Multiple Primary Malignancies

Once a clinical curiosity, multiple malignant tumors (MMT) are becoming more common. This state-of-the-art overview of MMT offers a clear definition and classification and explores various aspects including genetic, iatrogenic and environmental factors.

In 2006, when my colleague Andrea Renda proposed multiple primary malignancies (MPM) as the subject of the Biennial Report to the 2008 Congress of the Italian - ciety of Surgery, I, together with the Steering Committee, quickly agreed. Recent progress in our understanding of the etiopathology of these neoplasms has led to - novative and significant progress on the clinical level. Importantly, the incidence of the onset of two or more tumors in the same patient suggests a more than casual - lationship. Furthermore, the occurrence of MPM derives from several different me- anisms-viral, iatrogenic, immunologic, environmental, and hereditary-such that any form of treatment must take into account the etiology of these tumors. After an epidemiological introduction, this monograph analyzes various aspects of multitumoral syndromes based on the experience of the Department of Surgical Sciences, along with that of other clinical departments of the University Federico II of Naples. In the discussion of inherited tumors, reference is made to the series of patients treated at the Department of Surgery at the University of Siena. The many topics that comprise this volume range from carcinogenesis to diagnostic strategies, and from epidemiology to innovations in imaging and endoscopic techniques. Among the clinical aspects, particular emphasis is given to sporadic and hereditary syndromes, as these patients are frequently treated by general surgery departments.

Nosography. - Epidemiology: Data from Cancer Registries. - Bioinformatics in MPM: Using Decision Trees To Predict a Second Tumor Site. - Carcinogenesis. - Iatrogenic Second Tumors. - Immunodeficiency and Multiple Primary Malignancies. - Multiple Primary Malignancies and Human Papilloma Virus Infections. - The Hereditary Syndromes. - Multifocal and Multicentric Tumors. - The Cancer Spectrum Related to Hereditary and Familial Breast and Ovarian Cancers. - The Role of Genetic Predisposition and Environmental Factors in the Occurrence of Multiple Different Solid Tumors. The Experience of the University Hospital of Sienna. - Sporadic Colorectal Tumors in Multiple Primary Malignancies. - Multiple Primary Malignancies: Non-codified Associations. - Laboratory for Patients at Risk of Multiple Primary Malignancies. - Multiple Primary Malignancies: Role of Advanced Endoscopy To Identify Synchronous and Metachronous Tumors of the Digestive Tract. - Diagnostic Imaging Techniques for Synchronous Multiple Tumors. - DNA-Guided Therapy. - Chemoprevention. - Conclusions.