): 4210-4220.
7.	Shimizu R, Murakami T, Wadamori K, et al. The surgical management of synchronous hepatocellular carcinoma and thoracic esophageal carcinoma. Surg Today, 1993, 23(1): 63-67.
8.	中华人民共和国国家卫生健康委员会医政医管局. 原发性肝癌诊疗规范 (2019 年版). 临床肝胆病杂志, 2020, 36(2): 277-292.
9.	Working Group Report. International rules for multiple primary cancers (ICD-0 third edition). Eur J Cancer Prev, 2005, 14(4): 307-308.
10.	Warren S, Gates O. Multiple primary malignant tumors: a survey of the literature and statistical study. Am J Cancer, 1932, 16: 1358-1361.
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13.	Vogt A, Schmid S, Heinimann K, et al. Multiple primary tumours: challenges and approaches, a review. ESMO Open, 2017, 2(2): e000172.
14.	Romaszko-Wojtowicz A, Buciński A, Doboszyńska A. Impact of smoking on multiple primary cancers survival: a retrospective analysis. Clin Exp Med, 2018, 18(3): 391-397.
15.	Seegobin K, Staggs E, Khawaja R, et al. Pilot study on the occurrence of multiple cancers following cancer-related therapy at the University of Florida, Jacksonville (2011-2016). J Investig Med, 2018, 66(7): 1050-1054.
16.	Barroso-Vicens E, Ramirez G, Rabb H. Multiple primary malignancies in a renal transplant patient. Transplantation, 1996, 61(11): 1655-1656.
17.	孙海燕, 潘战宇, 张新伟, 等. 40 例多原发癌姑息治疗多学科会诊临床分析. 中国肿瘤临床, 2016, 43(15): 674-678.
18.	Rosso S, De Angelis R, Ciccolallo L, et al. Multiple tumours in survival estimates. Eur J Cancer, 2009, 45(6): 1080-1094.
19.	Liu Z, Liu C, Guo W, et al. Clinical analysis of 152 cases of multiple primary malignant tumors in 15,398 patients with malignant tumors. PLoS One, 2015, 10(5): e0125754.
20.	张稚淳, 贾梦冉, 丁皓, 等. 120 例多原发肿瘤临床分析. 肿瘤防治研究, 2019, 46(2): 153-158.
21.	Kudou M, Shiozaki A, Fujiwara H, et al. Multiple primary cancers of the esophagus and hepatocellular carcinoma-a report of 4 cases. Gan To Kagaku Ryoho, 2013, 40(12): 2164-2166.
22.	Chen D, Fan N, Mo J, et al. Multiple primary malignancies for squamous cell carcinoma and adenocarcinoma of the esophagus. J Thorac Dis, 2019, 11(8): 3292-3301.
23.	Peng C, Li Z, Gao H, et al. Synchronous primary sigmoid colon cancer and primary thyroid cancer followed by a malignant tumor of the kidney: case report of multiple primary cancer and review of the literature. Oncol Lett, 2019, 17(2): 2479-2484.
24.	Tranchart H, Chirica M, Sepulveda A, et al. Long-term outcomes following aggressive management of recurrent hepatocellular carcinoma after upfront liver resection. World J Surg, 2012, 36(11): 2684-2691.
25.	Nagahama T, Goseki N, Kato S, et al. Esophageal carcinoma and coexisting hepatocellular carcinoma resected simultaneously. Arch Surg, 1996, 131(2): 208-210.
26.	吴建国, 卢正茂, 罗天航, 等. 消化系多原发癌多次手术存活 35 年 1 例报告. 中国实用外科杂志, 2011, 31(6): 544-547.

