三原发恶性肿瘤14例临床分析

目的:分析三原发恶性肿瘤的发病、诊断、治疗及预后情况.方法:回顾性分析14例三原发恶性肿瘤的临床资料,随访患者的生存状态.结果:男性 10 例,中位发病年龄67.5岁,女性4 例,中位发病年龄72岁;合并肿瘤相关家族史2 例,既往吸烟史 5例(全部为男性),中位吸烟指数600;第三原发肿瘤距离第二原发肿瘤间隔时间,7例<7个月,其余均大于24个月,第二原发肿瘤距离第一原发肿瘤间隔时间,3例<7个月,其余均大于15个月;消化系统恶性肿瘤发病部位占全部47.6%,发病率远高于其他部位;上皮性恶性肿瘤占全部发病部位的90.5%;治疗方法中手术为主的治疗比例为61.9%,以化疗、放疗等为主的综合治疗为26.2%,0.07%的病例放弃治疗,且均发生在诊断第三原发恶性肿瘤时;14例三原发恶性肿瘤患者中位生存时间184个月.结论:综合治疗有助于提高患者的总生存时间,早期发现及采用综合治疗手段可改善三原发恶性肿瘤患者的预后.

Clinical analysis of 14 cases of three primary malignant neoplasms

Objective:To analyze the incidence, diagnosis, treatment and prognosis of three primary malignant neoplasms.Methods:The clinical data of 14 cases of three primary malignant neoplasms were retrospectively analyzed,and the survival status of the patients were followed up.Results:10 cases were males, the median age of onset was 67.5 years old, 4 cases were females, the median age of onset was 72 years.2 cases combined tumor-related family history, 5 cases combined previous smoking history (all men), the median smoking index was 600.In the interval time of third primary tumor away from second primary tumor, 7 cases were <7 months, the remaining > 24 months. In the interval time of second primary tumor away from first primary tumor, 3 cases were <7 months, the remaining≥ 15 months. The incidence of malignant tumors in the digestive system accounted for 47.6% of the total, the rate is much higher than other parts. Epithelial malignant tumors accounted for 90.5% in all pathological types. The rate of surgical treatment method was 61.9%, comprehensive treatment of radiotherapy and chemotherapy accounted for 26.2%, 0.07% cases gave up treatment, and all occurred in the diagnosis of the third malignant tumor. The median survival time was 184 months in 14 patients with three primary malignant neoplasms. Conclusion:Comprehensive treatment is helpful to improve the overall survival,early diagnosis and comprehensive treatment can improve the prognosis of patients with three primary malignant neoplasms.