Salem Ahmed, Abu-Hijlih Ramiz, Abdelrahman Fadwa, Turfa Rim, Amarin Rula, Farah Naim, Sughayer Maher, Almousa Abdelatief, Khader Jamal
Department of Radiation Oncology, King Hussein Cancer Center, HM Queen Rania Street, P.O. Box 1269, Amman, 11941, Jordan.
J Gastrointest Cancer. 2012 Sep;43(3):437-43. doi: 10.1007/s12029-011-9296-7.
There is scarcity of reports addressing patients with three or more malignancies. The aim of this study is to present a detailed analysis of patients presenting with at least three primary malignant tumors.
Records of cancer patients presenting to King Hussein Cancer Center (Amman, Jordan) between June 2006 and March 2011 were retrospectively reviewed. Patients harboring multiple primary tumors were included for detailed analysis. Data relating to epidemiological features, pathological characteristics, and disease outcomes were extracted.
Out of 14,040 cases, 319 patients (2.3%) harbored two or more while 23 patients (0.16%) harbored three or more primary malignant tumors. This study included 17 males and six females between 4 and 78 years of age (median, 52 years) at the time of diagnosis of the first malignancy. The most prevalent tumor was colorectal adenocarcinoma found in nine, followed by lymphoma in seven, and prostate adenocarcinoma in six patients. The most common tumor combinations were colorectum-non-melanoma skin, colorectum-kidney, and non-melanoma skin-kidney all found in four patients, respectively. At a median follow-up of 96 months from the time of diagnosis of the first primary (range, 2-337 months) and 8 months from the time of diagnosis of the last primary (range, 1-48 months), 13 were alive with no evidence of disease, six were alive with residual disease, three were dead due to disease, and one patient was alive with unknown disease status.
The possibility of multiple primary malignancies should always be considered during the treatment and follow-up of cancer patients. This case series could prove helpful to clinicians faced with similar, however, exceedingly rare scenarios. Due to the realistic potential for long-term survival, we recommend aggressive treatment of these patients.
关于患有三种或更多种恶性肿瘤患者的报道较为匮乏。本研究的目的是对患有至少三种原发性恶性肿瘤的患者进行详细分析。
回顾性分析了2006年6月至2011年3月期间在侯赛因国王癌症中心（约旦安曼）就诊的癌症患者记录。纳入患有多个原发性肿瘤的患者进行详细分析。提取了与流行病学特征、病理特征和疾病转归相关的数据。
在14040例病例中，319例患者（2.3%）患有两种或更多种原发性恶性肿瘤，23例患者（0.16%）患有三种或更多种原发性恶性肿瘤。本研究纳入了17例男性和6例女性，在诊断首例恶性肿瘤时年龄为4至78岁（中位数为52岁）。最常见的肿瘤是结肠直肠腺癌，有9例，其次是淋巴瘤，有7例，前列腺腺癌有6例。最常见的肿瘤组合是结肠直肠-非黑色素瘤皮肤、结肠直肠-肾脏和非黑色素瘤皮肤-肾脏，各有4例患者。从首例原发性肿瘤诊断时间起的中位随访时间为96个月（范围为2至337个月），从最后一例原发性肿瘤诊断时间起的随访时间为8个月（范围为1至48个月），13例患者存活且无疾病证据，6例患者存活但有残留疾病，3例患者因疾病死亡，1例患者存活但疾病状态不明。
在癌症患者的治疗和随访过程中，应始终考虑存在多种原发性恶性肿瘤的可能性。本病例系列可能对面临类似但极为罕见情况的临床医生有所帮助。鉴于长期生存的现实可能性，我们建议对这些患者进行积极治疗。
