title: Multiple primary malignancies in elderly patients with high-grade soft tissue sarcoma.
abstract: BACKGROUND
  Several previous reports have described multiple cancers with regard to epithelial tumors, but few reports have focused on multiple primary malignancies including soft tissue sarcomas (STS).
  
  
  METHODS
  The purpose of this study was to analyze the clinical features of patients with high-grade STS with multiple malignancies and possible clinical problems, compared with those with STS as a single malignancy, focusing on elderly patients. This study enrolled 107 patients aged 65 years or over with high-grade STS.
  
  
  RESULTS
  Eighty-four patients (79 %) had sarcomas only (S group), and 23 (21 %) had multiple primary malignancies (M group). STS preceded carcinoma in 10 patients, and carcinoma preceded STS in 13. In 7 patients (30 %), the interval between the first and second malignancy was less than a year. Of 7 patients who received treatment for sarcoma and carcinoma at the same time, the presence of other malignancies had an impact on determination of the treatment modality in 5 patients. The overall survival rate at 5 years was higher in M group (79 %) than in S group (69 %), although this difference was not significant (P = 0.095).
  
  
  CONCLUSIONS
  This study demonstrates that the presence of multiple malignancies was not correlated with a poor prognosis, and was actually associated with a better prognosis in elderly patients with STS. Physicians should be aware of the possible occurrence of a second malignancy, and on occasion the treatment modalities and their logistical aspects need to be well organized and carefully selected for patients with ongoing multiple malignancies.
authors.affiliation: Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa, Nagoya, Aichi, 466-8550, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Kozawa
authors.forename: Hideshi
authors.initials: H
authors.lastname: Sugiura
authors.forename: Satoshi
authors.initials: S
authors.lastname: Tsukushi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Urakawa
authors.forename: Eisuke
authors.initials: E
authors.lastname: Arai
authors.forename: Naohisa
authors.initials: N
authors.lastname: Futamura
authors.forename: Hiroatsu
authors.initials: H
authors.lastname: Nakashima
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Yamada
authors.forename: Naoki
authors.initials: N
authors.lastname: Ishiguro
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Nishida
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D009378:Neoplasms, Multiple Primary / Q000401:mortality / Q000628:therapy*; D012983:Soft Tissue Neoplasms / Q000401:mortality / Q000628:therapy*