Clinical Retrospective Analysis Of 170 Cases With Multiple Primary Malignant Neoplasms

Objective : To study the etiological factors,clinical characteristics,diagnosis and treatment strategy and prognosis of multiple primary malignant neoplasms (MPMN) in order to promote its diagnosis and therapy.Methods:The clinical data of 170 patients with MPMN,admitted to oncology department of the first affiliated hospital of anhui medical university from January 2004 to April 2010 were collected and analyzed retrospectively.Median was used to analyze categorical date.Chi-square test was used to analyze the primary foci of synchronous multiple primary malignant neoplasms(SMPMN)and metachronous multiple primary malignant neoplasms (MMPMN)patients. Median survival time was calculated by life-table while survival curve was plotted using the Kaplan-Meier method. Log-rank test was used to compare and analyze the survival time of different groups.Results 170 cases were found in 7547 cases with malignant tumors,and the overall incidence of MPMN was 2.25%.There were 167 cases with duplex primary malignant neoplasms,2 cases with triple primary malignant neoplasms,1 cases with quadruple primary malignant neoplasms,46 SMPMN and 124 MMPMN patients.There were 344 malignant neoplasms in the 170 MPMN patients.Of these malignant neoplasms,161 were cases in alimentary system,48 in respiratory system ,63 in mammary gland,30 in genital system,7 in urinary system,23 in head and neck,other 12 in brain,hematological system and soft tissue. Of these 344 malignant neoplasms ,318 were from epithelial tissue,4 were from mesenchymal tissue,16 were from lymphohematopoietic system,and other 6 were from nervous tissue,germ cell and placenta trophoblast cell. There were 22 bilateral primary breast cancer and 41 digestive MPMN.With a median survival time of 24 months,1-year,3-year and 5-year cumulative survival rate in 170 patients were 68.8%,39.1% and 25.2%. There was no statistically significant for the survival rate of SMPMN and MMPMN. The survival rate of the group that occurrence interval was less than 5 years was inferior to that of more than 5 years,but there had no statistically significant. The survival rate of the group that all primary foci were resected superior to that of not all were resected .Conclusion The commom locations of MPMN were alimentary system,mammary gland and respiratory system. MPMN were usually occurred in distinct organs of identical system, conjugate organs or identical organ.The survival rate of SMPMN is similar to that of MMPMN.There were differences in principle of treatment and diagnosis between MPMN and metastasis cancer or recurrent cancer.