High incidence combination of multiple primary malignant tumors of the digestive system

Abstract

BACKGROUND Clinical reports of multiple primary malignant tumors (MPMTs) in the digestive system are increasing. In China, although the survival rate of patients with MPMTs is increasing, the quality of life is very low. Many patients have reached the advanced stage when the second primary tumor is found, resulting in no early intervention and treatment. This is due to the misunderstanding of MPMTs by clinicians, who treat such tumors as metastases. Therefore, before a patient has a second primary tumor, doctors should understand some common combinations of digestive system MPMTs to provide clinical guidance to the patient. AIM To explore the high incidence combination of digestive system MPMTs under heterochronism and synchronization. METHODS A total of 1902 patients with MPMTs at Peking Union Medical College Hospital were analyzed retrospectively. They were divided into metachronous MPMT and synchronous MPMT groups, and then the high incidence combinations of the first primary cancer and the second primary cancer in metachronous cancer and synchronous cancer were sorted. Sex and age differences between metachronous and synchronous tumors were tested by the chi square test and t test, respectively. A P value < 0.05 was considered as statistically significant, and SPSS version 26.0 (SPSS Inc., Chicago, Illinois, United States) was used for statistical analysis. RESULTS Among the 1902 patients with MPMTs confirmed by pathology, 1811 (95.2%) cases were secondary primary cancers, 89 (4.7%) cases were tertiary primary cancers, and 2 (0.1%) cases were quaternary primary cancers. Most (88.2%) of the secondary primary cancers were identified as metachronous multiple primary cancers six months after diagnosis of the first primary cancer. The top ten most common MPMTs in the first primary cancer group ranged from high to low as follows: Breast cancer, thyroid cancer, nonuterine cancer, lung cancer, colon cancer, kidney cancer, uterine cancer, bladder cancer, rectal cancer, and gastric cancer. The highest incidence rate of the first primary cancer in male metachronous cancer was lung cancer (11.6%), the highest incidence rate of the second primary cancer was still lung cancer (24.9%), the highest incidence rate of the first primary cancer in female metachronous cancer was breast cancer (32.7%), and the highest incidence rate of the second primary cancer was lung cancer (20.8%). Among them, breast cancer, nonuterine cancer and uterine cancer were female-specific malignant tumor types, and thyroid cancer also accounted for 79.6% of female patients. The top five metachronous cancer combinations, independent of female-specific malignant tumor types and thyroid cancer, were colon cancer and lung cancer (26 cases), kidney cancer and lung cancer (25 cases), rectal cancer and lung cancer (20 cases), gastric cancer and lung cancer (17 cases), and bladder cancer and lung cance...

Synchronous Double Primary Tumors of Liver (Small Cell Neuroendocrine Carcinoma and Hepatocellular carcinoma): A Case Report

“…Due to the development of screening technologies and diagnostic tools, the detection rate of MPMTs is increasing. Zhai et al found that MPMTs harbored tumors whether in the same organ or in the different organs, the incidence of digestive system malignancies was the highest, 4 and the clinical reports on MPMTS in the digestive system is increasing, 5 but the incidence of synchronous double primary liver cancers is extremely low, about 0.1% to 1%, the most common pathological type was hepatic, neuroendocrine, and biliary components, when synchronous MPMTs occurred in liver independently, they also defined as collision type. 6 The mechanism of tumorigenesis remains unclear.…”

High-grade serous papillary ovarian carcinoma combined with nonkeratinizing squamous cell carcinoma of the cervix: a case report

“…This concept was first described in 1989. ( 4 – 6 ) MPMN is rare in clinical practice, accounting for only 0.52–11.7% of all malignant neoplasms ( 7 ). Based on the time interval between the occurrence of different primary tumors, MPMN can be further classified into (1) synchronous: relatively rare cases in which the intervals between the occurrences of MPMN are < 6 months, and (2) metachronous: common cases in which the intervals between the occurrences of MPMN are ≥ 6 months, ( 8 ) accounting for approximately 90% of MPMN cases.…”

Clinical analysis of multiple primary gastrointestinal malignant tumors: A 10-year case review of a single-center

“…We adopted the criteria proposed by Warren and Gates in 1932 for the diagnosis of MPMTs: (1) Each tumor must be a pathologically proven as malignant; (2) Each tumor must be histologically distinct; and (3) the possibility of the tumor resulting from the metastasis of another must be excluded[ 1 ]. MPMTs can be sub-classified into either synchronous MPMTs (SMPMTs) and metachronous MPMTs (MMPMTs), according to their time interval, defined as the time between the date of diagnosis of the first primary cancer and the date of diagnosis of the second primary cancer.…”

“…Multiple primary malignant tumors (MPMTs) are defined as the coexistence of two or more independent primary malignancies of different histologies in a single patient, either simultaneously or consecutively. MPMT was first described by Billroth as early as 1889, with the first report published by Warren and Gates in 1932[ 1 ]. Since then, numerous cases have been reported.…”