Multiple primary malignant neoplasms: Multi-center results from Turkey N.A. Babacan 1 , S. Aksoy 2 , B. Cetin 3 , N.Y. Ozdemir 2 , M. Benekli 3 , U. Uyeturk 4 , M. Ali Kaplan 5 , T. Kos 2 , H. Karaca 6 , B. Oksuzoglu 4 , N. Zengin 2 , S. Buyukberber 3 1 Cumhuriyet University Faculty of Medicine, Department of Medical Oncology, Sivas; 2 Ankara Numune Education and Research Hos- pital, Department of Medical Oncology, Ankara; 3 Gazi University Faculty of Medicine, Department of Medical Oncology, Ankara; 4 Dr. Abdurrahman Yurtaslan” Ankara Oncology Education and Research Hospital, Department of Medical Oncology, Ankara; 5 Dicle Univer- sity Faculty of Medicine, Department of Medical Oncology, Diyarbakir; 6 Erciyes University Faculty of Medicine, Department of Medical Oncology, Kayseri, Turkey Summary Purpose: Multiple primary malignant neoplasms (MPMNs) are defned as a diagnosis of two or more indepen- dent primary malignancies of different histologies/origins in an individual. The frequency of MPMN is being increasing. In this study we aimed to determine the frequency and clini- cal features of second primary cancers (SPCs). Methods: From January 1990 to December 2010, pa- tients with MPMNs were screened in 5 centers. Data were obtained retrospectively from hospital charts. Results: Three hundred seventy-seven patients with MPMNs were evaluated. The median age at initial cancer diagnosis was 61 years (range 18-88). The median age at second cancer was 64 years (range 20-89). The median time between two cancer diagnoses was 15 months (range 0-504). Male to female ratio was 1.44 (M/F 223/154). The most fre- quent initial cancer types were head and neck (54 patients, 14.3%), breast (54 patients, 14.3%), and colorectal (43 pa- tients, 11.4%). The most frequent second cancer types were lung (76 patients, 20.2%), colorectal (39 patients, 10.3%) and breast (33 patients, 8.8%). The most common cancer pairs in females were breast-gynecologic cancers (15 pa- tients, 9.7%), colorectal-breast cancers (9 patients, 5.8%) and breast-colorectal cancers (7 patients, 4.5%). The most common cancer pairs in males were head and neck-lung can- cers (29 patients, 13%), bladder-lung cancers (9 patients, 4%), and bladder-prostate cancers (7 patients, 3%). The me- dian follow up was 36 months (range 1-595). Conclusion: Physicians should be aware of SPCs prob- abilities. Newly developed suspicious lesions should be evalu- ated rigorously. Histopathologic evaluations of suspicious le- sions for second tumors should be used extensively if needed. In our series, the most common pairs were breast-gynecologic cancers in females and head and neck-lung cancers in males. Key words: cancer, chemotherapy, multiple primary malig- nancies, second primary Introduction The number of cancer survivors is increasing worldwide. Among all cancer patients the 5-year sur- vival rate is now almost 66% [1]. One of the most se- rious problems experienced by cancer survivors is the development of new cancers. The term MPMNs, was frst used by Billroth in 1889 and the frst literature re- port about MPMNs was published by Warren and Gates in 1932 [2]. According to Warren and Gates description, both the primary and secondary tumors should be ma- lignant, with histologic confrmation, there should be at least 2 cm of normal tissue between the two tumors (if the tumors are in the same region), they should be sep- arated in time by at least 5 years and metastatic tumor should be excluded. MPMNs may be synchronous or metachronous. The term “synchronous” is used when the second pri- mary malignancy is diagnosed within 6 months of the primary tumor and “metachronous” is used when the second primary malignancy is diagnosed more than 6 months after the diagnosis of the primary tumor [3]. Correspondence to: Sercan Aksoy, MD. Ankara Numune Education and Research Hospital, Department of Medical Oncology, 06100, Sihhiye, Ankara, Turkey. Tel: +90 312 508 4600, Fax: +90 312 311 2778, E-mail: saksoy07@yahoo.com Received 17-01-2012; Accepted 09-02-2012 Journal of BUON 17: 770-775, 2012 © 2012 Zerbinis Medical Publications. Printed in Greece ORIGINAL ARTICLE