1. Noguchi M, Naruki Y, Matsuo K, et al. A case report of triple malignant tumor including early gastric carcinoma–multiple primary malignant tumors, a survey of the literatures and a statistical study (author’s transl). Nihon Shokakibyo Gakkai Zasshi, 1978, 75(1): 71-79.
2. Caines A, Selim R, Salgia R. The changing global epidemiology of hepatocellular carcinoma. Clin Liver Dis, 2020, 24(4): 535-547.
3. McGlynn KA, Petrick JL, El-Serag HB. Epidemiology of hepatocellular carcinoma. Hepatology, 2020, [Online ahead of print].
4. Then EO, Lopez M, Saleem S, et al. Esophageal cancer: an updated surveillance epidemiology and end results database analysis. World J Oncol, 2020, 11(2): 55-64.
5. Uhlenhopp DJ, Then EO, Sunkara T, et al. Epidemiology of esophageal cancer: update in global trends, etiology and risk factors. Clin J Gastroenterol, 2020, [Online ahead of print].
6. Zhang L, Feng L, Cong H, et al. Multiple primary malignant neoplasms: a case report and literature review. Oncol Lett, 2019, 18(4): 4210-4220.
7. Shimizu R, Murakami T, Wadamori K, et al. The surgical management of synchronous hepatocellular carcinoma and thoracic esophageal carcinoma. Surg Today, 1993, 23(1): 63-67.
8. 中华人民共和国国家卫生健康委员会医政医管局. 原发性肝癌诊疗规范 (2019 年版). 临床肝胆病杂志, 2020, 36(2): 277-292.
9. Working Group Report. International rules for multiple primary cancers (ICD-0 third edition). Eur J Cancer Prev, 2005, 14(4): 307-308.
10. Warren S, Gates O. Multiple primary malignant tumors: a survey of the literature and statistical study. Am J Cancer, 1932, 16: 1358-1361.
11. Moertel CG. Multiple primary malignant neoplasms: historical perspectives. Cancer, 1977, 40(4 Suppl): 1786-1792.
12. 张献文, 江浩, 汪庚明, 等. 食管-口底异时性四重多原发癌 1 例并文献复习. 肿瘤防治研究, 2017, 44(7): 509-512.
13. Vogt A, Schmid S, Heinimann K, et al. Multiple primary tumours: challenges and approaches, a review. ESMO Open, 2017, 2(2): e000172.
14. Romaszko-Wojtowicz A, Buciński A, Doboszyńska A. Impact of smoking on multiple primary cancers survival: a retrospective analysis. Clin Exp Med, 2018, 18(3): 391-397.
15. Seegobin K, Staggs E, Khawaja R, et al. Pilot study on the occurrence of multiple cancers following cancer-related therapy at the University of Florida, Jacksonville (2011-2016). J Investig Med, 2018, 66(7): 1050-1054.
16. Barroso-Vicens E, Ramirez G, Rabb H. Multiple primary malignancies in a renal transplant patient. Transplantation, 1996, 61(11): 1655-1656.
17. 孙海燕, 潘战宇, 张新伟, 等. 40 例多原发癌姑息治疗多学科会诊临床分析. 中国肿瘤临床, 2016, 43(15): 674-678.
18. Rosso S, De Angelis R, Ciccolallo L, et al. Multiple tumours in survival estimates. Eur J Cancer, 2009, 45(6): 1080-1094.
19. Liu Z, Liu C, Guo W, et al. Clinical analysis of 152 cases of multiple primary malignant tumors in 15,398 patients with malignant tumors. PLoS One, 2015, 10(5): e0125754.
20. 张稚淳, 贾梦冉, 丁皓, 等. 120 例多原发肿瘤临床分析. 肿瘤防治研究, 2019, 46(2): 153-158.
21. Kudou M, Shiozaki A, Fujiwara H, et al. Multiple primary cancers of the esophagus and hepatocellular carcinoma-a report of 4 cases. Gan To Kagaku Ryoho, 2013, 40(12): 2164-2166.
22. Chen D, Fan N, Mo J, et al. Multiple primary malignancies for squamous cell carcinoma and adenocarcinoma of the esophagus. J Thorac Dis, 2019, 11(8): 3292-3301.
23. Peng C, Li Z, Gao H, et al. Synchronous primary sigmoid colon cancer and primary thyroid cancer followed by a malignant tumor of the kidney: case report of multiple primary cancer and review of the literature. Oncol Lett, 2019, 17(2): 2479-2484.
24. Tranchart H, Chirica M, Sepulveda A, et al. Long-term outcomes following aggressive management of recurrent hepatocellular carcinoma after upfront liver resection. World J Surg, 2012, 36(11): 2684-2691.
25. Nagahama T, Goseki N, Kato S, et al. Esophageal carcinoma and coexisting hepatocellular carcinoma resected simultaneously. Arch Surg, 1996, 131(2): 208-210.
26. 吴建国, 卢正茂, 罗天航, 等. 消化系多原发癌多次手术存活 35 年 1 例报告. 中国实用外科杂志, 2011, 31(6): 544-547.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

MDT discussion of a case of simultaneous multiple primary cancer–hepatocellular carcinoma and esophageal squamous cell carcinoma

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