Multiple Primary Cancers in Female Cancer Patients

女性癌症患者之複癌

林惠美(Whei-Mei Lin) ； 黃麗秋(Lie-Chiou Huang) ； 黃思誠(Su-Cheng Huang) ； 周松男(Song-Nan Chow)

《中華民國公共衛生學會雜誌》 10卷3&4期 (1990/12) Pp. 165-174

https://doi.org/10.6288/JNPHARC1991-10-0304-06

摘要

據台大醫院癌症登記資料顯示：1976年7月至1989年12月，13743個女性癌症個案中，有318個個案為複癌（占2.3%）。其中，有14個個案，其原發部位為3個或3個以上。
十大常見女性複癌，其第一原發部位，依次為子宮頸、乳房、結腸、鼻咽、腎臟、膀胱、直腸、甲狀腺、肺及胃。若以比例來看，則好發複癌之第一原發部位，依次為腎臟(7.5%)、膀胱(6.7%)、陰道及女陰(5.2%)、口腔(4.4%)、結腸(4.1%)、乳房(3.9%)、子宮體(3.3%)喉(2.8%)及子宮頸(2.7%)。
第一原發部位為子宮頸者，其常見之第二原發部位依次為肺、乳房、膀胱、鼻咽、結腸、直腸及骨髓與網狀內皮系統。子宮體癌和卵巢癌常同時出現。而第一原發為陰道及女陰者，常見其第二原發部位發生在子宮頸。
乳房癌常發展出對側乳房、子宮頸、皮膚、肺、結腸、食道及腎臟等第二原發部位。
結腸癌，其第二原發部位，多見於腸胃道（如結腸、直腸、胃及肝），乳房及泌尿生殖器官（如子宮頸、子宮體及膀胱）。
鼻咽癌、其第二原發部位，多發於口鼻部（舌、口腔、鼻腔），腸胃道（結腸、胃、肝）、乳房、子宮頸及皮膚。
腎臟及膀胱癌，常於泌尿生殖系統（腎臟、膀胱、子宮頸及子宮體），發現第二原發癌。
兩個原發癌發生期間之範圍為0至386個月，其中位數為31個月。
第一原發部位接受放射治療或化學治療或兩者都有的比例為54.6%(131/240)。以目前的研究，只能看出放射治療與發生第二原發癌的相關。至於化學治療或兩者組合治療，則與第二原發癌的發生沒有相關。
兩個原發癌發生期間若小於兩個月或超過五年，其五年存活率較好（52.8%及47.8%）。若發生期間在兩個月與五年之間，則其存活率較低(33.6%)。

並列摘要

During the period July 1976 to December 1989, there were 318 multiple primary cancers among 13,743 female cancer patients (2.3%) seen at this hospital. Fourteen of 318 patients had 3 or more than 3 primary cancers.
The ten most frequent female multiple cancers are those arising from cervix uteri, breast, colon, nasopharynx, kidney, bladder, rectum, thyroid, lung and stomach. The primary cancers most likely to develop a second primary cancer are kidney (7.5%), bladder (6.7%), vagina and vulva (5.2%), oral cavity (4.4%), colon (4.1%), breast (3.9%), corpus uteri (3.3%), larynx (2.8%) and cervix uteri (2.7%).
Cervical cancer is frequently followed by a second cancer arising from lung, breast, urinary bladder, nasopharynx, colon, rectum, bone marrow and the reticuloendothelial (B.M. & R-E) systems (in the order of decreasing frequency). Corpus cancer usually co-exists with an ovarian cancer. Vaginal and vulvar cancers are also followed by a second cancer arising from the cervix.
Breast cancer is frequently followed by a second cancer arising from the contralateral breast, cervix uteri, skin, lung, colon, esophagus or kidney.
Colon cancer is frequently followed by a second cancer arising from the gastrointestinal tract (different sites of the colon, rectum, stomach, liver), breast and urogenital organs (cervix uteri, corpus uteri, and. bladder).
Nasopharyngeal cancer is frequently followed by a second cancer arising from oral and nasal cavities (tongue, palate, oropharynx, nasal cavity) and gastrointestinal tract (colon, stomach, liver), breast, cervix uteri and skin.
Kidney or bladder cancer is frequently followed by a second cancer arising from urogenital organs (kidney, bladder, cervix uteri and corpus uteri).
Duration between the occurrence of the first primary and the second primary cancers ranged from 0 to 386 months with a median duration of 31 months.
The percentage of patients given radiotherapy and/or chemotherapy for the first cancer was 54.6% (131/240). In the present study, only the association of radiotherapy was observed; the carcinogenic effect of chemotherapy or a combination of radiotherapy and chemotherapy can not be demonstrated.
If the duration between the occurrence of the first and second cancer was less than two months or more than five years, the five-year survival rate is better (52.8% or 47.8%, respectively); but if the duration was above two months and less than five years, the five year survival rate is lower (33.6%).

並列關鍵字

multiple primary cancers ； female cancer patients