Evaluation of multiple primary tumors and single tumors charecteristics: A study from hospital-based cancer registry in İzmir

Abstract

OBJECTIVES To evaluate patients with multiple primary tumors (MPTs) from the data of Izmir Cancer Registry (ICR) in Izmir Atatürk Research and Training Hospital (IAEAH) and to compare them with single tumor (ST). METHODS 572 multiple primary tumors ( MPTs) (286 patients) out of 2 0.895 tumors recorded during the period of 1993-2005 by office of ICR located in IAEAH were analyzed. Double tumors (DTs) were analyzed. Chi-square test and Independent Samples t-test were performed by SPSS 10.0. RESULTS Of patients with MPTs 53.2% had synchronous whereas 43.1% had metachronous. The mean age were 55.81±15.4 years for ST group; 61.49±13.32 for DT group (p

Keywords

• Neoplasms, Unknown Primary,İzmir,Database,Registries,Chi-Square Distribution,Records as Topic

Çok primerli ve tek primerli kanser olguları: İzmir kanser kayıt merkezi verilerinden hastane tabanlı bir inceleme

Öz

AMAÇ Çalışmamızda İzmir Kanser İzlem Denetleme Merkezi'nin (KİDEM) İzmir Atatürk Eğitim ve Araştırma Hastanesi'ndeki (İAEAH) veri tabanınında ilk kez çoklu tümörler incelendi, tekli tümörlerle karşılaştırıldı. GEREÇ VE YÖNTEM Ekim-1993 ve Ekim-2005 arası 20.895 tümör İAEAH'de KİDEM'de kaydedildi. Çok primerli tümör 605'ti (297 hasta). Yalnızca çift primer tümörlü (ÇPT) hastalar incelendi. İstatistiksel analizlerde Chi-square test, Independent Samples t-test kullanıldı. Analizler %95'lik güven aralığında yapıldı; p < 0.05 değeri istatistiksel anlamlı kabul edildi. BULGULAR Senkron ÇPT %53.2; metakron ÇPT %43.1 idi. ÇPT’lerde kadın oranı tek primer tümörlü (TPT) olgulardan yüksekti (p < 0.008). Yaş ortalaması TPT’lerde 55.81±15.4; ÇPT’lerde 61.49±13.32 idi (p < 0.001). Ürogenital (%30.9) ve deri tümörleri (%17.1) ÇPT’de anlamlı olarak daha yüksekti. İki grupta en sık adenokarsinom gözlendi. ÇPT’lerde iki tümör arası süre (metakronlarda) 44.4±30.82 (38.99-49.77) aydı. SONUÇ ÇPT’lerde ürogenital ve cilt tümörlerinin sıklığı “alan kanserleşmesi”, ortak klonal köken, tarama-izlem, uzayan sağkalım konusunda ipuçları taşımaktadır. Uluslararası kayıt sistemini kullanan değişik toplumlarda insidans, ayrıca nedensel çalışmaların artışıyla aydınlatılma ihtiyacındadır.

Anahtar Kelimeler

• Tümör, çoklu primer, tekli primer, kanser kayıt

Kaynakça

1. 1. J e m a l A, Wa r d E M, Thun MJ. Epidemiology of ca ncer; cancer statistics. In: DeVita VT, Hellman S, R o s e n b e rg SA, editors. Cancer: principles and pr a c t i c e of on c o l o g y. 7th ed. CD-Room. Lippincott Wi l l i a m s & Wilkins. 530 Walnut Street Philadelphia PA 19106 USA LW W.com. 2005. Chapter 11; Section 2.
2. 2. Fidaner C, Eser SY, Parkin DM. Incidence in Izmir in 1993-1994: first results from Izmir Cancer Registry. Eur J Cancer 2001;37(1):83-92.
3. 3. ‹zmir Kanser izlem ve denetim merkezi: http://www.ism.gov.tr/kidem.
4. 4. Tachimori Y. Cancer screening in patients with cancer. Jpn J Clin Oncol 2002;32(4):118-9.
5. 5. Artac M, Bozcuk H, Ozdogan M, Demiral AN, Sarper A, Samur M, et al. Different clinical features of primary and secondary tumors in patients with multiple malignancies. Tumori 2005;91(4):317-20.
6. 6. Demandante CG, Troyer DA, Miles TP. Multiple primary malignant neoplasms: case report and a comprehensive review of the literature. Am J Clin Oncol 2003;26(1):79-83.
7. 7. Crocetti E, Arniani S, Buiatti E. Synchronous and metachronous diagnosis of multiple primary cancers. Tumori 1998;84(1):9-13.
8. 8. 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.

