Analysis of the structure of deaths from sporadic metachronous primary multiple malignant neoplasms in a general hospital

Aim. To analyze the structure of deaths from sporadic metachronous primary multiple malignant neoplasms in 2017–2023 in a multidisciplinary inpatient facility.
Materials and methods. The study included 2,394 fatal cases of patients hospitalized in a multidisciplinary inpatient facility for emergency medical care. In 2017–2023, 29 metachronous primary multiple malignant neoplasms were identified, which was 1.3% of the total number of fatal outcomes and 11% of malignant neoplasms. The median age of patients was 72.0 (69.0–82.0) years. We examined the protocols of pathological studies of autopsy material of patients hospitalized in the inpatient facility of multidisciplinary clinics of Siberian State Medical University. In patients with metachronous primary multiple malignant neoplasms, the nosological structure, stage of the process, histological form of the neoplasm, the period between the diagnosis of the first and second malignant tumor, and the immediate cause of death were analyzed. Statistical processing of the results was carried out using the Statistica 10.0 software package.
Results. The first tumor was most often caused by squamous cell skin cancer (21%) or invasive ductal carcinoma of the breast (17.5%). The interval between the diagnosis of the first and second tumor was 72.0 (48.0–96.0) months. All patients received definitive treatment for the first tumor without progression. The second metachronous tumors were verified in an advanced stage in 72% of cases and caused the death of patients. Most often (17.5%) these were diffuse gastric cancer.
Conclusion. Metachronous primary multiple malignant tumors can occur long after the first ones (about 6 years), often in advanced forms (in this case, tumors verified exclusively postmortem – 69%), being the cause of death of patients. The most common first tumors in sporadic metachronous primary multiple malignant neoplasms are recurrent squamous cell skin cancer and ductal carcinoma of the mammary gland. The main target organ for the development of oncopathology is the stomach.

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