Incidence Of Multiple Primary Cancers Research Articles

Clinical study of multiple primary and double cancers including oral squamous cell carcinoma

ObjectiveIn recent years, there has been an increase in the incidence of multiple and double cancers involving the oral cavity. In this study, we clinically reviewed patients with multiple or double cancers. Patients and methodsThe subjects were 696 patients with multiple oral squamous cell carcinomas who had visited the Department of Oral and Maxillofacial Surgery, Tokyo Dental College during the 26-year period between 1982 and 2008 and 497 patients with double cancers treated during the 16-year period from 1992, when endoscopy was started, to 2008. ResultsThe incidence of multiple primary cancers was 26 (3.7%) in 696 patients. The most common primary site of multiple cancers was the mandibular gingiva (42.3%). The maximum number of multiple cancers per patient was seven. On the other hand, the incidence of double cancers was 43 (8.7%) in 497 patients, with esophageal cancer being the most frequent (58.1%). The most common primary site of oral cancers in double cancer patients was the oral floor (32.6%). ConclusionsAbout 10% of all patients developed double cancers. Therefore, follow-up is necessary not only for recurrence and metastasis, but also for the development of a primary cancer elsewhere through strengthening endoscopy in close cooperation with the endoscopist.

Successfully treated synchronous double malignancy of the breast and esophagus: a case report

IntroductionThe incidence of multiple primary cancers is reported to be between 0.3% and 4.3%. The second primary lesion is identified either simultaneously with the primary lesion (synchronous) or after a period of time (metachronous). Few cases of metastasis of breast carcinoma to the esophagus and vice versa have been reported in the past.Case presentationWe report an extremely rare case of a 55-year-old Indian woman who had carcinomas in both the esophagus and the breast simultaneously. She was treated successfully using combined modalities of surgery, chemotherapy and radiation therapy.ConclusionCases of synchronous double malignancies can be treated by dealing with the malignancy in the two sites as independent carcinomas. We have to take into consideration the total dose of radiation to a critical organ as well as the effect of the total dose of toxic chemotherapeutic drugs on our patient.

HPV induced triple neoplasms: a case report

The incidence of multiple primary cancers has greatly increased in the last decade. We report the first case of a woman who suffered from 3 distinct HPV-induced neoplasms: cervical, vulvar, and head and neck carcinomas.

Incidence of multiple primary cancers in Nagasaki atomic bomb survivors: Association with radiation exposure

To assess the effects of atomic bomb radiation on the incidence of multiple primary cancers (MPC), we analyzed the association between the incidence of second primary cancers in survivors of the atomic bombing of Nagasaki, and exposure distance. The incidence rate (IR) of a second primary cancer was calculated and stratified by the distance from the hypocenter and age at the time of bombing for the years 1968 through 1999. The IR of the first primary cancer was also calculated and compared with the second primary cancer to determine whether atomic bomb radiation was associated with the multiplicity of tumors. There were 511 confirmed cases of MPC in the 7572 cancer-bearing survivors. The crude IR was 27.6 per 100,000 person-years. The IR of second primaries decreased significantly with increasing distance from the hypocenter: relative risk, 0.89 per 1.0 km; 95% confidence interval, 0.84-0.94. A significant decrease was also noted for those of older ages at the time of the bombing, based on the attained age of the second primary cancer: relative risk, 0.91 per 1 year; 95% confidence interval, 0.90-0.92. These findings suggest that the radiation has affected the incidence of MPC. Furthermore, when compared with the first primary cancer, a stronger distance effect was suggested on the occurrence of a second primary cancer in the survivors. The present study suggests the significance of atomic bomb radiation on MPC in the survivors. These results on the incidence of MPC in the tumor-bearing survivors and its correlations with the atomic bombing of 62 years ago are described for the first time in this report.

頭頚部多重癌の検討

Recent reports have indicated that the incidence of multiple primary cancers in patients with head and neck cancer has increased. We investigated 25 clinical characteristics of multiple primary cancers in 210 patients who received their initial treatment against their head and neck cancer at our clinic between 1995 and 2002. Clinical stages of these 210 patients were; stage I, 34 cases; stage II, 21; stage III, 29; stage IV, 108; and unknown, 18. Of these 210 patients, 25 patients with hypopharyngeal, laryngeal or mesopharyngeal carcinoma, had multiple primary cancers were diagnosed simultaneously (68%) or metachronously (32%). The multiple primary cancers were frequently observed in the thyroid gland, mesopharynx, larynx, hypopharynx, esophagus and stomach. There were no significant relationships between multiple primary cancers and smoking or drinking habits. It is important to diagnose multiple primary cancers in patients with head and neck cancers as soon as possible.

Incidence of multiple primary cancers in a cohort of women diagnosed with breast cancer in southeast England.