9. 9. Carey TE. Field cancerization: are multiple primary cancers monoclonal or polyclonal? Ann Med 1996;28(3):183-8.
10. 10. Dong C, Hemminki K. Multiple primary cancers of the colon, breast and skin (melanoma) as models for polygenic cancers. Int J Cancer 2001;92(6):883-7.
11. 11. Miki Y, Swensen J, Shattuck-Eidens D, Futreal PA, Harshman K, Tavtigian S, et al. A strong candidate for the breast and ovarian cancer susceptibility gene BRCA1. Science 1994;266(5182):66-71.
12. 12.Bedi GC, Westra WH, Gabrielson E, Koch W, Sidransky D. Multiple head and neck tumors: evidence for a common clonal origin. Cancer Res 1996;56(11):2484-7.
13. 13. Kagei K, Hosokawa M, Shirato H, Kusumi T, Shimizu Y, Watanabe A, et al. Efficacy of intense screening and treatment for synchronous second primary cancers in patients with esophageal cancer. Jpn J Clin Oncol 2002;32(4):120-7.
14. 14. van Westreenen HL, Westerterp M, Jager PL, van Dullemen HM, Sloof GW, Comans EF, et al. Synchronous primary neoplasms detected on 18FFDG PET in staging of patients with esophageal cancer. J Nucl Med 2005;46(8):1321-5.
15. 15. Koutsopoulos AV, Dambaki KI, Datseris G, Giannikaki E, Froudarakis M, Stathopoulos E. A novel combination of multiple primary carcinomas: urinary bladder transitional cell carcinoma, prostate adenocarcinoma and small cell lung carcinoma-report of a case and review of the literature. World J Surg Oncol 2005;3:51.
16. 16. Palou J, Rodríguez-Rubio F, Huguet J, Segarra J, Ribal MJ, Alcaraz A, et al. Multivariate analysis of clinical parameters of synchronous primary superficial bladder cancer and upper urinary tract tumor. J Urol 2005;174(3):859-61.
17. 17. Tanaka H, Tsukuma H, Koyama H, Kinoshita Y, Kinoshita N, Oshima A. Second primary cancers following breast cancer in the Japanese female population. Jpn J Cancer Res 2001;92(1):1-8.
18. 18.International rules for multiple primary cancers (ICDO Third Edition), Internal Report No. 2004/ 02. IARC, Lyon (France), 2004.
19. 19. Fritz A, Percy C, Jack A, Sobin L, Parkin M, Whelan S, editors. International Classification of Diseases for Oncology (ICD-O-3). Geneva (Switzerland); WHO; 2000.
20. 20. Aydiner A, Karadeniz A, Uygun K, Tas S, Tas F, Disci R, et al. Multiple primary neoplasms at a single institution: differences between synchronous and metachronous neoplasms. Am J Clin Oncol 2000;23(4):364-70.
21. 21. Engin K. Cancers in multiple primary sites. Int Surg 1994;79(1):33-7.
22. 22. Dong C, Hemminki K. Second primary neoplasms in 633,964 cancer patients in Sweden, 1958-1996. Int J Cancer 2001;93(2):155-61.
23. 23. Kaneko S, Yamaguchi N. Epidemiological analysis of site relationships of synchronous and metachronous multiple primary cancers in the National Cancer Center, Japan, 1962-1996. Jpn J Clin Oncol. 1996; 29:96-105. \ 23. Kaneko S, Yamaguchi N. Epidemiological analysis of site relationships of synchronous and metachronous multiple primary cancers in the National Cancer C e n t e r, Japan, 1962-1996. Jpn J Clin Oncol 1999;29(2):96-105.
24. 24.Crocetti E, Buiatti E, Falini P; Italian Multiple Primary Cancer Working Group. Multiple primary cancer incidence in Italy. Eur J Cancer 2001;37(18):2449-56.
25. 25. Flannery JT, Boice JD, Devesa SS, Kleinerman RA, Curtis RE, Fraumeni JF. Cancer registration in Connecticut and the study of multiple primary cancers, 1935-82. Natl Cancer Inst Monogr 1985;68:13-24.
26. 26. Evans HS, Lewis CM, Robinson D, Bell CM, Møller H, Hodgson SV. Incidence of multiple primary cancers in a cohort of women diagnosed with breast cancer in southeast England. Br J Cancer 2001;84(3):435-40.
27. 27. Schoenberg BS, Myers MH. Statistical methods for studying multiple primary malignant neoplasms. Cancer 1977;40(4 Suppl):1892-8.
28. 28. Merrill RM, Capocaccia R, Feuer EJ, Mariotto A. Cancer prevalence estimates based on tumour registry data in the Surveillance, Epidemiology, and End Results (SEER) Program. Int J Epidemiol 2000;29(2):197-207.
29. 29. Ueno M, Muto T, Oya M, Ota H, Azekura K, Yamaguchi T. Multiple primary cancer: an experience at the Cancer Institute Hospital with special reference to colorectal cancer. Int J Clin Oncol 2003;8(3):162-7.
30. 30. Balducci L, Beghe’ C. Specific interactions of cancer and aging include: Increased incidence of cancer with the age: This association may be reported to three factors: duration of carcinogenesis; increased susceptibility of older tissues to late stage carcinogens, and systemic effects of aging, including immune-senescence and enhanced cytokine production Cancer and age in the USA. Crit Rev Oncol Hematol 2001;37(2):137-45.
31. 31.Buiatti E, Crocetti E, Gafà L, Falcini F, Amorosi A, Milandri C, et al. Agreement estimate among three Italian cancer registries in the coding of multiple primary cancers. Tumori 1996;82(6):533-8.
32. 32.Crocetti E, Lecker S, Buiatti E, Storm HH. Problems related to the coding of multiple primary cancers. Eur J Cancer 1996;32A(8):1366-70.
33. 33. Giles GG, Thursfield V. Cancer statistics: everything you wanted to know about the cancer registry data but were too afraid to ask. ANZ J Surg 2004;74(11 ) : 9 3 1 - 4 .