Multiple tumors.
Analysis of 25 cases.
DOI:
https://doi.org/10.35954/SM2006.28.1.7Keywords:
Metachronous cancer; Synchronous cancer; Multiple neoplasms; Solid tumors.Abstract
INTRODUCTION The description of multiple primary neoplasms dates back to the end of the 19th century. Warren and Gates established the anatomic-clinical criteria for their diagnosis. The frequency of clinical presentation is 1.5% to 5.4% of cancers and 5% to 11% in autopsies. In recent years there has been an increase in early diagnosis of second tumors, perhaps due to staging, better patient follow-up and improved survival since the diagnosis of the primary tumor.
OBJECTIVE
To evaluate the incidence of multiple malignant tumors in patients attended at the Oncology Department of the Central Hospital of the Armed Forces (H.C.FF.AA.) from January 1997 to August 2002.
PATIENTS AND METHODS
Patients registered at the H.C.FF.AA. with 2 or more histologically documented malignant tumors were included. The Tumor Registry and oncologic medical records were reviewed, describing age, sex, date of diagnosis and type of tumor. Frequency of such tumors and interval of occurrence were analyzed.
RESULTS
In the period analyzed, 1884 patients were registered and 25 multiple neoplasms were diagnosed, 1.3 %. The median age at presentation was 65 years (40 to 80) and average age was 61 years. There were 8 synchronous and 17 metachronous cases. The median interval between the first and second tumor was 11 months (0-99). Five had a third tumor. The most frequent tumors were: breast carcinoma 10, skin 9, colon 6 and kidney 5. Breast tumors were associated with endometrial 3, ovarian 2, meningioma 1, tumors with possible hormonal dependence; skin 2, kidney and colon the remaining ones.
CONCLUSIONS
Most of the patients did not present clear etiological factors of association. The percentage of multiple tumors and their occurrence over time is in accordance with what is described in the literature. Adequate staging and follow-up of cancer patients could improve the timely diagnosis and treatment of second tumors.
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