Patients with duplex cancer at our department

Aim: We analyzed the clinical history of patients having duplex primary tumor with gastrointestinal involvement. Our purpose was to improve the prevention in clinical practice, improve the efficacy of preoperative evaluation, work out the operative management and prepare follow-up protocols.

Method: Between 1996 and 2003 3547 patients had been treated with oncological disease at our Department. Multiple cancer were found in 98 cases (2,76%), at 42 (1,18%) of these the gastrointestinal tract was involved.

Results: Among the 42 patients 22 had synchrone and 20 metachrone cancers. 24 (57%) duplex tumor were found in women, in men only 18 (43%). Moreover in those cases with duplex tumor the malignant colorectal lesions were accompanied in men with colorectal cancer (61%) the most, while in women with breast cancer (20,8%).

During the preoperative evaluation interdisciplinary cooperation was developed. In patients with synchrone tumor the lesions in the same cavity were removed simultaneously as multivisceral operation first performing the resection with higher surgical risk. In cases of tumors located in different cavities the aspects of the sterility had the highest impact in surgical planning. In high risk patients the two-stage intervention with 6 weeks of interval was considered. We worked out protocols for postoperative care of the patients with breast-, liver- and rectum cancer.

Conclusion: in order to improve the life expectancy and quality of life of the patients the preoperative evaluation protocol should be set strictly and the follow-up should be consistent. The role of genetic and etiological factors should be cleared and they need to be screened when familiar accumulation is found. Multivisceral radical surgical interventions may give longer life expectancy.