Morais Samantha, Antunes Luís, Bento Maria José, Lunet Nuno
EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, no 135, 4050-600 Porto, Portugal.
Registo Oncológico Regional do Norte (RORENO) - Instituto Português de Oncologia do Porto, Rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal.
Cancer Epidemiol. 2017 Oct;50(Pt A):85-91. doi: 10.1016/j.canep.2017.08.007. Epub 2017 Aug 23.
The growing number of incident cases of gastric cancer along with improved survival result in a rising population of survivors at risk of second primary cancers (SPC). We estimated the cumulative incidence of metachronous (diagnosed >2months after first primary cancer [FPC]) SPC in gastric FPC patients and compared the incidence of metachronous SPC with that expected in the general population.
A cohort of gastric FPC patients from the North Region Cancer Registry of Portugal, diagnosed in 2000-2006 (n=7427) was followed to 31 December 2010 for synchronous and metachronous SPCs. Cumulative incidence of metachronous SPCs taking into account death as a competing event and standardized incidence ratios (SIR) of metachronous SPCs were estimated.
Overall, 331 (4.5%) patients developed an SPC (26.9% synchronous and 73.1% metachronous). Over half of the SPCs occurred in digestive organs. Among men, the most frequent were colon, prostate, and trachea, bronchus and lung; in women, colon, breast and thyroid were the most common. The 10-year cumulative incidence of metachronous SPC for males was 5.7% and for females 3.5%. The SIR for all cancers was 1.30 in males and 1.20 in females. Among both sexes, significantly higher SIRs were observed for cancers of the oesophagus (males: 4.99; females: 8.03), small intestine (males: 11.04; females: 13.09) and colon (males: 2.42; females: 2.58).
Patients with a gastric FPC were found to be at increased risk of developing SPC, mainly in digestive organs, when compared to the general population. Close surveillance of these patients may allow early detection of SPC.
胃癌新发病例数量不断增加，同时生存率提高，导致处于患第二原发性癌症（SPC）风险的幸存者群体不断扩大。我们估计了胃癌第一原发性癌症（FPC）患者中异时性（在第一原发性癌症确诊>2个月后诊断）SPC的累积发病率，并将异时性SPC的发病率与一般人群中的预期发病率进行了比较。
对2000年至2006年在葡萄牙北部地区癌症登记处诊断的一组胃癌FPC患者（n=7427）进行随访，直至2010年12月31日，以观察同时性和异时性SPC。估计了将死亡作为竞争事件的异时性SPC的累积发病率以及异时性SPC的标准化发病率（SIR）。
总体而言，331名（4.5%）患者发生了SPC（26.9%为同时性，73.1%为异时性）。超过一半的SPC发生在消化器官。在男性中，最常见的是结肠癌、前列腺癌以及气管、支气管和肺癌；在女性中，最常见的是结肠癌、乳腺癌和甲状腺癌。男性异时性SPC的10年累积发病率为5.7%，女性为3.5%。所有癌症的SIR男性为1.30，女性为1.20。在两性中，食管癌（男性：4.99；女性：8.03）、小肠癌（男性：11.04；女性：13.09）和结肠癌（男性：2.42；女性：2.58）的SIR均显著更高。
与一般人群相比，胃癌FPC患者发生SPC的风险增加，主要发生在消化器官。对这些患者进行密切监测可能有助于早期发现SPC。
