老年人多原发恶性肿瘤57例分析

目的总结老年人原发恶性肿瘤的临床和病理特点。方法统计本院２４年间经病理确诊的老年人多原发恶性肿瘤５７例，从检出率、发病年龄、发病部位、间隔时间、死亡原因、肿瘤组合等方面加以分析。结果５７例中，２癌４５例，３癌１０例，４场２例；死亡４３例，尸检率８８．４％；发病（或发现）年龄６０～８０岁３７例（６４．９％）；发病部位前４位依次为：肺、结肠、前列腺、胃；发生于同一或成对器官的肿瘤１６例；同时性肿瘤１５例，异时性４２例；平均肿瘤发生间隔时间７年４个月。结论（１）尸检率较高的老年人群中，多原发恶性肿瘤发生率高；（２）肺、结肠、前列腺、胃及同一或成对器官易发生多原发恶性肿瘤；（３）尽早手术在老年人多原发恶性肿瘤中不失为良策。

An analysis of 57 cases of multiple primary malignancy in the aged

Objective To have a better understanding of the clinical and pathological features of multiple primary malignancy in the aged with respect to its occurrence, age of disease onset, predilecting sites , and time intermitting between the two malignancies. Methods The clinical and pathological data of 57 aged patients with multiple primary malignancy were studied. Forty-five patients had two, 10 had three and two had four primary malignant tumors. Results Forty-six of the 57 cases accounted for 15. 7% of the aged patients with malignancy hospitalized in the same period. The age of disease onset was between 60 and 80. The four predilecting sites were lung, colon, prostate and stomach.Sixteen patients had tumors in the same organ or paired organs. Fifteen patients had synchronous and 42 asynchronous multiple primary malignant tumors. The average time intermitting between two tumors was 7 years and 4 months. Forty three of the 57 patients died during the course of follow up and the autopsy rate was 88. 4%. Conclusions There is an increasing tendency of occurrence of multiple primary malignancy in the aged, especially in hospital with high autopsy rate. Early operation with supportive therapy is required for the aged with multiple primary malignancy if the general condition of the patient allows.