Öz
Amaç: Ege Üniversitesi Hastanesi (EÜH) kanser veri tabanında birden çok sayıda kanserleri olan
Çoklu Primer Kanser (ÇPK)’li olguların sayıca artışı dikkat çekici bulunmuş, bu artışın istatistik olarak
analizi planlanmıştır.
Gereç ve Yöntem: EÜH’de EÜKAM tarafından CANREG-4 özel bilgisayar programına kayıt edilen
kanser verileri WHO ve Surveillance, Epidemiology, and End Results (SEER) sistemleri temelinde
gruplanarak analizler yapılmıştır. İstatistik analizlerde Ki-kare, General Linear Model, Kaplan Meier
sağkalım analizleri uygulanmıştır. Kaplan Meier Sağkalım analizinde Log Rank (Mantel-Cox), Breslow
(Generalized Wilcoxon) ve Tarone-Ware istatistikleri kullanılmış, istatistik analizlerde p <0,05
istatistiksel olarak anlamlı kabul edilmiştir.
Bulgular: EÜH veri tabanında 1992-2018 yılları arasında kaydedilmiş 124.321 kanser olgusunun
6.311’inde birden çok kanser (%5,1) saptanmıştır. ÇPK görülüşü erkeklerde daha belirgindir
(p<0,0001). ÇPK’de yıllara göre bir artış saptanmıştır (p<0,0001). Her iki cinste en sık görülen
Gastrointestinal sistem (GİS) kanserlerinde ÇPK genellikle yine GİS ile ilgili olmakta, bunu ürogenital
sistem (ÜGS) kanserleri izlemektedir. Akciğer kanseri ile beraber görülen ÇPK’lerin başında diğer
solunum sistemi kanserleri gelmekte, bunu mesane kanserleri izlemektedir. Meme kanserini izleyen
ÇPK’ler endometrium ve over kanseridir. ÇPK’lerde sağkalım tek primer kanserlilere göre daha kötü
ve çoklu ÇPK sayısı arttıkça sağkalımlar daha kötü olmaktadır (p<0,001). Olguların %18,2’si senkron,
%81,8’i metakron olup sağkalım açısından istatistiksel olarak aradaki fark anlamlı değildir (p=0,506).
Sonuç: EÜH Hastanesi veri tabanında %5,1 ÇPK saptanmış olup yıllara göre bir artış eğilimi vardır.
Senkron veya metakron gelişen ÇPK’lar da sağkalım farkı bulunmamıştır. Çoklu primer kanserlerde
sağkalım tekli kanserlere göre daha kötü olup ÇPK sayısı arttıkça GSK’lar daha kötü olmaktadır.
Anahtar Kelimeler
Kaynakça
- Fitzmaurice C, Allen C, Barber RM et al. Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-years for 32 Cancer Groups, 1990 to 2015: A Systematic Analysis for the Global Burden of Disease Study. JAMA Oncol 2017 Apr 1; 3 (4): 524-48.
- Bray F, Ferlay J, Soerjomataram I and et al. Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. Cancer J Clin 2018; 68 (6):394-424
- Xu LL and Gu KS. Clinical retrospective analysis of cases with multiple primary malignant neoplasms. Genetics and Molecular Research 2014; 13 (4): 9271-84
- Weir KH, Johnson CJ et al. The effect of multiple primary rules on cancer incidence rates and trends Cancer Causes Control 2016 Mar; 27 (3): 377–90
- Mao R, Chen T et al. The burdens of lung cancer involved multiple primary cancers and its occurring patterns–SEER Analysis between 1973 and 2006. Sci Rep 7, 6451 (2017). https://doi.org/10.1038/s41598- 017-06763-2
- Cybulski C, Nazarali S, Narod SA. Multiple primary cancers as a guide to heritability. Int. J. Cancer 2014; 135 (8): 1756–63
- Shibahara Y, Sugawara Y et al. Analysis of multiple primary cancer autopsy cases associated with breast cancer: 2002–2010. Pathology International 2016; 66 (12): 695–700
- Petru E, Schmähl D. Cytotoxic chemotherapy-induced second primary neoplasms: clinical aspects. Neoplasma 1991; 38 (2): 147-55
- Warschkow R, Güller U, Cerny T, et al. Secondary malignancies after rectal cancer resection with and without radiation therapy: A propensity-adjusted, population-based SEER analysis. Radiother Oncol 2017 Apr; 123 (1): 139-46
- 10. Hegemann NS, Schlesinger-Raab A et al. Risk of second cancer following radiotherapy for prostate cancer: a population-based analysis. Radiat Oncol 2017 Jan 3; 12 (1): 2
- Wynder EL, Mushinski MH, Spivak JC. Tobacco and alcohol consumption in relation to the development of multiple primary cancers. Cancer 1977 Oct; 40 (4 Suppl): 1872-8.
