Multiple primary malignancies involving lung cancer.

Feng Li,Yi-Long Wu,Ning Zhao,Hong-Hong Yan,Jin-Ji Yang,Wen-Zhao Zhong,Fei-Yu Niu

doi:10.1186/s12885-015-1733-8

Abstract

BackgroundThe incidence of multiple primary malignancies (MPM) has increased sharply in recent decades. However, the clinical characteristics and prognosis of MPM patients involving lung cancer were not fully elucidated. This retrospective study was designed to explore the clinical characteristics and prognosis of MPM patients involving lung cancer in the People’s Republic of China.MethodsOf 5405 lung cancer cases diagnosed at the Guangdong Lung Cancer Institute between 2005 and 2013, we analyzed 185 patients (3.4 %) with MPM involving lung cancer.ResultsAmong 185 patients with MPM involving lung cancer, 10 (5.4 %)had three malignancies and 175 (94.6 %) had two malignancies. 10 patients with three malignancies were excluded from the analysis to avoid misunderstanding. Of 175 accompanying malignancies, 64 (36.6 %) were synchronous MPM patients and 111 (63.4 %) were metachronous MPM patients; 49 (28.0 %) were lung cancer first MPM patients and 126 (72.0 %) were other cancer first MPM patients. The most frequent accompanying malignancy was colon cancer (25/175), followed by rectal cancer (18/175), esophageal cancer (17/175), and thyroid cancer (13/175). Metachronous MPM patients showed significantly better overall survival (OS) than synchronous MPM, with a median OS of 72.8 (range 12.2–391.0) and 12.9 (range 0.8–86.3)months, respectively (P < 0.001). Cox regression analysis revealed that time of occurrence and stage were independent factors for OS.ConclusionsColorectal cancer, esophageal cancer, and thyroid cancer were the tumors that most frequently accompanying lung cancer. Metachronous MPM patients showed significantly better OS compared with synchronous MPM patients.

Highlights

The incidence of multiple primary malignancies (MPM) has increased sharply in recent decades
This study retrospectively focused on the incidence, clinical features, and prognosis of MPM patients involving lung cancer at the Guangdong Lung Cancer Institute (GLCI)
In lung cancer first (LCF) MPM, lung cancer occurred before the secondary primary malignancy, while in other cancer first (OCF) MPM, the other primary malignancy occurred before lung cancer

Summary

Introduction

The incidence of multiple primary malignancies (MPM) has increased sharply in recent decades. The clinical characteristics and prognosis of MPM patients involving lung cancer were not fully elucidated. Multiple primary malignancies (MPM) are defined by the presence of two or more independent primary malignancies in the same or different organs in an individual patient [1]. One of the earliest systematic studies of MPM was performed by Warren and Gates in 1932 [2]. Based on an analysis of several studies, the incidence of MPM was estimated at 0.73–5.2 % in all tumor patients. This wide variation is related to the diverse experiences of doctors and different diagnostic tools used at different.

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Discussion

Conclusion