Qiu M, Lian Y Y, Lu M, Wang B S, Tian X J, Lu J, Liu C, Zhang S D, Jiang M, Ma L L
Department of Urology, Peking University Third Hospital, Beijing 100191, China.
The Third Clinical Medical College of Beijing University of Chinese Medicine, Beijing 100029, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2022 Aug 18;54(4):680-685. doi: 10.19723/j.issn.1671-167X.2022.04.016.
To investigate the treatment and prognosis of multiple primary malignant neoplasms (MPMN) complicated with renal cell carcinoma (RCC), and to make risk stratification.
A retrospective study of 27 cases of MPMN with RCC in two centers, including the different tumors of MPMN, specific treatment methods, and the interval between primary cancers. At the same time, the survival conditions, including recurrence, metastasis and survival, were followed up for statistical analysis. The interval between the two kinds of primary cancer within 6 months was simultaneous MPMNs, and more than 6 months was metachronous MPMNs. For simple risk stratification of cases, as long as one of the MPMNs had a stage Ⅲ or higher malignancy, which was defined as high risk.
Among the 27 patients, 20 were male and 7 were female, with age at the time of diagnosis was 42-82 years, with an average age of (61.3±11.7) years. The age at the diagnosis of renal cancer was 43-87 years, with an average age of (66.0±11.3) years. There were 21 cases with duplex primary malignant neoplasms, 4 cases with triple primary malignant neoplasms, and 2 cases with quadruple primary malignant neoplasms. The interval between first cancer and second cancer was 0-360 months, with a median of 18 months. There were 17 cases of metachronous multiple primary malignant neoplasms and 10 cases of simultaneous multiple primary malignant neoplasms. The most common system of MPMN with comorbid RCC involved urologic system, digestive system and respiratory system. The most common locations of MPMN with comorbid RCC were bladder cancer, lung cancer and colon cancer. Follow-up time calcu- lated from the last cancer was 2-156 months, with a median of 32 months. And 14 cases survived and 13 cases died, with 11 cases being tumor related. Tumor stage was the risk factor of prognosis. Any kind of tumor stage in stage Ⅲ or above had a relatively poor prognosis.
MPMN complicated with RCC is relatively rare. Standard treatment should be used for each cancer type during the treatment process. The prognosis mainly depends on the highest stage of each tumor. Simple risk stratification shows that the prognosis of the high-risk group is worse. This simple stratification method may be helpful to predict the prognosis.
探讨合并肾细胞癌（RCC）的多原发性恶性肿瘤（MPMN）的治疗及预后情况，并进行风险分层。
对两个中心的27例合并RCC的MPMN患者进行回顾性研究，内容包括MPMN的不同肿瘤类型、具体治疗方法以及原发性癌症之间的间隔时间。同时，对生存情况，包括复发、转移及生存情况进行随访并进行统计分析。两种原发性癌症间隔时间在6个月以内为同时性MPMN，超过6个月为异时性MPMN。对于病例的简单风险分层，只要其中一种MPMN的恶性程度为Ⅲ期或更高，即定义为高危。
27例患者中，男性20例，女性7例，诊断时年龄为42 - 82岁，平均年龄为（61.3±11.7）岁。肾癌诊断时年龄为43 - 87岁，平均年龄为（66.0±11.3）岁。双原发性恶性肿瘤21例，三原发性恶性肿瘤4例，四原发性恶性肿瘤2例。首例癌症与第二例癌症的间隔时间为0 - 360个月，中位数为18个月。异时性多原发性恶性肿瘤17例，同时性多原发性恶性肿瘤10例。合并RCC的MPMN最常见的系统累及泌尿系统、消化系统和呼吸系统。合并RCC的MPMN最常见的部位为膀胱癌、肺癌和结肠癌。从最后一次癌症计算的随访时间为2 - 156个月，中位数为32个月。14例存活，13例死亡，11例与肿瘤相关。肿瘤分期是预后的危险因素。Ⅲ期及以上的任何一种肿瘤分期预后相对较差。
合并RCC的MPMN相对少见。治疗过程中应对每种癌症类型采用标准治疗。预后主要取决于每种肿瘤的最高分期。简单风险分层显示高危组预后较差。这种简单的分层方法可能有助于预测预后。
