Jiao Feng, Yao Li-Juan, Zhou Jin, Hu Hai, Wang Li-Wei
Department of Oncology, Shanghai Jiao Tong University Affiliated First People's Hospital, Shanghai, China E-mail :
Asian Pac J Cancer Prev. 2014;15(1):331-4. doi: 10.7314/apjcp.2014.15.1.331.
There is a scarcity of reports addressing patients with multiple primary malignancies (MPM), especially for Chinese cses. The aim of this study was to present a detailed analysis of Chinese patients presenting with at least two primary malignancies. Particularly, the clinical characteristics and survival between synchronous and metachronous MPM were compared. Out of 6,545 cases, 72 patients (1.1%) including 39 males (54.2%) and 33 females (45.8%) were diagnosed as MPM, giving a male: female sex ratio of 1.2:1. Of these, there were 16 (22.2%) cases of synchronous MPM (7 males, 9 females), 55(76.4%) metachronous (31 males, 24 females), and 1 "mixed form". For first tumor diagnosis time, synchronous MPM patients generally presented later than the metachronous cases. The top three sites for malignancies with metachronous MPM were colorectum, head and neck, and lung, while for synchronous they were lung, colorectum and breast. Among MPM patients, the median survival time was 15.7 years and the 5-year survival was 56%, and there was statistical difference in MPM categories (P < 0.05). The median survival time was 17.3 years and 3.8 years for metachronous and synchronous MPM patients, respectively. In comparison with synchronous MPM patients, those metachronous had a longer survival. This studies increase understanding of the clinical features of Chinese MPM patients and suggest that those presenting with metachronous cancers have a higher incidence and a better prognosis.
关于多原发性恶性肿瘤(MPM)患者的报道较少,尤其是中国患者的情况。本研究旨在对至少患有两种原发性恶性肿瘤的中国患者进行详细分析。特别地,比较了同时性和异时性MPM的临床特征和生存率。在6545例病例中,72例(1.1%)被诊断为MPM,其中男性39例(54.2%),女性33例(45.8%),男女比例为1.2:1。其中,同时性MPM有16例(22.2%)(男性7例,女性9例),异时性55例(76.4%)(男性31例,女性24例),还有1例“混合形式”。对于首次肿瘤诊断时间,同时性MPM患者通常比异时性患者出现得晚。异时性MPM的前三位恶性肿瘤发生部位是结直肠、头颈部和肺部,而同时性的是肺部、结直肠和乳腺。在MPM患者中,中位生存时间为15.7年,5年生存率为56%,不同MPM类型之间存在统计学差异(P<0.05)。异时性和同时性MPM患者的中位生存时间分别为17.3年和3.8年。与同时性MPM患者相比,异时性患者的生存期更长。本研究增进了对中国MPM患者临床特征的了解,并表明异时性癌症患者的发病率较高且预后较好。