[Clinical features and prognosis of multiple primary tumors of lung combined with other organs--report of 281 cases].
OBJECTIVE
Along with the progress of tumor diagnosis, the detection of multiple primary tumors (MPT) of the lung combined with other organs is increasing, but their clinical features and prognosis are unclear yet. This study was to investigate clinical features and prognosis of MPT of the lung combined with other organs.


METHODS
Of the 281 patients with MPT of the lung combined with other organs, treated in our hospital from Jan. 1990 to Dec. 2000, 115 had lung cancer diagnosed first (Group A), 116 had other cancers diagnosed first (Group B). Clinical features and prognosis of the patients were analyzed.


RESULTS
There was no significant difference in sex distribution between the 2 groups (P=0.51). At the diagnosis of the first cancer of MPT, the median age of the patients was significantly older in Group A than in Group B (62.5 years vs. 54.5 years, P=0.02), while at the diagnosis of the second cancer, it showed no significant difference between the 2 groups (64.5 years vs. 63.5 years, P=0.08). The interval between first and second primary tumors was significantly shorter in Group A than in Group B (36.0 months vs. 49.0 months, P<0.001). The proportion of stage I-II lung cancer was significantly higher in Group A than in Group B (83.9% vs. 63.7%, P<0.01). Since the diagnosis of first primary cancer, the medium survival time was shorter in Group A than in Group B (69.0 months vs. 87.5 months), and the 5-year survival rate was significantly lower in Group A than in Group B (59.0% vs. 70.0%, P<0.001). Since the diagnosis of second primary cancer, no significant difference in medium survival time and 5-year survival rate was observed between the two groups (25.0 months vs. 28.0 months, 10.5% vs. 13.5%, P=0.92). Second primary cancers occurred in the lung, upper respiratory tract, breast, esophagus, colon, rectum, stomach, and cervix. Smoking was a significant risk factor in the development of MPT of the lung combined with upper respiratory tract.


CONCLUSIONS
Lung cancer is closely correlated to upper respiratory tract tumors among MPTs of the lung combined with other organs, and smoking is a potential risk factor. Compared with the patients who had lung cancer diagnosed first, the patients who had other cancers diagnosed first are younger at the first diagnosis, and have longer interval between first and second primary tumors, with better prognosis.
Yi
Sheng-Zhong
SZ
Department of Thoracic Surgery, Cancer Institute/Cancer Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, 100021, P. R. China.
Zhang
De-Chao
DC
Wang
Yong-Gang
YG
Sun
Ke-Lin
KL
D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D004938:Esophageal Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D012142:Respiratory Tract Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D055752:Small Cell Lung Carcinoma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D012907:Smoking / Q000009:adverse effects*; D015996:Survival Rate