Among women in the Thames Cancer Registry database with a first breast cancer diagnosed between 1961–1995 observed numbers of subsequent cancers were compared with expected numbers and standardized incidence ratios were calculated. The occurrence of breast cancers subsequent to cancers at other sites was also examined. Women diagnosed with breast cancer before age 50 had significantly elevated risks for 9 cancer sites namely, oesophagus, stomach, lung, bone, connective tissue, breast, corpus uteri, ovary and myeloid leukaemia compared with 2 sites (corpus uteri and myeloid leukaemia) in women diagnosed at age 50 and above. Some of these associations are consistent with the effects of known inherited cancer susceptibility genes, shared environmental factors, or therapy. © 2001 Cancer Research Campaign http://www.bjcancer.com

Multiple Primary Cancers in Esophageal Squamous Cell Carcinoma: Incidence and Implications

Background. The occurrence of multiple primary cancers in the aerodigestive tract is a well-known phenomenon. This study aims to elucidate the incidence and the therapeutic and prognostic implications of a nonesophageal primary cancer in patients with squamous cell carcinoma of the esophagus. Methods. Between 1982 and 1996, 1,055 patients with esophageal squamous cell carcinoma treated at our institution were reviewed for the presence of an additional primary cancer. The effects of the nonesophageal cancer on treatment of the esophageal carcinoma and survival were analyzed. Results. Among 1,055 patients, 114 nonesophageal primary cancers were documented in 100 patients (9.5%), 70% of which were aerodigestive tract cancers. Forty-seven patients had antecedent tumors and 43 had synchronous tumors. Treatment strategies for esophageal carcinoma in these patients were similar to patients without multiple tumors, not influenced by the nonesophageal tumor except in 6 patients. The overall survival of patients with antecedent tumors, synchronous tumors, and without multiple tumors was similar (median survival, 8.6, 8.5, and 8.8 months, respectively) ( p = 0.84). Subsequent primary cancers developed in 10 patients (0.9%), 9 of them with previous curative resection of esophageal cancer, and all died of the subsequent cancer. Conclusions. There is a high incidence of multiple primary cancers in patients with esophageal carcinoma but the treatment and prognosis of these patients are primarily determined by the esophageal carcinoma itself. Subsequent cancer is, however, a significant cause of death among patients cured of esophageal carcinoma.

頭頚部四重癌例

The incidence of multiple primary cancers in the head and neck region has increased in recent years. While we often treat double cancers, triple or more primary cancers are rare. We report a case of metachronous quadruple primary cancer in the head and neck region of a 65-year-old man. The 1st cancer, a left tonsillar carcinoma was diagnosed in Sep.1993; the 2nd one, a tracheal carcinoma was in Jan. 1994; the 3rd, a lingual carcinoma, in Oct. 1995; and the 4th, a hypopharyngeal carcinoma, in Feb. 1997. All of the cancers were highly differentiated squamous cell carcinomas. All of tumors were resected curatively without lymph node imvolvement or distant metastasis.

口腔癌の重複癌発生に関する臨床的検討

A cohort survey of the occurrence of multiple primary cancers was carried out in patients with oral cancer (n=310) at Tokyo Metropolitan Komagome Hospital. The subjects consisted of 203 males and 107 females.The incidence of multiple primary cancers over the course of 20 years (1976 to 1996) was 18.4%(n=57).Among 57 multiple primary cancers, 44 primary oral cancers, (77.2%) occurred in the oral cavity, and the specific sites were the tongue (19), gingiva (10), buccal mucosa (7), floor of the mouth (5), soft palate (2), and lip (1).Multiple primary cancers occurred frequently in the esophagus (12), stomach (8), lung (6), hypopharynx (2) in males and in the uterus (3) in females.In esophageal cancer, the O/E ratio of male patients was significantly higher, than that in females, differing by a factor of 39.61 times.In males, primary occurrence in elderly patients was associated with a short period until the occurrence of a second cancer, The development of a second cancer reguired a longer period in younger patients than in older patients, i. e., 4.5 years for 40 years old, 3.3 years for 50 years old, 2.5 years for 60 years old, 1.9 years for 70 years old, and 1.7 years for 80 years old.

Quintuple cancers: report of a case with triple cancers in the head and neck

The incidence of multiple primary cancers is increasing. We report a case of quintuple cancers, two located in the genitourinary tract and three arising on the upper aerodigestive tract, two synchronous squamous cell carcinomas of the oral mucosa and another on the larynx. We also present a brief review of the literature.