- 12. Corso G, Veronesi P et al. Multiple primary non-breast tumors in breast cancer survivors. J Cancer Res Clin Oncol 2018;144:979–86
- Baba Y, Yoshida N et al. Clinical and Prognostic Features of Patients With Esophageal Cancer and Multiple Primary Cancers. Ann Surg 2018; 267 (3): 478–83
- Sert F, Caner A, Haydaroglu A: Trends in the incidence and overall survival of multiple primary cancers in Turkey. J BUON 2020; 25 (2): 1230-6
Öz
Aim: To evaluate the remarkable increase in the incidence of multiple primary cancers (MPCs) in the
cancer database of Ege University Hospital (EUH).
Materials and Methods: The data recorded in CANREG from EUKAM, which is special computer
program, were grouped on the basis of WHO and SEER systems and analyzes were performed. In
statistical analysis, chi-square, General Linear Model, and Kaplan-Meier survival curves were used.
Log-Rank (Mantel-Cox), Breslow (Generalized Wilcoxon), and Tarone-Ware statistics were applied for
survival analysis. p<0.05 was accepted statistically significant.
Results: The total number of recorded cancer patients between 1992-2018 years was 124,321. The
proportion of patients with MPCs during the searched period was 5.1% (n=6,311). MPCs were
detected more common in men than in women (p<0.001).
There was an increase in the incidence of MPCs over years. MPCs were most commonly detected in
the gastrointestinal system (GIS) in both sexes. GIS cancers were seen as a secondary for GIS itself
and GIS cancers were followed by urogenital system (UGS) cancers. MPCs seen with lung cancer
were other respiratory organ cancers, as well. Bladder cancers were other commonly detected MPCs
with lung cancer. Endometrium and ovary cancers were cancers which were seen as MPCs after
breast cancer. Survival in MPCs was worse than in single primary cancers. Additionally, Overall
survival rates were getting worse accordingly to the increase in MPCs number (p<0.001). 18.2% of the
cases are synchronous, 81.7% of them are metachronous and there is no statistically significant
difference in survival (p=0.506).
Conclusion: In EUH cancer database, 5.1 % MPCs were detected and there was an increasing trend
over the years. There is no statistically significant difference in survival of synchronous and
metachronous MPCs. Survival in MPCs was worse than in single primary cancers and Overall survival
rates were getting worse accordingly to the increase in MPCs number.
Anahtar Kelimeler
Kaynakça
- Fitzmaurice C, Allen C, Barber RM et al. Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-years for 32 Cancer Groups, 1990 to 2015: A Systematic Analysis for the Global Burden of Disease Study. JAMA Oncol 2017 Apr 1; 3 (4): 524-48.
- Bray F, Ferlay J, Soerjomataram I and et al. Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. Cancer J Clin 2018; 68 (6):394-424
- Xu LL and Gu KS. Clinical retrospective analysis of cases with multiple primary malignant neoplasms. Genetics and Molecular Research 2014; 13 (4): 9271-84
- Weir KH, Johnson CJ et al. The effect of multiple primary rules on cancer incidence rates and trends Cancer Causes Control 2016 Mar; 27 (3): 377–90
- Mao R, Chen T et al. The burdens of lung cancer involved multiple primary cancers and its occurring patterns–SEER Analysis between 1973 and 2006. Sci Rep 7, 6451 (2017). https://doi.org/10.1038/s41598- 017-06763-2
- Cybulski C, Nazarali S, Narod SA. Multiple primary cancers as a guide to heritability. Int. J. Cancer 2014; 135 (8): 1756–63
- Shibahara Y, Sugawara Y et al. Analysis of multiple primary cancer autopsy cases associated with breast cancer: 2002–2010. Pathology International 2016; 66 (12): 695–700
- Petru E, Schmähl D. Cytotoxic chemotherapy-induced second primary neoplasms: clinical aspects. Neoplasma 1991; 38 (2): 147-55
- Warschkow R, Güller U, Cerny T, et al. Secondary malignancies after rectal cancer resection with and without radiation therapy: A propensity-adjusted, population-based SEER analysis. Radiother Oncol 2017 Apr; 123 (1): 139-46
- 10. Hegemann NS, Schlesinger-Raab A et al. Risk of second cancer following radiotherapy for prostate cancer: a population-based analysis. Radiat Oncol 2017 Jan 3; 12 (1): 2
- Wynder EL, Mushinski MH, Spivak JC. Tobacco and alcohol consumption in relation to the development of multiple primary cancers. Cancer 1977 Oct; 40 (4 Suppl): 1872-8.
- 12. Corso G, Veronesi P et al. Multiple primary non-breast tumors in breast cancer survivors. J Cancer Res Clin Oncol 2018;144:979–86
- Baba Y, Yoshida N et al. Clinical and Prognostic Features of Patients With Esophageal Cancer and Multiple Primary Cancers. Ann Surg 2018; 267 (3): 478–83
- Sert F, Caner A, Haydaroglu A: Trends in the incidence and overall survival of multiple primary cancers in Turkey. J BUON 2020; 25 (2): 1230-6
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 26 Ekim 2020 |
| Gönderilme Tarihi | 28 Ağustos 2020 |
| Yayımlandığı Sayı | Yıl 2020 |