Skoropad V Iu, Bedrov B A, Rukhadze G O
Vopr Onkol. 2012;58(6):754-61.
Patterns of polyneoplasia development were analyzed in radically operated gastric cancer patients. The second tumors were revealed in 99 of 1255 patients (7,9%) as soon as patients with early gastric cancer manifested primary-multiple malignant tumors almost two times more (15,4%). Among second tumors there were predominantly tumors of the colon, urogenital system, head and neck and also lymphoproliferative diseases. Along with tumors prior to the diagnosis "gastric cancer" there were met mostly lymphoproliferative diseases and breast cancer; of synchronous--cancer of the colon and bladder; among exposed after treatment of gastric cancer-cancer of the colon, pancreas, and skin. Radical surgery because of the second tumor was provided to 77,6% patients, palliative surgery--to 12,6%. In the treatment of second tumors there were most commonly used surgical technique--in 40 (39%) patients, radiotherapy +/- chemotherapy--in 27 (26%), the combined method (surgery+radiotherapy/chemotherapy)--in 22 (21%). Second tumors (both synchronous and metachronous) were the main cause of death of patients. Thus, the occurrence of a second tumor in patients with gastric cancer is constantly increasing the frequency of the event, with the possibility of early detection and curative treatment of synchronous and especially metachronous tumors determine the prognosis in this group of patients. Primary tumor multiplicity is not a contraindication both to a radical, including combined, and palliative treatment of each of the tumors.
对接受根治性手术的胃癌患者的多原发肿瘤发展模式进行了分析。在1255例患者中,有99例(7.9%)发现了第二原发肿瘤,而早期胃癌患者出现原发性多发恶性肿瘤的比例几乎高出一倍(15.4%)。第二原发肿瘤主要为结肠、泌尿生殖系统、头颈部肿瘤以及淋巴增殖性疾病。在诊断为“胃癌”之前出现的肿瘤中,最常见的是淋巴增殖性疾病和乳腺癌;同步出现的肿瘤为结肠癌和膀胱癌;在胃癌治疗后出现的肿瘤为结肠癌、胰腺癌和皮肤癌。因第二原发肿瘤接受根治性手术的患者占77.6%,接受姑息性手术的患者占12.6%。在治疗第二原发肿瘤时,最常用的手术技术——40例(39%)患者采用,放疗+/-化疗——27例(26%)患者采用,联合方法(手术+放疗/化疗)——22例(21%)患者采用。第二原发肿瘤(包括同步和异时性肿瘤)是患者死亡的主要原因。因此,胃癌患者出现第二原发肿瘤的事件发生率不断增加,早期发现同步尤其是异时性肿瘤并进行根治性治疗的可能性决定了该组患者的预后。原发肿瘤的多发性并非对每个肿瘤进行根治性(包括联合)和姑息性治疗的禁忌证。