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DOI: 10.1055/s-0045-1807946
Clinical and epidemiological evaluation of patients diagnosed with two or more primary tumors
Introduction: Cancer patients have a higher risk of developing a new primary malignancy compared to the general population. There are several risk factors that may be associated with the presence of synchronous and metachronous tumors, such as exposure to environmental carcinogens, effects of ionizing radiation, side effects of treatments used for another tumor and genetic predisposition to neoplasms.
Objective: To describe the clinical and epidemiological profile of patients diagnosed with two or more primary tumors, treated in a public oncology service.
Methodology: This is a cross-sectional, descriptive study, carried out through the analysis of medical records of patients, between 2022 and 2023.
Results: A total of 102 patients were analyzed, of whom only six (5.9%) were diagnosed with three primary tumors and 13 (12.7%) had synchronous tumors (with less than two months of difference between diagnoses). The majority of patients were male (63.7%) and the median age at diagnosis of the first tumor (FT) was 58 years and that of the second tumor (ST) was 63 years. The most prevalent sites for the FT were breast (36.3%), prostate (12.7%), colorectal (12.7%) and head and neck (10.8%). For the ST, the most prevalent sites were breast (30.4%), colorectal (20.6%) and head and neck (12.7%). There was a predominance of stages I-II (59.8% for FT and 53.9% for ST), compared to stages III-IV (39.2% for FT and 45.1% for ST). The most common treatment was surgery (82.3% for FT and 40.2% for ST), followed by chemotherapy (49% for FT and 40.2% for ST) and radiotherapy (44.1% for FT and 22.5% for ST). Smoking was reported in 37.2% of cases and ten (9.8%) patients had multiple tumors known to be associated with smoking. Family history was positive in 35.3% of patients. Only nine (8.8%) of the patients underwent some type of test to evaluate potentially associated genetic mutations.
Conclusion: Analyzing first and second tumors together, the most prevalent sites were breast, colorectal and head and neck, with the rate of the last two being higher in the second neoplasm. The diagnosis of stage III-IV tumors was also higher in the second neoplasm. Smoking cessation and genetic testing programs should be encouraged in public health services to better monitor patients at risk of developing two or more tumors.
Corresponding author: Poliana leite Diniz Santos Gomes (e-mail: poly_diniz@hotmail.com).
No conflict of interest has been declared by the author(s).
Publication History
Article published online:
06 May 2025
© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)
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Lígia Araújo Milanez, Athos Martins Correa, Igor Esmeraldo de Oliveira, Poliana Leite Diniz Santos Gomes, Monique Sedmaier França. Clinical and epidemiological evaluation of patients diagnosed with two or more primary tumors. Brazilian Journal of Oncology 2025; 21.
DOI: 10.1055/s-0045-1807946