J Korean Surg Soc.
1999 Jan;56(1):137-142.
Clinical Analysis of 65 Multiple Primary Cancer Cases
- Affiliations
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- 1Department of Surgery, Kangdong Sacred Heart Hospital, Hallym University College of Medicine.
Abstract
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BACKGROUND: Multiple primary cancer (MPC), which is defined as the multiple occurrence of malignant neoplasms in the same individual, has been reported as gradually increasing among patients treated for initial cancers. Therefore, there have been many reports about multiple primary cancers, but there is in sufficient information on the incidence or the relative risk. Furthermore, diagnostic access to the early detection of MPC has not been established. The purpose of this report is to present an overview of a clinical analysis of MPC, with attention to above aspects.
METHODS
During the 7.6 years from 1990 until August 1997, 6,346 cancer patients were registered at Kang-dong Sacred Heart Hospital, among which were 91 cases (1.43%) of MPC compatible with Warren & Gates' criteria. Among these 91 cases, 65 cases (1.02%) which received surgical treatment are analysed in this report. Medical records were reviewed retrospectively, and data were analyzed for annual incidence, sex, age, the site of the cancer, the time interval between cancers, etiology, etc.
RESULTS
The mean age was 60.1 years old. The sex ratio was 1.32:1 (male 37, female 28). Synchronous cancers were present in 28 cases and metachronous cancers in 37 cases. Among index cancers, stomach cancer was the most common (16 cases, 24.6%). In metachronous cancers, the average time duration between the discovery of the index and the additional cancer was 6.6 years. In the 28 synchronous cancers, only 10 cases (35.7%) received a curative resection, but in the 37 metachronous cancers, 18 cases (50%) received a curative resection.
CONCLUSIONS
Among the 65 MPCs, multiple primary cancers associated with stomach cancer were most common. The curability of metachronous cancer was higher than that of synchronous cancer. We may carefully infer that synchronous MPCs have a poorer prognosis than metachronous MPCs. Therefore, only knowledge of MPC and efforts for early diagnosis may increase the survival rate for MPC patients. Thus, further prospective study is needed.
