| Background:Within this century,cancer may surpass cardiovascular disease as the leading cause of premature death in most countries.With increased health awareness,development of screening methods and improved treatment options for tumors,the number of survivors of malignant tumors is also increasing.According to the report by the American Cancer Society,as of January 2019,there were more than 16.9 million malignant tumor survivors in the United States,and it is expected that by January 2030,the number of malignant tumor survivors will exceed 22.1 million.Compared to the general population,patients who survive malignant tumors are at a higher risk of developing malignant tumors again.Due to the prolonged survival of cancer patients and the dramatic increase in the aging population of our society,the number of multiple primary malignant neoplasms has been increasing in recent years.The previous reports related to multiple primary malignant neoplasms mainly focused on the head and neck tumors,the digestive system tumors,while female-characterized multiple primary malignant neoplasms were less frequently reported.In addition,the former studies were mainly related to clinical features and the prognostic studies were insufficient.Owing to the insufficient degree of awareness of female-characterized multiple primary malignant neoplasms,it is easy to cause the underdiagnosis or misdiagnosis of the secondary malignancies.Objective:The aim of this study was to analyze the clinical characteristics and prognosis of patients with female-characterized multiple primary malignant neoplasms and to further investigate the factors associated with their prognosis.Methods:The clinical data of 80 patients with female-characterized multiple primary malignant neoplasms admitted to Nanfang Hospital,Southern Medical University from January 2008 to February 2018 were collected.We statistically described their relevant clinical characteristics.Fisher exact test and chi-square test were applied to test for tumor associations.Among the 80 patients,52 patients included in the prognostic analysis group were analyzed for survival,and the Kaplan-Meier method was used to calculate the survival probability,and the Log-rank test was used to compare the differences in survival curves under different clinical characteristics,independent prognostic factors were explored by the performance of Cox proportional hazard univariate and multivariate analysis,P<0.05 was considered a statistically significant difference.Results:A total of 55,404 patients with primary malignant neoplasms were admitted to Nanfang Hospital,Southern Medical University from January 2008 to February 2018,of which 367 were multiple primary malignant neoplasms with a prevalence rate of 0.66%.During the same period,5707 patients with femalecharacterized primary malignant neoplasms were admitted,among which 80 cases were multiple primary malignant neoplasms(75 cases of double cancer and 5 cases of triple cancer),with a prevalence rate of 1.4%.The median age of the first tumor was 48 years and the median age of the second tumor was 52 years.9 patients had a family history of tumor.74 patients had a precise interval,11(14.86%)with synchronous multiple primary malignant tumors and 63(85.14%)with metachronous multiple primary malignant tumors,and 67.57%had the second primary malignancies diagnosed within 5 years.Of all primary malignancies,56.97%were the femalecharacterized malignancies,13.33%were the digestive system tumors,and 9.10%were the respiratory system tumors,and female-characterized tumors were mainly distributed in the breast(44.68%).The first tumor was female characteristic in 63 patients,the second tumor was female characteristic in 30 patients,both the first and second tumors were female characteristic in 11 patients.The overall survival rates of 52 patients with femalecharacterized multiple primary malignancies at 12,36,and 60 months were 86.4%,74.3%,and 69.8%.Clinical stage of the last tumor(stage Ⅲ-Ⅳ)(P=0.046),type of surgery(non-radical)(P=0.002)and type of tumor(female-characterized tumor)(P=0.019)were associated with poor prognosis.Conclusion:Female patients with female-characterized primary malignancies should pay attention to screening for the second tumor,especially within 4 years after the first tumor diagnosed.Furthermore,during tumor screening,it may be recommended for these patients to focus on colorectal cancer and lung cancer.Clinical stage of the last tumor(stage Ⅲ-Ⅳ),type of surgery(non-radical)and type of tumor(female-characterized tumor)are independent factors for poor prognosis. |
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