Zhai Chongya, Cai Yulan, Lou Fang, Liu Zhen, Xie Jiansheng, Zhou Xiaoyun, Wang Zhanggui, Fang Yong, Pan Hongming, Han Weidong
Department of Medical Oncology, Xiasha Campus, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
Department of Medical Oncology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
J Cancer. 2018 Jul 16;9(16):2795-2801. doi: 10.7150/jca.25482. eCollection 2018.
Multiple primary malignant tumors (MPMTs) are defined as two or more histologically distinct malignancies in one individual, standard treatments for MPMTs are not well established, we aimed to clinical analyze the factors influence the treatment efficacy of MPMTs. This study retrospectively analyzed 15,321 malignant tumor patients at the Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, China, between March 2006 and June 2016. The survival analysis was performed with SPSS version 22.0 (SPSS Inc., Chicago, IL, USA) with Kaplan-Meier methodology. The prevalence of MPMTs in our study was 1.09% (167/15321), with a male to female ratio of 2.34:1. Specifically, 98 patients harbored synchronous MPMTs, and 69 patients harbored metachronous MPMTs. The most common cancer pairs were digestive-digestive tumor (43 patients, 25.75%), digestive-lung cancer (32 patients, 19.16%), and head & neck-digestive tumor (11 patients, 6.59%). Among patients with synchronous and metachronous first primary cancers, 65.86% received surgery. 33.33% (27/81) of the patients with synchronous MPMTs received simultaneous resection. Of the 69 patients with metachronous MPMTs, 31.88% (22/69) were treated with surgery alone, 62.32% (43/69) received chemotherapy and/or radiotherapy for the first primary tumor, and 44.93% (31/69) received surgery for the other primary tumor. 98.20% (164/167) of patients with MPMTs were effectively followed up, the overall 2- and 5-year survival rates were 54.3% and 31.4%, respectively, with a median survival time of 28.0 months. The early diagnosis of rare MPMTs should not be neglected in patients not only when treated for a primary malignancy but also during long-term follow-up. Effective treatment for MPMTs may yield promising curative effect and warrants further investigation.
多原发性恶性肿瘤（MPMTs）被定义为同一个体中两个或更多组织学上不同的恶性肿瘤，MPMTs的标准治疗方法尚未明确确立，我们旨在临床分析影响MPMTs治疗效果的因素。本研究回顾性分析了2006年3月至2016年6月期间在中国浙江大学医学院附属邵逸夫医院的15321例恶性肿瘤患者。使用SPSS 22.0版（美国伊利诺伊州芝加哥SPSS公司）采用Kaplan-Meier方法进行生存分析。我们研究中MPMTs的患病率为1.09%（167/15321），男女比例为2.34:1。具体而言，98例患者患有同时性MPMTs，69例患者患有异时性MPMTs。最常见的癌症组合是消化-消化肿瘤（43例，25.75%）、消化-肺癌（32例，19.16%）和头颈部-消化肿瘤（11例，6.59%）。在患有同时性和异时性第一原发性癌症的患者中，65.86%接受了手术。81例同时性MPMTs患者中有33.33%（27/81）接受了同步切除。在69例异时性MPMTs患者中，31.88%（22/69）仅接受了手术治疗，62.32%（43/69）对第一原发性肿瘤接受了化疗和/或放疗，44.93%（31/69）对另一原发性肿瘤接受了手术治疗。98.20%（164/167）的MPMTs患者得到了有效随访，总体2年和5年生存率分别为54.3%和31.4%，中位生存时间为28.0个月。对于罕见的MPMTs患者，不仅在治疗原发性恶性肿瘤时，而且在长期随访期间，都不应忽视早期诊断。MPMTs的有效治疗可能会产生有前景的疗效，值得进一步研究。
