Multiple Primary Malignant Neoplasms:Clinical And Prognostic Analysis Of74Cases

[Objective] To study the clinical characteristics, pathogenesis, diagnosis, pathological types, stages, treatment strategies and prognosis of the multiple primary malignant neoplasms (MPMNs).[Methods]74patients of MPMNs admitted to the Department of Medical Oncology, Sir Run Run Shaw Hospital between Jan2003and Mar2013were studied retrospectively. The relationship between clinical data and prognosis of MPMNs were analyzed by SPSS19.0.[Results]47patients were male, and27patients were female. The age of first primary malignant neoplasm onset was ranged from8to84years old, with mean of58.0years old. The age of second primary malignant neoplasm onset was ranged from16to84years old, with mean of60.9years old.24cases were synchronous MPMNs, while50cases were metachronous MPMNs. The number of Double primary malignant neoplasms, Triplicate primary malignant neoplasms and Quadruplex primary malignant neoplasm were65,8and1, respectively. There were158measurable sites in the74MPMNs patients, among which80sites in alimentary system,29sites in respiratory system,25sites in urogenital system,9sites in breast and15sites in endocrine system, hematological system, nervous system, skin tissue and peritoneal tissue. While68sites were adenocarcinoma,26sites were squamous carcinoma,7sites were invasive ductal carcinoma of the breast,6sites were gastrointestinal stromal tumors (GIST) and41sites were hepatocellular carcinoma, small cell carcinoma, lymphoma, thyroid papillary carcinoma. For the first primary malignant neoplasm,55cases received surgical treatment, and31,10,5cases respectively accepted chemotherapy, radiotherapy and endocrine therapy after the operation therapy. The resection rate was74.3%in the first primary malignant neoplasm. For the second malignant neoplasm, surgical treatment was performed in44cases, and26,8, lcases respectively accepted chemotherapy, radiotherapy and endocrine therapy after the operation therapy. The operation resection rate was60.8%in the second primary malignant neoplasm. There were two cases never received any type of therapy. As a result, the mean survival time of the first and second primary malignant neoplasm was64.3(1～371) months and23.4(1～197) months. Respectively, The1-,3-,5-year survival rates of the first primary malignant neoplasm were93.8%,79.2%,62.5%. The1-,3-,5-year survival rates of the second primary malignant neoplasm were77.6%,32.4%,18.8%.[Conclusions] The common locations of MPMNs were alimentary, respiratory and urogenital system. MPMNs are more likely to occur in same system, paired organs, or even in the same organs. Regular screening and early diagnosis are clinically important in patients with MPMNs. After diagnosis, standardized and effective treatment play a key role in patients prognosis and quality of life. In addition, MPMNs patients are subject of long-term and close follow-up in order to early discover new neoplasm, which is critical in improving survival of MPMNs patients.