Clinical Retrospective Analysis Of 53 Cases Of Multiple Primary Malignant Tumor Patients

ObjectiveTo study the etiological factors,clinical characteristics,diagnosis,differentia diagnosis,treatment and prognosis of multiple primary malignant neoplasms (MPMNs) by clinical retrospective analysis,and to count and analyze genders,ages,interval time,family inherited history and correlations between different treatments and survival time,in order to promote its recognition and therapy.MethodsBased on the literature on summarizing the etiology and pathogenesis,diagnosis and treatments of MPMN,the clinical data of 53 patients with MPMNs, admitted to oncology department of Dongfang Hospital, Beijing University of Chinese Medicine from September 2013 to February 2016 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(SMPMNs)and metachronous multiple primary malignant neoplasms (MMPMNs) 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.Results53 cases were found in 5749 cases with malignant tumors,and the overall incidence of MPMN was 0.92%.There were 49 cases with duplex primary malignant neoplasms,3 cases with triple primary malignant neoplasms,1 case with quadruple primary malignant neoplasms,8 SMPMNs and 45 MMPMNs patients.There were 111 malignant neoplasms in the 53 MPMNs patients.Of these malignant neoplasms,33 were cases in alimentary system,29 in respiratory system,11 in mammary gland,6 in gynecology system,9 in urinary system,20 in head and neck,other 3 in brain,hematological system and soft tissue. There were 3 pulmonary MPMNs and 6 digestive MPMNs Of 45 MMPMNs cases.The survival time of the 53 patients ranged from 2 to 360 months. With a median survival time of 60 months,1-year,3-year and 5-year cumulative survival rate in 53 patients were 84.4%,65.5% and 49.2%. There was no statistically significant for the survival rate of SMPMNs and MMPMNs. 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 was no statistically significant.In the one-factor analysis made by The Kaplan-Meier method and Log-rank test showed there were 3 statistically significant factors,including the ages when the patients suffered the second primary malignant neoplasms,family inherited histories and chemotherapy during the first primary malignant neoplasms.In the multi-factor analysis made by The Kaplan-Meier method and Log-rank test showed first chemotherapy was the only correlative factor to the survival time(p<0.05),which is a independent risk factor in the prognosis.ConclusionAmong MPMNs,the first primary malignant neoplasm’s high-incidence age ranges from 49-61,the second primary malignant neoplasm’s high-incidence age ranges from 60-79.The gender ratio of incidence is 0.89:1,and DPMNs occurs more often than TPMNs and QPMNs. Moreover,MMPMNs occurs more often than SMPMNs.The common locations of MPMN are alimentary system, respiratory system,and head and neck.In terms of pathological pattern,solid tumors occurs more often than lymph-gland tumors.In the aspect of metastasis of MPMNs,the metastasis occurs in organs is more than that in lymph.53 MPMNs patients have unbalanced physique,and both phlegm-damp and blood stasis occur most.The first chemotherapy is a independent risk factor to the survival time in MPMNs.