目的:癌症幸存者可能会经历随后的原发癌,从而影响他们的生存和生活质量。本研究旨在调查克尔曼省多原发恶性肿瘤(MPMNs)的流行病学。2014-2020年伊朗东南部。
方法:在这项回顾性队列研究中,纳入了2014-2020年期间被诊断为原发性癌症并在Kerman癌症注册计划(KPBCR)注册的所有患者.MPMNs被定义为在不同部位出现和/或具有不同组织学或形态学起源的原发性恶性肿瘤。如果第二个恶性肿瘤在第一个肿瘤诊断的前六个月内被诊断出来,它被认为是同步的,如果六个月后它被定义为异期。采用Logistic回归分析年龄、性别,和原发性癌症部位,在整个人群中发病率和生存率均为继发性。
结果:在26,315名登记为原发癌诊断的患者中,492(1.86%)发展为随后的原发性癌症。最常见的继发性癌症类型是皮肤和粘膜(n=131,26.63%),其次是泌尿生殖道(n=115,23.37%),其次是,胃肠道(n=62,14.45%),和乳腺肿瘤(n=57,11.59%)。大多数患者患有异时性肿瘤(n=350,71.13%)。原发癌部位(皮肤和粘膜,泌尿生殖系统,和乳房)与癌症幸存者中的后续癌症发展显着相关。MPMNs病例的5年总生存率超过50%。诊断年龄(HR=1.02)和患有同步肿瘤(HR=1.41)与MPMNs患者的生存时间呈负相关。
结论:患者和医生都应该被告知在癌症幸存者中预防和提供护理和筛查服务的重要性。研究流行病学,易感性,癌症幸存者中MPMNs的风险因素将为更好地理解这一现象和政策制定打开窗口。
OBJECTIVE: Cancer survivors may experience a subsequent primary cancer that affects their survival and quality of life. This study aimed to investigate the epidemiology of multiple primary malignant neoplasms (MPMNs) in Kerman province, southeast Iran during 2014-2020.
METHODS: In this retrospective cohort study, all patients who had been diagnosed with primary cancers and registered with the Kerman Cancer Registry Program (KPBCR) during 2014-2020 were included. MPMNs were defined as primary malignant tumors arising in different sites and/or were of different histological or morphological origins. If the second malignancy was diagnosed within the first six months from the diagnosis of the first tumor it was considered synchronous, and if after six months it was defined as metachronous. Logistic regression was used to analyze the relationship between age, sex, and primary cancer site with incidence and survival of secondary in the entire population.
RESULTS: Of 26,315 patients registered with a primary cancer diagnosis, 492 (1.86%) developed subsequent primary cancers. The most common type of secondary cancer was skin and mucosa (n=131, 26.63%) followed by urogenital (n=115, 23.37%), followed by, gastrointestinal (n=62, 14.45%), and breast neoplasms (n=57, 11.59%). Most patients had metachronous tumors (n=350, 71.13%). The primary cancer site (Skin and mucosa, urogenital, and breast) was significantly associated with developing subsequent cancer among cancer survivors. The overall 5-year survival of MPMNs cases was over 50%. Older age at diagnosis (HR= 1.02) and having synchronous tumors (HR=1.41) were negatively associated with the survival time of patients with MPMNs.
CONCLUSIONS: Both patients and physicians should be taught about the importance of prevention and the provision of care and screening services among cancer survivors. Studying the epidemiology, susceptibility, and risk factors of MPMNs among cancer survivors will open windows to a better understanding of this phenomenon and policy making.