Retrospective Cohort Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 6, 2021; 9(34): 10484-10493
Published online Dec 6, 2021. doi: 10.12998/wjcc.v9.i34.10484
Clinical features and survival of patients with multiple primary malignancies
Xin-Kun Wang, Min-Hang Zhou
Xin-Kun Wang, Department of Radiology, the Fourth Medical Center, Chinese PLA General Hospital, Beijing 100048, China
Min-Hang Zhou, Department of Geriatric Oncology, the Fourth Medical Center, Chinese PLA General Hospital, Beijing 100048, China
Author contributions: Wang XK collected and analyzed the data, and drafted the work; Zhou MH performed the design of the work, the interpretation of data and revised the work; all authors read and approved the final manuscript.
Institutional review board statement: The study was approved by the institutional review board of our hospital (2020KY018-KS001).
Informed consent statement: The study was retrospective and the data were anonymous, so the requirement for informed consent was waived.
Conflict-of-interest statement: The authors declare that they have no competing interests.
Data sharing statement: The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
STROBE statement: The authors have read the STROBE statement, and the manuscript was prepared and revised according to the STROBE statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Min-Hang Zhou, MM, Attending Doctor, Department of Geriatric Oncology, the Fourth Medical Center, Chinese PLA General Hospital, No. 51 Fucheng Road, Beijing 100048, China. zhou_minhang@163.com
Received: April 8, 2021
Peer-review started: April 8, 2021
First decision: April 28, 2021
Revised: May 9, 2021
Accepted: September 14, 2021
Article in press: September 14, 2021
Published online: December 6, 2021
Processing time: 235 Days and 19.1 Hours
Abstract
BACKGROUND

Multiple primary malignancies (MPM) are characterized by two or more primary malignancies in the same patient, excluding relapse or metastasis of prior cancer. We aimed to elucidate the clinical features and survival of MPM patients.

AIM

To elucidate the clinical features and survival of MPM patients.

METHODS

A retrospective study of MPM patients was conducted in our hospital between June 2016 and June 2019. Overall survival (OS) was calculated using the Kaplan-Meier method. The log-rank test was used to compare the survival of different groups.

RESULTS

A total of 243 MPM patients were enrolled, including 222 patients with two malignancies and 21 patients with three malignancies. Of patients with two malignancies, 51 (23.0%) had synchronous MPM, and 171 (77.7%) had metachronous MPM. The most common first cancers were breast cancer (33, 14.9%) and colorectal cancer (31, 14.0%). The most common second cancers were non-small cell lung cancer (NSCLC) (66, 29.7%) and gastric cancer (24, 10.8%). There was no survival difference between synchronous and metachronous MPM patients (36.4 vs 35.3 mo, P = 0.809). Patients aged > 65 years at diagnosis of the second cancer had a shorter survival than patients ≤ 65 years (28.4 vs 36.4 mo, P = 0.038). Patients with distant metastasis had worse survival than patients without metastasis (20.4 vs 86.9 mo, P = 0.000). Following multivariate analyses, age > 65 years and distant metastasis were independent adverse prognostic factors for OS.

CONCLUSION

During follow-up of a first cancer, the occurrence of a second or more cancers should receive greater attention, especially for common concomitant MPM, to ensure early detection and treatment of the subsequent cancer.

Keywords: Multiple primary malignancies; Overall survival; Prognostic factor; Distant metastasis; Age

Core Tip: In the paper we investigated the clinical features and survival of 243 patients with multiple primary malignancies (MPM), including 222 patients with two malignancies and 21 patients with three malignancies. There was no survival difference between synchronous and metachronous MPM patients. After multivariate analyses, age > 65 years and distant metastasis were independent adverse prognostic factors for overall survival. In clinical procedure and follow-up of initial cancer, the occurrence of second or more cancer should be paid great attention to.