Clinical analysis of multiple primary carcinoma in 37 elderly patients / 中华老年医学杂志

ABSTRACT

Objective To explore the clinical characteristics of multiple primary carcinoma (MPC) in elderly patients and the effects of postoperative adjuvant chemotherapy on the prognosis and advanced cancer genesis. Methods The study population consisted of 220 elderly patients with malignant tumor. Thirty-seven elderly patients with MPC were selected in the study. The characteristics including onset age, carcinoma sites, effects of postoperative adjuvant chemotherapy, interval and survival time between first and advanced cancer were analyzed. Results of the 220 subjects,37(16.8%) patients were MPC, among whom 2 patients were synchronous multiple primary carcinomas (SMPC) and 35 patients were metachronous multiple primary carcinomas(MMPC). The median ages at onset were 70,77 and 77.5 years old for the first,second and third tumor respectively. Among a total of 82 tumor focus, the most predilection site of MPC was gastrointestinal tract, with a 34.2%(28 cases) in colorectum and a 13.4%(11 cases) in stomach. The postoperative patients were divided into two groups: 23 accepted adjuvant chemotherapy (chemotherapy group) and 14 accepted no adjuvant chemotherapy (no chemotherapy group). The survival time of chemotherapy group was significantly longer than no chemotherapy group (x2= 4.63, P = 0.0427 ). The median intervals between the first and the second cancer were 6 years and 4 years in chemotherapy group and no chemotherapy group, respectively(x2=1.63, P = 0.207), while the median intervals between the second and the third cancer were 7 years and 2 years, respectively(x2 = 4.255,P=0.043). The mediansurvival time of the third cancer postoperative patients were 3.5 years and 7 months in chemotherapy group and no chemotherapy group, respectively (x2 = 4.62, P = 0.0316 ) . ConclusionsPostoperative adjuvant chemotherapy may prolong the survival time and delay the advanced cancer genesis in elderly patients with MPC.