Multiple neoplasms, single primaries, and patient survival

Blogger's Note:  references data from numerous countries

open access (published 2014)

 (single blinded retrospective study) Between 2005 and 2012, of 1,873 cancer patients, 322 developed second malignancies....

 The best survival was for patients with three or more primaries (median 10.9 years)......

 Such an entity of multiple neoplasms is not rare or new, being described by Billroth as far back as 1889.¹

 It has been suggested that, in patients with familial cancer syndrome, the risk of a second primary is approximately 3% for each year of survival after the first cancer occurrence.

 Practically all types of hereditary cancers showed an excess of multiple primaries as well as an early age of onset.^{22,24,27,28,31–33,36} It has been suggested that abnormal genes or gene variants might be responsible for the clustering observed with some tumors.

 In the present study, a strong family history of cancer reflecting a close relationship between first-degree relatives was statistically more common in patients with multiple primaries, especially those with three or more primaries, and in those with metachronous primaries, highly suggestive of inherited cancer predisposition gene mutations, especially among Caucasian patients.....

 Background: Multiple primary neoplasms in surviving cancer patients are relatively common, with an increasing incidence. Their impact on survival has not been clearly defined.

 Conclusion: Patients with multiple primaries are usually of Caucasian ancestry, have less aggressive malignancies, present at earlier stages, frequently have a strong family history of similar cancer, and their cancers tend to have indolent clinical behavior with longer survival rates, possibly related to genetic predisposition.

 Table 4 Risk of developing multiple primaries in cancer patients relative to initial primary site and initial cancer staging