頭頚部領域の重複癌の検討

The incidence of multiple primary cancers in patients with head and neck cancer has increased recently. Recent reports descrive the frequency of second primary cancers as being over 10% of the incidence of first primary cancers.Fifty five cases with multiple primary cancers were found among 501 cases with head and neck cancer who had been treated at the Department of Head and Neck Surgery, Kanagawa Cancer Center from 1986 to 1996. These patients were evaluated according to prognosis and therapy. The highest incidence of second primary cancers was found in hypopharyngeal cancers. Second primary cancers also developed frequently in stomach, esophagus and lung cancers. The 5-year survival rate of the patients was 24.4%. There was a significance in the survival rate according to the presence or the absence of curative treatment for first primary cancers. However, there was no significant difference between treatments for the second primary cancers, either curatively or palliatively.Therefore, it was concluded that the control of first primary cancers is the most important factor in treatment, and it is suggested that second primary cancers be treated considering a patient's prognosis, quality of life and volition according to the tumor location.

顎口腔領域における多重癌の臨床的研究

A trend toward an increased incidence of multiple primary cancers has been reported. This report is consistent with this trend and describes the results of an investigation of patients registered at our hospital. Seventy-two patients with multiple primary cancers (7.8% incidence) were identified among 927 patients with oral and maxillofacial cancers from January 1975 through December 1992.In the former period (1975 to 1983) and the latter period (1984 to 1992), multiple primary cancers accounted for 5.4% and 10.2% of all oral and maxillofacial cancers, respectively. As for tumor site, the socalled multicentric zone, which includes the oral cavity, pharynx, larynx, esophagus, and lung, accounted for 68.3%. Among 20 cases of synchronous occurrence, 9 subsequent cancers were detected in an early stage. However, among 26 cases of metachronous occurrence, 16 cases were in an advanced stage.Smoking tobacco, alcohol intake, and familial history were also investigated as risk factors for malignancy. A family history was present in 23 patients (31.9%), a smoking history in 47 patients (65.3%), and a drinking history in 37 patients (51.4%). The degrees of smoking and drinking were evaluated on the basis of Brinkman index and Sake index respectively. The mean Brinkman in the 72 patients was 486.7, and the Sake index was 56.4. The mean average of Brinkman index in the smokers was 745.5, and the Sake index was 109.7. A high Brinkman index score was related to cancers of the oral floor and, soft palate, and a high Sake index score to cancers of the soft palate and esophagus.Histologically, the incidence of squamous cell carcinoma was 65.2%, and coincident squamous cell carcinomas were found in 31 patients (43.1%).

P53 tumor suppressor oncogene expression in squamous cell carcinoma of the hypopharynx

Although abnormalities of the p53 tumor suppressor oncogene system are being detected in many human cancers, the frequency and prognostic significance of such events in squamous cell cancer of the head and neck remain unknown. Immunohistochemical studies were performed on archival tumor tissue taken from 43 patients with squamous cell carcinoma of the hypopharynx. Statistical analyses examining potential associations between p53 oncoprotein accumulation and various clinicopathologic parameters (including survival) were conducted. Sixteen (37%) tumors demonstrated strong specific staining for p53. Patients whose tumors stained strongly for p53 were significantly younger, presented at a more advanced clinical disease stage, and tended to have increased expression of epidermal growth factor receptor (P = 0.056). There was no correlation between p53 expression and the incidence of multiple primary cancers, tumor grade, DNA ploidy, or percent of S-phase. Median survival times were 11.6 months and 18.0 months for the p53-positive and p53-negative groups (NS). A Cox regression analysis confirmed the lack of significance of p53 in overall survival. These data suggest that although abnormalities of the p53 oncoprotein are common in this cancer, this finding is of little clinical significance.

Multiple genetic alterations in human carcinogenesis.

Cancer development in man appeared to be a multistage process as suggested by epidemiological studies on commonly occurring gastric, colon, and breast cancers and also on human retrovirus-related leukemia, and by the finding by physicians and surgeons of precancerous lesions for many types of neoplasias. In the last 10 years it has become evident that human cancers have multiple genetic alterations caused by point mutations, recombinations, amplifications, and/or deletions. The genes affected include both oncogenes and tumor-suppressor genes and genes that accelerate cell proliferation and metastasis. Cancers with more malignant properties and poorer prognosis are generally associated with larger numbers of genetic alterations. These multiple genetic alterations are considered to be a direct reflection of the multiple steps involved in carcinogenesis. The multiple genetic alterations are caused by multiple environmental carcinogenic substances or factors, each of which usually exists only at minute concentrations and does not exert any major impact alone except under particular occupational, iatrogenic, and locally geographic conditions. The fact that carcinogenesis is a multistep process involving multiple genetic alterations clearly needs to be taken into consideration in assessing the risks of environmental carcinogenic substances or factors. The increasing incidence of multiple primary cancers is also most easily understood from the viewpoint of multiple steps in carcinogenesis. Possible multiple approaches to cancer prevention should therefore be considered in relation to multistep carcinogenesis and multiple carcinogenic factors.

