多原发肿瘤诊治中国专家共识(2024版)  

Chinese expert consensus on diagnosis and treatment of multiple primary neoplasms(2024 edition)

作　　者：中国抗癌协会多原发和不明原发肿瘤整合康复专业委员会 陕西省抗癌协会罕见肿瘤专业委员会 廖子君 罗志国 Integrated Rehabilitation Committee for Multiple Primary Neoplasms and Unknown Primary Tumors of Chinese Anti-Cancer Association;Rare Tumor Committee of Shaanxi Anti-Cancer Association;Liao Zijun;Luo Zhiguo(不详;Department of Oncology,Shaanxi Provincial Cancer Hospital,Xi'an 710061,China;Department of Oncology,Fudan University Shanghai Cancer Center,Shanghai 200032,China)

机构地区：[1]不详 [2]陕西省肿瘤医院肿瘤内科,西安710061 [3]复旦大学附属肿瘤医院肿瘤内科,上海200032

出　　处：《中华消化外科杂志》2024年第10期1261-1276,共16页Chinese Journal of Digestive Surgery

基　　金：国家自然科学基金(81774078)。

摘　　要：多原发肿瘤(MPNs)指机体同时性或异时性发生≥2个彼此无关的原发恶性肿瘤,可分别来源于同一器官、成对器官,同一系统的不同部位,不同系统的不同器官.MPNs的发生不取决于时间,每个原发肿瘤独立起源,而非侵袭、复发或转移.MPNs发病率较低,发病因素、机制目前尚不清楚.临床上通常将MPNs分为同时性和异时性2类,其发生部位广泛而多样.充分排除第一原发肿瘤转移是MPNs临床诊断面临的最大挑战,且准确的临床分期亦存在难度.目前,MPNs治疗无统一标准,亦无规范或指南可遵循,通常需开展多学科团队讨论,综合考虑肿瘤本身因素、患者体能状态及意愿,实施以手术、放化疗、靶向治疗、免疫治疗等为主的综合治疗策略.MPNs患者预后生存情况、影响预后相关因素目前均无定论,不同文献报道存在较大差异.MPNs较难开展前瞻性临床研究,因难以准确预测第一原发肿瘤患者发生MPNs.中国抗癌协会多原发和不明原发肿瘤整合康复专业委员会和陕西省抗癌协会罕见肿瘤专业委员会组织全国相关领域专家制订《多原发肿瘤诊治中国专家共识(2024版)》,旨在为肿瘤临床医师诊断和治疗MPNs提供参考.Multiple primary neoplasms(MPNs)refer to the simultaneous or sequential occurrence of two or more histologically distinct primary malignant tumors in the body,which can originate from the same organ,paired organs,different parts of the same system,or different organs of different systems.The occurrence of MPNs is independent of time,with each primary tumor arising from a distinct tissue rather than being due to invasion,recurrence,or metastasis.The incidence of MPNs is relatively low,and the factors and mechanisms involved in their development are not yet fully understood.Clinically,MPNs are typically classified into the synchronous and metachronous MPNs,with a wide and diverse range of locations.One of the greatest challenges in clinical diagnosis of MPNs is to thoroughly exclude the possibility of metastasis from the first primary tumors,and initial accurate clinical staging also presents a significant challenge.Currently,there is no uniform standard for the treatment of MPNs,nor are there any guideline or protocol to follow.Treatment usually requires multidisciplinary team discussion,taking into account both the characteristics of the tumors themselves and the patient's performance status and preferences,to implement an integrated therapeutic strategy that may include surgery,radiation therapy,chemo-therapy,targeted therapy,immunotherapy,and so on.There is currently no consensus on the prognostic survival outcomes and factors affecting prognosis in patients with MPNs,with significant variability reported in the literatures.It is difficult to conduct prospective clinical studies on MPNs because it is clinically challenging to accurately predict which patients with the first primary tumor will inevitably develop MPNs.Integrated Rehabilitation Committee for Multiple Primary Neoplasms and Unknown Primary Tumors of Chinese Anti-Cancer Association and Rare Tumor Committee of Shaanxi Anti-Cancer Association organize experts in relevant fields nationwide to formulate the Chinese Expert Consensus on Diagnosis and Treat

关 键 词：多原发肿瘤 筛查 预防 诊断 治疗 随访 专家共识 

分 类 号：R730.5[医药卫生—肿瘤]