目的:收集第二原发癌为肺癌的多原发癌(lung cancer as second primary malignancy,LCSPM)患者临床特点、肿瘤部位和生存预后等临床信息进行回顾性分析,以期为指导临床实践提供一定的研究证据。方法:回顾性收集上海交通大学附属胸科医院...目的:收集第二原发癌为肺癌的多原发癌(lung cancer as second primary malignancy,LCSPM)患者临床特点、肿瘤部位和生存预后等临床信息进行回顾性分析,以期为指导临床实践提供一定的研究证据。方法:回顾性收集上海交通大学附属胸科医院2012年1月至2016年2月LCSPM患者病例,采用卡方检验和Fisher精确概率法比较分类资料,Kaplan-Meier法进行生存分析,得到影响LCSPM患者生存的因素及生存率。结果:LCSPM患者第一原发癌最多见的是乳腺癌,其次是上呼吸消化道恶性肿瘤、甲状腺癌和结直肠癌;两原发癌的中位间隔时间是72个月,53.9%的患者超过5年;LCSPM患者2年生存率为71.2%,手术和分期可影响预后。结论:对于存在肿瘤史的病人,随访同一器官的同时其他器官的情况也不容忽视。及早发现、及早治疗并争取手术机会,LCSPM患者的生存期将显著延长。展开更多
Objective: To evaluate the clinical course of patients with small cell lung cancer (SCLC) as second primary malignancy. Methods: Among the 355 patients diagnosed with SCLC at Helen and Harry Gray Cancer Center of ...Objective: To evaluate the clinical course of patients with small cell lung cancer (SCLC) as second primary malignancy. Methods: Among the 355 patients diagnosed with SCLC at Helen and Harry Gray Cancer Center of Hartford Hospital Connecticut USA between 1988 and 1998, the records of 48 patients, which had been diagnosed with other malignancies before their diagnosis of SCLC, were retro- spectively reviewed. Results: Forty-eight patients (13.5%) were diagnosed with other malignancies prior to their SCLC among which 43 had documented smoking history and 93% of them (40/43) were current/former smokers. Of the 28-second primary SCLC patients who were treated with standard method, 11 (39.3%) achieved CR. 12 (42.8%) achieved PR, and the RR was 82.1%. The median survival of the 28 treated with standard method was 11.3 months (5.1-77.7 months), while that of the rest 19 untreated patients (1 of 20 was lost to follow-up) was only 2.0 months (0.5 34.0 months). There was no significant difference in the median survival and RR between 165 treated first primary SCLC (13.5 months and 77.6% respectively) and 28 treated secondary primary SCLC (11.3 months and 82.1% respectively) (P〉0.05). The patients who had prostate cancer were older and subjected to less treatments than those with skin cancer, so their survival was shorter than the latter (3.5 months vs. 15 months, P〈0.05). Conclusion: The response and survival of the treated patients with SCLC as a second malignancy showed no difference as compared to the treated ones with SCLC only. Therefore, an active medical treatment is important to relieve symptom and prolong survival of the second primary SCLC patients.展开更多
文摘目的:收集第二原发癌为肺癌的多原发癌(lung cancer as second primary malignancy,LCSPM)患者临床特点、肿瘤部位和生存预后等临床信息进行回顾性分析,以期为指导临床实践提供一定的研究证据。方法:回顾性收集上海交通大学附属胸科医院2012年1月至2016年2月LCSPM患者病例,采用卡方检验和Fisher精确概率法比较分类资料,Kaplan-Meier法进行生存分析,得到影响LCSPM患者生存的因素及生存率。结果:LCSPM患者第一原发癌最多见的是乳腺癌,其次是上呼吸消化道恶性肿瘤、甲状腺癌和结直肠癌;两原发癌的中位间隔时间是72个月,53.9%的患者超过5年;LCSPM患者2年生存率为71.2%,手术和分期可影响预后。结论:对于存在肿瘤史的病人,随访同一器官的同时其他器官的情况也不容忽视。及早发现、及早治疗并争取手术机会,LCSPM患者的生存期将显著延长。
文摘Objective: To evaluate the clinical course of patients with small cell lung cancer (SCLC) as second primary malignancy. Methods: Among the 355 patients diagnosed with SCLC at Helen and Harry Gray Cancer Center of Hartford Hospital Connecticut USA between 1988 and 1998, the records of 48 patients, which had been diagnosed with other malignancies before their diagnosis of SCLC, were retro- spectively reviewed. Results: Forty-eight patients (13.5%) were diagnosed with other malignancies prior to their SCLC among which 43 had documented smoking history and 93% of them (40/43) were current/former smokers. Of the 28-second primary SCLC patients who were treated with standard method, 11 (39.3%) achieved CR. 12 (42.8%) achieved PR, and the RR was 82.1%. The median survival of the 28 treated with standard method was 11.3 months (5.1-77.7 months), while that of the rest 19 untreated patients (1 of 20 was lost to follow-up) was only 2.0 months (0.5 34.0 months). There was no significant difference in the median survival and RR between 165 treated first primary SCLC (13.5 months and 77.6% respectively) and 28 treated secondary primary SCLC (11.3 months and 82.1% respectively) (P〉0.05). The patients who had prostate cancer were older and subjected to less treatments than those with skin cancer, so their survival was shorter than the latter (3.5 months vs. 15 months, P〈0.05). Conclusion: The response and survival of the treated patients with SCLC as a second malignancy showed no difference as compared to the treated ones with SCLC only. Therefore, an active medical treatment is important to relieve symptom and prolong survival of the second primary SCLC patients.