Multiple Genetic Alterations in Human Carcinogenesis

Cancer development in man appeared to be a multistage process as suggested by epidemiological studies on commonly occurring gastric, colon, and breast cancers and also on human retrovirus-related leukemia, and by the finding by physicians and surgeons of precancerous lesions for many types of neoplasias. In the last 10 years it has become evident that human cancers have multiple genetic alterations caused by point mutations, recombinations, amplifications, and/or deletions. The genes affected include both oncogenes and tumor-suppressor genes and genes that accelerate cell proliferation and metastasis. Cancers with more malignant properties and poorer prognosis are generally associated with larger numbers of genetic alterations. These multiple genetic alterations are considered to be a direct reflection of the multiple steps involved in carcinogenesis. The multiple genetic alterations are caused by multiple environmental carcinogenic substances or factors, each of which usually exists only at minute concentrations and does not exert any major impact alone except under particular occupational, iatrogenic, and locally geographic conditions. The fact that carcinogenesis is a multistep process involving multiple genetic alterations clearly needs to be taken into consideration in assessing the risks of environmental carcinogenic substances or factors. The increasing incidence of multiple primary cancers is also most easily understood from the viewpoint of multiple steps in carcinogenesis. Possible multiple approaches to cancer prevention should therefore be considered in relation to multistep carcinogenesis and multiple carcinogenic factors.

Multiple primary cancers in squamous cell cancer of the head and neck.

A retrospective review of 832 patients with squamous cell cancer of the head and neck between 1961 and 1985 was carried out to determine the incidence of multiple primary cancers (MPC) at the time of autopsy and the number who died of the second cancer. The overall risk of developing a second MPC of the head and neck, lung, or esophagus from treatment of first head and neck cancer to time of autopsy was 4.04% per year.

MULTIPLE PRIMARY CANCERS IN THE STOMACH AND OTHER ORGANS

The incidence of multiple primary cancers has been increasing year by year due to advances in diagnosis and treatment. Multiple primary cancers were most frequently present in the digestive system, especially in the stomach and other organs. During the 20 years from 1966 to 1985, 2106 patients with gastric cancers were admitted to our hospital and, of these, 53 patients 41 males and 12 females (2.5%) had cancer in other organs. Thirty-one patients had synchronous multiple primary cancers in the stomach and other organs and 21 had metachronous cancers. The majority of synchronous cancers were seen in the esophagus and the lung, these are known to have a poor prognosis. On the other hand, metachronous cancers were seen mainly in the colon, breast and uterus, they are known to have a good prognosis.

Second primary malignancy in endometrial carcinoma patients

An epidemiologic study of multiple primary malignant neoplasms in endometrial cancer patients in Israel is presented. During the 7-year period of the study, 104 patients (10.3%) out of 1007 patients diagnosed as having endometrial cancer had another primary cancer. There was a significant difference in the incidence of multiple primary cancers between various ethnic groups, women of European/American origin having higher incidence than women of Asian/African origin. A significantly higher than expected incidence of second primary cancers occurred at the following sites: breast (relative risk, 4.1), ovary (relative risk, 11.6), cervix (relative risk, 5.1), and colon (relative risk, 5.9). The prognosis was mainly influenced by the site of the second primary cancer. The increased incidence of multiple primary malignancies justifies a high level of alertness to the possibility of second primary cancer in endometrial cancer patients.

Multiple primary cancers: with reference to atomic bomb survivors in Hiroshima.

We treated 44 patients with multiple primary cancers, at the Second Department of Surgery, Hiroshima University, during the 14 year period from 1968-1981. The total number of malignant tumors was 1,934 during this period, thus the incidence of multiple primary cancers was 2.3 per cent. Nine of the 44 were atomic bomb survivors in Hiroshima and were characterized by the frequent incidence of the second tumor about 30 years after exposure to the atomic bomb. In addition, the second tumor tended to develop later in patients prescribed radiotherapy for the first tumor. As for the site of tumor, there was no tendency of more frequent development of tumors in organs highly sensitive to radiation other than the thyroid.

Multiple and multifocal carcinomas in female genital organs and breast

Sixty-seven cases of multiple primary malignant tumors of the genital organs and breast were analyzed in their different combinations. A percentage of 5.4% of multiple primary tumors was found in a cancer population of 1235. In addition, cases of multifocal primary carcinoma in symmetrical organs (breasts and ovaries) were discussed. A higher incidence of multiple primary cancers was found in embryologically related organs, such as vulva, vagina and uterine exocervix, or endometrium and ovary. Endometriosis with malignant foci was frequently found associated with the multiple primary tumors of the mullerian derived organs. Carcinoma <i>in situ</i> was found synchronously with overt multiple and multifocal carcinoma of the female genital organs and breasts and therefore considered as a previous stage of the carcinomatous progression. The area response of the embryologically related organs was discussed as a factor in the genesis of the multiple and multifocal multiple primary tumors of the female genital organs and breast.