老年双原发癌48例病人的长期随访结果分析

分析影响老年多原发癌病人预后的因素及再发恶性肿瘤的可能性。随访从病人首癌确诊开始 ,自 1980年 1月～2 0 0 2年 12月诊治的双原发癌共 4 8例 ,分析其影响生存的非肿瘤死亡比例、化疗放疗后再发生原发癌的间隔时间。结果随访至 2 0 0 2年 12月 ,已死亡 37例 ,其 5年生存率为 76 % ,中位生存时间 86个月 ;12例死于非肿瘤事件 ,占死亡病例的 32 4 %。双早期癌与进展期癌生存时间无显著差异 (P >0 0 5 ) ;2 4例接受放疗、化疗的病人中 12例发生第三恶性肿瘤 ,中位间隔时间 72个月。表明双原癌的早期诊断、治疗是多原发癌老年病人得以长期生存的一个重要因素 ;突发心脑血管事件、呼吸衰竭、消化道出血是老年无癌病人死亡的重要原因

AN ANALYSIS OF LIFELONG FOLLOW-UP OF DOUBLE PRIMARY CANCERS IN 48 ELDERLY PATIENTS

To explore the factors affecting the prognosis of elderly patients with meltiple primary cancers and possibility of recrudescence of malignant tumors. Forty eight cases with double cancers, admitted between January 1980 and December 2002, were reviewed retrospectively. Among them 46 were male and two female. The rate of non cancer death and the interval between recrudescence of primary carcinoma after radiotherapy and chemotherapy were analyzed. During the follow up period after diagnosis of first primary cancer, 37 patients died, 25 of them due to cancer and the other 12 due to other causes. Eleven patients were still alive and well. In 16 patients another malignancy dereloped during follow up period. Twenty forty patients who received radiotherapy/chemotherapy with median interval time of 72 months were found to have malignarcy again. Most of the third primary tumors were discovered in a yearly check up after their second primary tumors. The 5 and 10 year survival rates in patients with first primary tumor were 76% and 32 4% respectively. Five year survival rate for resection of the second carcinoma in early stage was 56%. There was no difference between the survival time of double early cancer and that of advanced cancer ( P >0 05). The results suggested that early diagnosis and treament were important factors to improve survival rate and prolong life expectancy for elderly patients with mutiple primary malignant tumors. Cardiac and cerebral vascular accidents, respiratary faliure, and gastrointestinal bleeding were common causes of death in elderly without eancer.