Santos M C, Gardner B, Feldman J
Department of Surgery, Omaha V.A. Hospital, Nebraska.
J Surg Oncol. 1994 Feb;55(2):95-9. doi: 10.1002/jso.2930550207.
Records of 120 patients with two and 16 with three primary cancers were evaluated. There were 49 males and 71 females among the double primaries with ages ranging from 27-102 years (average 68 years at the time of fist cancer). Of 35 breast cancer patients 16 new primaries developed in the opposite breast and other sites including four colon, three lung, and three endometrium. Of 20 colon cancer patients second primaries occurred in 11 sites most commonly colon (four) and lung (three). The frequency of second primaries may be skewed by the fact that patients with lethal cancers did not live long enough to develop them. This is borne out by the fact that 74 of the 120 patients were alive at the time of the study, implying a highly favorable group of patients. The interval between primaries was longer in females than males (P < 0.05) and this difference disappeared when breast and endometrial cancer were eliminated. When age was evaluated as a factor younger patients appeared to have a longer interval between primaries (P = 0.24) and this became significant for breast patients under age 55 years (91 months vs. 36 months) (P < 0.05). The stage of the second breast primary bore no relationship to the interval between primaries.
对120例患有两种原发性癌症的患者以及16例患有三种原发性癌症的患者的记录进行了评估。在患有两种原发性癌症的患者中，有49名男性和71名女性，年龄范围为27至102岁（首次患癌时平均年龄为68岁）。在35例乳腺癌患者中，16例在对侧乳房及其他部位出现了新的原发性癌症，包括4例结肠癌、3例肺癌和3例子宫内膜癌。在20例结肠癌患者中，第二原发性癌症发生在11个部位，最常见的是结肠癌（4例）和肺癌（3例）。第二原发性癌症的发生率可能因致命癌症患者存活时间不足以发展出第二原发性癌症这一事实而产生偏差。这一点从研究时120例患者中有74例存活这一事实得到证实，这意味着这是一组预后非常好的患者。女性原发性癌症之间的间隔比男性更长（P < 0.05），当排除乳腺癌和子宫内膜癌时，这种差异消失。当将年龄作为一个因素进行评估时，年轻患者原发性癌症之间的间隔似乎更长（P = 0.24），对于55岁以下的乳腺癌患者而言，这种差异变得显著（91个月对36个月）（P < 0.05）。第二原发性乳腺癌的分期与原发性癌症之间的间隔无关。
