Clinical characteristics and prognosis of patients with multiple primary cancers complicated with colorectal cancer
Objective To analyze the clinical features and prognosis of patients with multiple primary cancers(MPC)com-plicated with colorectal cancer,understand its risk factors and make early diagnosis to avoid missed diagnosis.Methods The clinical data of 165 patients with multiple primary cancers complicated with colorectal cancer and 330 patients with single colorectal cancer(CRC)admitted to the Cancer Hospital affiliated to Guangxi Medical University Cancer Hospital from January 1,2014 to July 31,2022 were analyzed retrospectively.The data were statistically analyzed by SPSS26.0,and the counting data were represented by n(％),and the comparison between groups was test or Fisher exact test,Kaplan-Meier survival curve was used for survival analysis.Results The male-female ratio of 330 patients with single colorectal cancer and 165 patients with MPC complicated with colorectal cancer was 1∶1.87 and 1∶1.55 respectively.The onset age of MPC complicated with colorectal cancer patients with colorectal cancer was＞50 years old;Single colorectal cancer was mainly in stage Ⅲ and Ⅳ.MPC with concomitant colorectal cancer was mainly in stages Ⅱ and Ⅲ.There were signif-icant differences in family history of tumor(12.72％vs 2.42％,x2=21.350,P＜0.001),smoking history(31.52％vs 20.61％,x2=4.245,P=0.039),drinking history(22.43％vs 12.12％,x2=9.064,P=0.003),adenomatous polyp(38.18％vs 22.73％,x2=13.359,P＜0.001),CA125 increased(23.03％vs 13.33％,x2=7.115,P=0.008),CA153 increased(4.85％vs 1.52％,x2=4.834,P=0.028)and microsatellite instability(9.09％vs 3.93％,x2=5.550,P=0.018)between MPC with colorectal cancer and patients with single colorectal cancer.There was no significant difference between the two groups in sex,location,histological type,degree of differentiation,number of lymph node metastasis and the longest diameter of tumor,all P＞0.05.Among the patients with metachronous MPC,the peak of the second primary cancer occurred within 3 years after the di-agnosis of the first primary cancer,accounting for 50.53％,and the top four common diseased organs outside colorectal cancer were breast,lung、nasopharynx respectively and stomach.In simultaneous MPC,the top three common extracolorectal organs were stomach,lung and cervix respectively.There was significant difference in survival rate between patients with single colorectal canc-er and MPC patients with colorectal cancer(x2=10.558,P=0.001).Conclusion Patients over 50 years old,with a family histo-ry of cancer,smoking and drinking are more likely to suffer from MPC complicated with colorectal cancer.Gastric cancer and breast cancer are the most common extraintestinal cancers,and the reexamination should be strengthened within three years after the diagnosis of malignant tumors,especially in patients with microsatellite instability.
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