Multiple primary tumours: challenges and approaches, a review

Abstract

When in a patient more than one tumour in the same or a different organ is diagnosed, multiple primary tumours may be present. For epidemiological studies, different definitions of multiple primaries are used with the two main definitions coming from the project Surveillance Epidemiology and End Results and the International Association of Cancer Registries and International Agency for Research on Cancer. The differences in the two definitions have to be taken into consideration when reports on multiple primaries are analysed. In this review, the literature on multiple primaries is reviewed and summarised. Overall, the frequency of multiple primaries is reported in the range of 2–17%.Aetiological factors that may predispose patients to multiple primaries can be grouped into host related, lifestyle factors and environmental influences. Some of the most common cancer predisposition syndromes based on a clinical presentation are discussed and the relevant genetic evaluation and testing are characterised.Importantly, from a clinical standpoint, clinical situations when multiple primaries should be suspected and ruled out in a patient are discussed.Furthermore, general principles and possible treatment strategies for patients with synchronous and metachronous multiple primary tumours are highlighted.

Multiple Primary Malignancies in Renal Transplant Recipients: a Single Centre Retrospective Cohort Study

“…The incidence of MPM has increased significantly due to improvements in diagnostic methods and with the discovery of new treatments, which allows for more patients to survive long enough to develop additional primary tumors [6]. Attributing factors involve improved screening, advances in diagnostic testing, more sophisticated anticancer treatment regimens, an improved overall surveillance of patients with cancer and better nutritional support.…”

Prolonged survival with maintenance pemetrexed for a multiple primary malignancy

“…In general, developing more than one synchronous or metachronous cancer in the same person is regarded as MPMs 1. The distinguishing period for the diagnosis of synchronous or metachronous tumours also varies between the SEER guideline (2-month period)3 and the IACR guideline (6-month period) 4.…”

“…With innovations in modern diagnostic tests and advancements in screening procedures, the frequency of multiple primaries has increased over the last decades 1. The incidence of second primary malignancy varies greatly in different cancer sites, ranging from 2% to 17% 1.…”

“…The incidence of second primary malignancy varies greatly in different cancer sites, ranging from 2% to 17% 1. Lung cancer is, by far, at the highest risk of developing second primary, accounting for 21% and 19.9% as reported by the Surveillance Epidemiology and End Results (SEER) and the International Association of Cancer Registries (IACR), respectively 2.…”

Multiple primary malignancies

“…Extensive literature study shows some synchronous and metachronous triple combination of tumors mostly of renal, bladder and prostate origin. 10 As the patient was a smoker (20-pack-year), we could associate this with the only detectable risk factor. Unfortunately, he couldn't go through genetic study to exhibit any concealed genetic mutation and we couldn't correlate this to any treatment related neoplasm or any syndromic case.…”