Cases Of Multiple Primary Carcinoma Research Articles

Clinical characteristics and prognosis of multiple primary colorectal carcinoma

Objective To explore the clinical characteristics and prognosis of multiple primary colorectal carcinoma. Methods The clinical data of 42 cases of colorectal cancer admitted to the First Affiliated Hospital of Nanjing Medical University between January 2013 and December 2018 were retrospectively analyzed. The clinicopathological features, diagnosis, treatment and prognosis were summarized. Results There were 42 patients with multiple primary colorectal carcinoma, accounting for 1.20% (42/3 499) of all colorectal carcinoma patients in the same period. The main pathological type was adenocarcinoma. Among them, 32 cases were synchronous multiple primary carcinoma. And the age ranged 38-86 years old, and the median age was 66 years old. A total of 73 colorectal cancer lesions were detected, mostly located in the proximal colon, sigmoid colon and rectum. A total of 527 lymph nodes were detected, and the positive rate was 1.9% (10). Patients with positive lymph nodes accounted for 37.5% (12/32), including 27 cases of multiple primary carcinoma, 3 cases of triple primary carcinoma, 2 cases of five primary carcinoma. The 1-year and 3-year overall survival rates were 83.75% and 74.38%, respectively. There were 10 cases of metachronous multiple primary carcinoma. Patients were aged 33-86 years old. The first cancer was mostly located in the rectum and sigmoid colon, and the second cancer was mostly located in the ascending colon area. A total of 276 lymph nodes were detected, and the positive rate was 12.3% (34). The 1-year and 3-year overall survival rates were 100.00% and 66.67%, respectively. Conclusions Multiple primary colorectal cancer is not rare clinically and its distribution shows a certain regularity. More attention should be paid to improve the early diagnosis rate. Early operation is needed to improve the survival rate of patients. Key words: Colorectal neoplasms; Neoplasms, multiple primary; Clinical characteristics; Prognosis

A CLINICAL STUDY OF THE LARGE INTESTINAL CARCINOMA ASSOCIATED WITH MALIGNANT TUMORS OF THE OTHER ORGANS

A recent 10 year-experience with 40 cases of multiple primary carcinoma of the large intestine and other organs was clinically studied. The 40 cases represented 4.8% of 835 cases operated on for colorectal carcinoma in the same period, including 11 synchronous, 27 heterochronous and 2 synchronous/heterochronous multiple carcinoma cases.Among carcinoma in other organs, gastric carcinoma was the most common (53.5%). Multiple carcinoma cases were more common in males and in elders, and appeared to have a family history of cancer in a higher frequency than the 835 operated cases. The clinicopathological findings of colorectal carcinomas in 32 multiple primary malignant cases with resection of colorectal carcinoma were not so characteristic compared to the 658 resectable cases without carcinoma of other organs. The cumulative 5-year survival rate of the 31 cases with resection of both colorectal carcinoma and carcinoma of other organs was significantly lower than that of 658 resectable cases described above. In order to improve the prognosis of multiple carcinomas, we have to make more effort at improving the prognosis of primary malignant tumors of other organs, especially gastric carcinoma, in synchronous cases, and at detecting early the associated colorectal carcinoma in heterochronous cases, if another carcinoma of other organ preceded.

口底と肝臓の重複癌の１症例ならびに本邦頭頚部領域重複癌の統計的観察

口底と肝臓の重複癌の１症例ならびに本邦頭頚部領域重複癌の統計的観察

Cases of Multiple Primary Carcinoma

Cases of Multiple Primary Carcinoma

Consecutive primary carcinomas of bronchus and larynx.

THE PHENOMENON OF primary carcinomas occurring simultaneously or consecutively in two or more organs is encountered not uncommonly in modern oncologic literature. However, an autopsy series of 234 multiple primary malignant neoplasms performed from 1926 to 1944 and reported by Warren and co-workers in 1932¹and 1944²contained only a single instance of primary carcinoma of bronchus and larynx in the same patient. In a series of 113 patients with multiple primary malignant neoplasms who were treated surgically at the Mayo Clinic in 1937 and reported by Stalker and co-workers,³there was not a single primary carcinoma of bronchus and larynx in the same patient. In 1955 Cahan⁴reported 19 instances of this combination of primary neoplasms among 81 cases of multiple primary carcinomas which were collected over a period of 28 yr at the Memorial Center for Cancer and Allied Diseases. A recent published report

Multiple primary carcinomas of the small intestine: a review of the literature.

(1) A survey of the available literature revealed an extremely low incidence of multiple primary carcinomata of the small intestine. (2) Six cases of multiple primary carcinoma were found in which the growths were limited to the small bowel. (3) Nine other recorded cases were found in which there were multiple carcinomata in which one growth involved the small bowel, the second growth involved other organs of the gastrointestinal tract. (4) A comment on the etiologic factors rendering the small intestinal segment unfavorable for the development of carcinoma is discussed.

Case of Multiple Primary Carcinoma Involving the Rectum and Ovary

The occurrence of primary carcinoma involving both the rectum and ovary has been found to be extremely rare. The record of only one such case has been published. This was by Rau (1) who, in 1922, reported a case in which both of these organs were the site of a primary carcinoma. The age of the patient and the types of carcinoma present were not recorded. In the case to be reported here a papillary cystic adenocarcinoma was found in a patient aged thirty-two, one year after resection of the rectum for adenocarcinoma. The incidence of multiple primary malignant tumors involving the colon and the ovary has been somewhat greater. In a very complete survey of the literature recently made by Warren and Gates (2), 6 cases were listed. The age in one was twenty-eight, and in the remainder ranged from forty to fifty-four. This age group, as in the present case, is considerably lower than the average age at which multiple primary malignant tumors usually have been found (3, 4). In the establishment of a diagnosis in the present case, the recognized criteria for multiple primary tumors were applied. The two important postulates of the three laid down by Billroth are believed to be adequately fulfilled. First, each growth showed distinct histologic differences which were sufficiently pronounced to exclude their interpretation as merely different stages of development. Second, each tumor sprang from its parent epithelium in different situations. The fulfillment of the third requirement, that each tumor must produce its own metastasis, could not be expected, in view of the clinical history of the case. The possibility that the second tumor may have been metastatic has been ruled out by the histologic differences and the fact that the ovary is not a common site for metastasis from rectal carcinoma.

Multiple Primary Carcinomas

Two or more primary carcinomas rarely occur in the same person. I have recently reviewed the literature on the subject and place on record forty-nine additional cases. This paper is divided into three sections: (1) a partial record of my survey of the literature; (2) an analysis of eighteen cases of multiple primary carcinomas occurring in 3000 consecutive post-mortem examinations at The Mayo Clinic; (3) an analysis of thirty-one cases in which a clinical diagnosis was made at The Mayo Clinic. Review of the Literature Billroth (2) reported a case in 1869 of a patient with carcinoma of the stomach and also one of the external ear. He emphasized the importance of the criteria used as a basis for diagnosis, and established three postulates which he felt were necessary for the diagnosis of multiple primary tumors: (1) each tumor must have an independent histologic appearance; (2) the tumors must arise in different situations; (3) each tumor must produce its own metastasis. Mercanton (9) added a fourth requirement, that there be no recurrence of tumors after their removal.