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Journal of Peking University (Health Sciences) ›› 2022, Vol. 54 ›› Issue (4): 680-685. doi: 10.19723/j.issn.1671-167X.2022.04.016

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Treatment and prognosis of multiple primary malignant neoplasms complicated with renal cell carcinoma

Min QIU1,Yan-yan LIAN2,Min LU3,Bin-shuai WANG1,Xiao-jun TIAN1,Jian LU1,Cheng LIU1,*(),Shu-dong ZHANG1,Min JIANG4,Lu-lin MA1,*()   

  1. 1. Department of Urology, Peking University Third Hospital, Beijing 100191, China
    2. The Third Clinical Medical College of Beijing University of Chinese Medicine, Beijing 100029, China
    3. Department of Pathology, Peking University Third Hospital, Beijing 100191, China
    4. Department of Oncology, Dong Fang Hospital of Beijing University of Chinese Medicine, Beijing 100078, China
  • Received:2022-03-31 Online:2022-08-18 Published:2022-08-11
  • Contact: Cheng LIU,Lu-lin MA E-mail:chengliu@bjmu.edu.cn;malulin@bjmu.edu.cn

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Abstract:

Objective: To investigate the treatment and prognosis of multiple primary malignant neoplasms (MPMN) complicated with renal cell carcinoma (RCC), and to make risk stratification. Methods: A retrospective study of 27 cases of MPMN with RCC in two centers, including the different tumors of MPMN, specific treatment methods, and the interval between primary cancers. At the same time, the survival conditions, including recurrence, metastasis and survival, were followed up for statistical analysis. The interval between the two kinds of primary cancer within 6 months was simultaneous MPMNs, and more than 6 months was metachronous MPMNs. For simple risk stratification of cases, as long as one of the MPMNs had a stage Ⅲ or higher malignancy, which was defined as high risk. Results: Among the 27 patients, 20 were male and 7 were female, with age at the time of diagnosis was 42-82 years, with an average age of (61.3±11.7) years. The age at the diagnosis of renal cancer was 43-87 years, with an average age of (66.0±11.3) years. There were 21 cases with duplex primary malignant neoplasms, 4 cases with triple primary malignant neoplasms, and 2 cases with quadruple primary malignant neoplasms. The interval between first cancer and second cancer was 0-360 months, with a median of 18 months. There were 17 cases of metachronous multiple primary malignant neoplasms and 10 cases of simultaneous multiple primary malignant neoplasms. The most common system of MPMN with comorbid RCC involved urologic system, digestive system and respiratory system. The most common locations of MPMN with comorbid RCC were bladder cancer, lung cancer and colon cancer. Follow-up time calcu- lated from the last cancer was 2-156 months, with a median of 32 months. And 14 cases survived and 13 cases died, with 11 cases being tumor related. Tumor stage was the risk factor of prognosis. Any kind of tumor stage in stage Ⅲ or above had a relatively poor prognosis. Conclusion: MPMN complicated with RCC is relatively rare. Standard treatment should be used for each cancer type during the treatment process. The prognosis mainly depends on the highest stage of each tumor. Simple risk stratification shows that the prognosis of the high-risk group is worse. This simple stratification method may be helpful to predict the prognosis.

Key words: Neoplasms, multiple primary, Neoplasms, second primary, Carcinoma, renal cell, Prognosis

CLC Number: 

  • R737.11

Table 1

Clinical data of the patients with MPMN"

No. Gender Age/years FPC/Stage IT/months SPC/Stage IT/months TPC/Stage IT/months FOPC/Stage Follow up time/months Outcome
1 F 49 THCA/Ⅰ 110 RCC/Ⅰ 113 Survival
2 M 59 COAD/Ⅱ 2 RCC/Ⅰ 4 Survival
3 F 64 STAD/Ⅲ 1 RCC/Ⅰ 62 Survival
4 M 60 READ/Ⅳ 6 RCC/Ⅰ 22 Death
5 M 79 RCC/Ⅲ 45 NONB/Ⅰ 60 Survival
6 M 56 LUAD/Ⅱ 5 RCC/Ⅰ 48 Survival
7 M 66 RCC/Ⅰ 7 BCC/Ⅰ 28 Survival
8 M 87 BLCA 264 RCC/Ⅰ 420 Death
9 M 77 BLCA 360 RCC/Ⅰ 408 Death
10 M 72 RCC/Ⅰ 73 COAD/Ⅰ 111 Survival
11 M 42 NPC/Ⅳ 26 RCC/Ⅰ 34 Death
12 M 46 BLCA/Ⅰ 18 RCC/Ⅰ 92 Survival
13 M 64 RCC/Ⅰ 0 BLCA/Ⅰ 52 Survival
14 M 82 BLCA/Ⅰ 0 RCC/Ⅰ 48 Survival
15 M 66 BLCA/Ⅰ 21 RCC/Ⅰ 12 COAD/Ⅰ 70 Survival
16 M 57 NHL/Ⅱ 3 RCC/Ⅰ 3 PC/Ⅱ 84 Survival
17 F 70 BC/Ⅱ 24 LUAD/Ⅰ 12 RCC/Ⅰ 16 NHL/Ⅰ 75 Survival
18 M 77 LE 276 BLCA/Ⅰ 93 RCC/Ⅰ 2 EC/Ⅲ 432 Death
19 M 43 LUAD/Ⅳ 0 RCC/Ⅱ 11 Death
20 M 70 STAD/Ⅱ 1 RCC/Ⅱ 134 Death
21 M 82 LUAD/Ⅲ 0 RCC/Ⅱ 25 Death
22 M 61 COAD/Ⅳ 4 RCC/Ⅱ 31 Death
23 M 66 RCC/Ⅲ 98 LUAD/Ⅲ 122 Death
24 F 61 RCC/Ⅱ 235 LUAD/Ⅳ 237 Death
25 F 61 RCC/Ⅱ 44 HL/Ⅳ 89 Survival
26 F 45 BC/Ⅱ 348 STAD/Ⅳ 1 RCC/Ⅱ 360 Death
27 F 75 RCC/Ⅱ 12 UC/Ⅲ 0 BLCA/Ⅳ 44 Death

Figure 1

Survival curve of different risk stratification Group 1 for low-risk group, and Group 2 for high-risk group. The estimated median survival time is 133 months in low-risk group and 25 months in high-risk group."

Figure 2

Survival curve of different centers The estimated median survival time was 156 months in center 1 and 25 months in center 2."

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