Development of multiple primary tumours, as well as tumour recurrences, are major causes of treatment failure.
Some experts have challenged the old dogma relating to hepatic resection and candidates with multiple and bilobar tumours, as well as patients with limited extrahepatic infiltration, are now considered for resection.
Higher prevalence is associated with a family history of BC and/or OC, early onset, male BC or multiple tumours such as bilateral breast cancer (BBC) or BC and OC in the same patient [ 5].
However, in patients with inherited conditions resulting in multiple tumours (such as those with Gorlin's syndrome), repeated surgical interventions may become untenable, and radiation therapy may be contraindicated because of the high risk of patients developing further BCCs (Leger et al, 2011).
Multivariate analysis revealed that high serum bilirubin (>3 mg dl−1), the presence of uncontrollable ascites, and a high platelet count (>8 × 10 mm−3), so-called background liver factors, as well as multiple tumours, large tumours (>3 cm), high alpha-fetoprotein (>400 ng ml−1), and the presence of portal vein thrombus, so-called tumour factors, were factors of poor prognosis.
Multiple tumours were identified as those with discrete malignancies separated by one low-power field diameter.
When the multivariate model was forced to include the TACE type, ECOG-1, serum albumin, and multiple tumours were confirmed as independent prognostic factors, and the treatment type remained insignificant (P=0.410; Hazard ratio: 0.821; 95% CI: 0.513 1.313) (Table 3).
Sixty percent of these cases present as multiple tumours [33].
This is now a focus area of multiple tumours". Statistics on infant tumours are not considered as reliable as new data about nervous system anomalies, which are usually evident immediately after birth.
These risks, together with the very high SIRs from multiple tumours in the parental probands, such as 7.25 from three tumours and 14.93 from four tumours provide strong evidence for heritable effects in skin SCC.
