[Second tumours in patients with malignant neoplasms of the digestive apparatus. A retrospective study on 2406 cases]

Abstract

Background: Incidence of a second tumor is elevated, between 2-10%, in patients previously affected by another tumor. Second tumor may concern the same organ, as a synchronous or metachronous way, or different organs. The present work is based on 4286 patients who underwent surgical treatment for gastric, small bowel, colorectal or pancreatic cancer at Surgical Unit 1- Minni- Bologna University and regards multiple primitive malignant tumor (T.M.M.P) of the II type (Möertel classification), such as different organs or tissues based second tumors; it also analyses overall incidence, sites, lesion number, latency period, and main association in our series.

Patients and methods: 1742 patients with colorectal carcinoma, 1418 patients with gastric cancer, 91 patients with malignant tumour of the small bowel, 867 patients with pancreatic cancer and 68 with hepatocellular carcinoma have been included in the present study. A careful history, aimed at checking the presence of a previous tumor in a different site, was taken. One hundred eighty one patients (82 male and 99 female) reported tumor of a second type. Eleven cases of synchronous tumor and 170 cases of metachronous tumors were found, at a distance of 1-39 years. Moreover 7 patients reported more than one second tumor. Female genital tract tumors (37 cases), hematopoietic system tumors (34 cases), breast cancer (29 cases), and cutaneous tumor (20 cases) 9 were the most observed previous tumor. Incidence of a second tumor was more elevated in patients with small bowel neoplasms (18/91, 19.8%) than in patients with others tumors of gastrointestinal tract.

Conclusions: Present study, although win part retrospective, point out an overall incidence of 4.3% of second tumors of the II type. Incidence of second tumours in patients with small bowel neoplasm, is particularly high; this confirm that small bowel plays a possible immunoprotective role and the immunodepression characterise patients with tumors in this site.