Rabbani F, Reuter V E, Katz J, Russo P
Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
Urology. 2000 Sep 1;56(3):399-403. doi: 10.1016/s0090-4295(00)00682-8.
This study was performed to determine which histologic types of renal cell carcinoma have an association with a second primary malignancy.
Seven hundred sixty-three patients underwent an operation for renal cell carcinoma between July 1989 and January 1999. The incidence of antecedent, synchronous, or subsequent second malignancies was determined. Statistical tests based on the Poisson model were used to compare the observed number of subsequent malignancies developing after a diagnosis of renal cell carcinoma with the expected number calculated using the 1973 to 1994 U.S. Surveillance, Epidemiology, and End Results age, race, gender, and calendar-year specific incidence rates.
Second primary malignancies were present in 209 of 763 (27.4%) patients, with prostate, breast, colon, and bladder cancer and non-Hodgkin's lymphoma being the five most common second malignancies. The other malignancies were antecedent in 118 cases (44.5%), synchronous in 104 cases (39.2%), and subsequent in 43 cases (16.2%). Patients with papillary renal cell carcinoma were at increased risk of developing bladder cancer (standardized incidence ratio [SIR] 6.5, P = 0.038). Men with papillary renal cell carcinoma were also at increased risk of developing prostate cancer (SIR 2.8, P = 0.035).
There is an increased risk of subsequent bladder and prostate cancer in patients with papillary renal cell carcinoma.
本研究旨在确定哪些组织学类型的肾细胞癌与第二原发性恶性肿瘤有关。
1989年7月至1999年1月期间，763例患者接受了肾细胞癌手术。确定先前、同步或后续第二原发性恶性肿瘤的发生率。基于泊松模型的统计检验用于比较肾细胞癌诊断后发生的后续恶性肿瘤的观察数量与使用1973年至1994年美国监测、流行病学和最终结果年龄、种族、性别和历年特定发病率计算的预期数量。
763例患者中有209例（27.4%）存在第二原发性恶性肿瘤，前列腺癌、乳腺癌、结肠癌、膀胱癌和非霍奇金淋巴瘤是五种最常见的第二原发性恶性肿瘤。其他恶性肿瘤中，先前存在的有118例（44.5%），同步存在的有104例（39.2%），后续发生的有43例（16.2%）。乳头状肾细胞癌患者患膀胱癌的风险增加（标准化发病率[SIR]为6.5，P = 0.038）。患有乳头状肾细胞癌的男性患前列腺癌的风险也增加（SIR为2.8，P = 0.035）。
乳头状肾细胞癌患者发生后续膀胱癌和前列腺癌的风险增加。
