多發性原發癌：彰化基督教醫院近七年病例之流行病學研究

Multiple Primary Cancers: A Seven-year Epidemiological Study in Changhua Christian Hospital

王毓芬(Yu-Fen Wang) ； 張惠媚(Julia Huei-Mei Chang) ； 張正雄(Cheng-Shyong Chang) ； 梁雅芬(Ya-Fen Liang) ； 黃凱琳(Kai-Lin Hwang) ； 詹閔如(Min-Ru Jan) ； 葉坤土(Kun-Tu Yeh)

《The Changhua Journal of Medicine》 7卷1期 (2002/01) Pp. 25-31

摘要

During the 7-year period (1993-1999) of our study, 14,607 patients with cancer were admitted to Changhua Christian Hospital. Of these, 165(1.1%) patients had multiple primary cancers (MPC). Ninety-nine (60%) patients had synchronous tumors, and 66(40%) patients had metachronous tumors. The mean age at first diagnosis was approximately equal in these two groups. The ratio of male to female was 2.1 in the synchronous group and 1.4 in the metachronous group. The common sites of MPC by organ were colorectum, liver, urinary bladder, lung, oral cavity, breast, prostate and skin, and by system were gastrointestinal tract, head and neck, genitourinary tract, female genital tract and respiratoy tract. The common sites of metachronous MPC in first cancer by organ were breast, skin, kidney and oral cavity and by system were head and neck, female genital tract, gastrointestinal tract and genital urinary tract. By organ, lung, colorectum, urinary bladder, skin and kidney were common sites of metachronous MPC in secondary cancer, while by system, the gastrointestinal tract, respiratory tract, genital urinary tract, skin and female genital tract were commonly affected. The occurrence of colorectal cancer as the secondary cancer of metachronous MPC was significantly higher in females than in males (P＜0.05). Colorectal cancer is more common in females than in males in all MPC (P＜0.05). Oral and lung cancers are more common in males than in females (P＜0.05). We hope these figures alert clinicians to the potential of MPC in cancer patients. Tissue biopsy is strongly recommended during the follow-up of cancer patients in order to determine tumor recurrence, metastasis or multiple primary cancers, and to choose the most appropriate therapy.

關鍵字

多發性原發癌 ； 同時發生 ； 異時發生

並列摘要

During the 7-year period (1993-1999) of our study, 14,607 patients with cancer were admitted to Changhua Christian Hospital. Of these, 165(1.1%) patients had multiple primary cancers (MPC). Ninety-nine (60%) patients had synchronous tumors, and 66(40%) patients had metachronous tumors. The mean age at first diagnosis was approximately equal in these two groups. The ratio of male to female was 2.1 in the synchronous group and 1.4 in the metachronous group. The common sites of MPC by organ were colorectum, liver, urinary bladder, lung, oral cavity, breast, prostate and skin, and by system were gastrointestinal tract, head and neck, genitourinary tract, female genital tract and respiratoy tract. The common sites of metachronous MPC in first cancer by organ were breast, skin, kidney and oral cavity and by system were head and neck, female genital tract, gastrointestinal tract and genital urinary tract. By organ, lung, colorectum, urinary bladder, skin and kidney were common sites of metachronous MPC in secondary cancer, while by system, the gastrointestinal tract, respiratory tract, genital urinary tract, skin and female genital tract were commonly affected. The occurrence of colorectal cancer as the secondary cancer of metachronous MPC was significantly higher in females than in males (P＜0.05). Colorectal cancer is more common in females than in males in all MPC (P＜0.05). Oral and lung cancers are more common in males than in females (P＜0.05). We hope these figures alert clinicians to the potential of MPC in cancer patients. Tissue biopsy is strongly recommended during the follow-up of cancer patients in order to determine tumor recurrence, metastasis or multiple primary cancers, and to choose the most appropriate therapy.

並列關鍵字

multiple primary cancers ； synchronous ； metachronous