Distinct patterns of occurrence, common associations, and survival of patients with second primary maligancies: A 5-year single institute experience with review of literature

Multiple primary malignancy (MPM) is defined as occurrence of two or more synchronous or metachronous primary malignancies. With the rise in cancer burden and meticulous screening of index primary malignancy (IPM) during treatment, increased incidence of second primary malignancy (SPM) is expected....

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Published in:	Indian journal of pathology & microbiology Vol. 64; no. 4; pp. 725 - 731
Main Authors:	Vadgaonkar, Rohit Avinash, Nayak, Sonali Susmita, Doni, Subhashreddy, Digumarti, Leela, Mullapally, Sujith Kumar, Digumarti, Raghunadharao
Format:	Journal Article
Language:	English
Published:	India 01-10-2021
Subjects:	Adolescent Adult Aged Child Female Head and Neck Neoplasms - complications Head and Neck Neoplasms - epidemiology Head and Neck Neoplasms - mortality Humans Incidence India - epidemiology Male Middle Aged Neoplasms, Multiple Primary - epidemiology Neoplasms, Multiple Primary - mortality Neoplasms, Second Primary - epidemiology Neoplasms, Second Primary - etiology Neoplasms, Second Primary - mortality Prevalence Retrospective Studies Survival Rate Tertiary Care Centers - statistics & numerical data Young Adult India Multidisciplinary management multiple primary malignancies second primary
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Summary:	Multiple primary malignancy (MPM) is defined as occurrence of two or more synchronous or metachronous primary malignancies. With the rise in cancer burden and meticulous screening of index primary malignancy (IPM) during treatment, increased incidence of second primary malignancy (SPM) is expected. This study was undertaken with an attempt to analyze the incidence, commonest associations, management strategies, and clinical outcomes of MPM. This is an observational retrospective study carried out in a single institute with patients registered between 1 January 2015 and 31 August 2019. The International Association of Cancer Registries and International Agency for Research on Cancer (IACR/IARC) definition was used for identification of IPM and SPM. Synchronous SPM was defined as malignancy occurring within 6 months from the diagnosis of IPM. Out of 16,461 registered patients during the study interval, 44 (0.26%) cases were found to have MPM. A total of 31 (70.5%) cases were women and 13 (29.5%) cases were men. Median age at presentation of IPM was 48 years and of SPM was 56 years, with median duration between two primaries being 38 months. Seven patients (15.9%) had synchronous malignancies. Gynecological tumors were the most common site of IPM presentation (n = 14, 31.8%) followed by breast (n = 09, 20.5%) and head and neck tumors (n = 07, 15.9%), respectively. The most common SPM was gynecological tumors (n = 12, 27.3%) followed by gastrointestinal malignancies (n = 10, 23.3%). Curative treatment was offered to 88% of patients with IPM and 70% patients with SPM. At a median follow-up of 365 days, 21 (47.72%) patients were disease free, six (13.6%) died of disease and nine (20.5%) were lost to follow-up. The study emphasizes the importance of detecting SPM as a result of improved diagnostic and screening procedures. Clinicians should be aware of it and offer multidisciplinary management.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-3 content type line 23 ObjectType-Review-1
ISSN:	0377-4929 0974-5130
DOI:	10.4103/IJPM.IJPM_1055_20