Gökşen İMAMOĞLU İNANÇ, Tülay EREN, Süleyman ŞAHİN, Doğan YAZILITAŞ, MUSTAFA ALTINBAŞ, RAMAZAN ESEN, Ebru ÇILBIR, FATİH KARATAŞ, ÖZGÜR ÖMER YILDIZ, Pelin GÜMÜŞ

Çoklu Primer Tümörler-Tek Merkez Deneyimi

Amaç: Onkolojik hastalıkların erken tanı ve tedavisinde yeni gelişmeler hayatta kalma oranlarının artmasına neden olsa da, artmış sağ kalım oranlarına bağlı olarak gelişen uzun takipler sırasında ikinci primer maligniteler ortaya çıkabilmektedir. İkincil primer tümörlerin gelişimi için birçok faktör vardır. En önemlisi, yaşlı hastaların uzun vadede kanserojenlere maruz kalma olasılıkları daha yüksektir. Çoklu primer tümörler, genellikle iki malignite tanısı arasındaki zaman çizelgesine bağlı olarak metakron veya senkron olarak görülür. Senkron hastalıklar sıklıkla benzer karsinojenlere maruz kalma sonucu oluşsa da, metakron olanlar daha çok primer tümörün tedavisine bağlı advers etkilerle ilişkili olabilir. Bu tek merkezli çalışma, Ocak 2007 ile Aralık 2016 arasında multipl primer tümörlü hastaların klinikopatolojik özelliklerini araştırmayı amaçladı ve bunlardan 20'si senkron, 36'sı metakron olarak toplam 56 hasta dahil edildi. En yaygın kanser çiftlerinin erkeklerde kolon-akciğer ve prostat-mesane, kadınlarda meme-kolon ve meme-tiroid olduğu tespit edilmiştirYöntemler: Ocak 2007 ile Aralık 2017 tarihleri arasında merkezimizde takip edilen ÇPT' lü hastaların dosyaları retrospektif olarak incelendi, 56 hastada multiple primer tümör olduğu tespit edildi. Hastaların cinsiyetler, yaşları tespit edildi. Tümörün hangi organlarda oluştuğu, ne zaman geliştiği, bulunabilen etyolojik veriler, sağ kalım oranları araştırıldı. Tüm istatistiksel analizler Package for Social Sciences (SPSS v 15.0, SPSS Inc., Chicago, IL, USA) ile yapıldı. Sonuç: Senkron hastalıklar genellikle benzer kanserojenlere maruz kalmanın bir sonucu olarak ortaya çıkarken, metakronöz hastalıkların primer tümörlerin tedavisinin yan etkileri ile ilişkili olması muhtemeldir.

Multiple Primary Tumors-Single Center Study

Objective: Although new advances in early diagnosis and treatments of oncologic diseases have resulted in improved survival rates, second primary malignancies may occur as a result of prolonged follow-up durations related to increased survival rates. There are many factors for the development of secondary primary tumors. Most importantly, elderly patients are more likely to be exposed to carcinogens in long term. Multiple primary tumors are usually seen as either metachronus or synchronous, depending on the timeline between the diagnosis of two malignancies. While synchronous diseases often occur as a result of exposure to the similar carcinogens, metachronous diseases are likely to be associated with adverse effects of the treatment of primary tumors. This single-center study aimed to investigate the clinicopathological features of patients with multiple primary tumors between January 2007 and December 2016, including a total of 56 patients, 20 of whom were synchronous and 36 were metachronous. The most common cancer pairs have been found to be colon-lung and prostate-bladder in men and breast-thyroid, and breast-colon in women. Method: Between January 2007 and December 2017, the files of our patients with multiple primary tumors (MPT) were reviewed retrospectively and it was determined that 56 patients had multiple primary tumors. Gender and age of the patients were determined. In which organs the tumor developed, when it developed, the etiologic findings that could be found, survival rates were investigated. All statistical analyzes were performed with Package for Social Sciences (SPSS v 15.0, SPSS Inc., Chicago, IL, USA). Result: Synchronous diseases are often seen as a consequence of exposure to similar carcinogens, while metachronous diseases are likely to be associated with side effects of treatment of primary tumors.

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Warren S, Gates O. Multiple primarymalignant tumors: A survey of the literature and a statistical study. Am J Cancer 1932;16:1358-414.
Suzuki T, Takahashi H, Yao K, et al. Multiple primary malignancies in the head and neck: a clinical review of 121 patients. Acta Otolayngol Suppl 2002;547:88-92.
Hemminki K, Boffetta P. Multiple primary cancers as clues to environmental and heritable causes of cancer and mechanisms of carcinogenesis. IARC Sci Publ 2004;157:289-97.
Carey TE. Field cancerization: are multiple primary cancers monoclonal or polyclonal? Ann Med 1996;28:183-8.
Dong C, Hemminki K. Multiple primary cancers of the colon, breast and skin (melanoma) as models for polygenic cancers. Int J Cancer 2001;92:883-7.
Miki Y, Swensen J, Shattuck-Eidens D, et al. A strong candidate for the breast and ovarian cancer susceptibility gene BRCA1. Science 1994;266:66-71.
Ries LAG, Harkins D, Krapcho M, Mariotto A, Miller BA, Feuer EJ, et al. SEER Cancer Statistics Review, 1975- 2003, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2003.
Shikhani AH, Matonoski GM, Jones MM, Kashima HK, Johns ME. Multipleprimary malignandes in head and neckcancer. Surg1986;112:1172-5. Otolaryngol Head Neck
Demandante CG, Troyer DA, Miles TP. Multipleprimary malignant neoplasms: case reportand a comprehensive review of the literature. Am J Clin Oncol 2003;26:79-83.
Hayat MJ, Howlader N, Reichman ME, Edwards BK. Cancer statistics, trends, and multiple primary cancer analyses from the Surveillance, Epidemiology, and End Results (SEER) Program. Oncologist 2007;12:20-37.
Fraumeni JF Jr.,Curtis RE, Edwards BK et al.Introduction. In: Curtis RE, Freedman DM, Ron E etal.,eds. New malignancies among cancer survivors: SEER Cancer Registries, 1973-2000. Bethesda, MD:National Cancer Institute, 2006.
Gokyer A, Kostek O, Hacioglu MB, Erdogan B, Kodaz H, Tutkmen E, et al. Clinical features of the patient with multiple primary tumors: Single center experience. North Clin İstanb 2017;10: 43-51.