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

Rohit Avinash Vadgaonkar; Sonali Susmita Nayak; Subhashreddy Doni; Leela Digumarti; Sujith Kumar Mullapally; Raghunadharao Digumarti

doi:10.4103/IJPM.IJPM_1055_20

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

Indian J Pathol Microbiol. 2021 Oct-Dec;64(4):725-731. doi: 10.4103/IJPM.IJPM_1055_20.

Authors

Rohit Avinash Vadgaonkar¹, Sonali Susmita Nayak², Subhashreddy Doni³, Leela Digumarti⁴, Sujith Kumar Mullapally⁵, Raghunadharao Digumarti⁶

Affiliations

¹ Department of Radiation Oncology, Homi Bhabha Cancer Hospital and Research Centre, Aganampudi, Visakhapatnam, Andhra Pradesh, India.
² Department of Pathology, Homi Bhabha Cancer Hospital and Research Centre, Aganampudi, Visakhapatnam, Andhra Pradesh, India.
³ Department of Radiodiagnosis, SVS Medical College, Mahabubnagar, Telangana, India.
⁴ Department of Gynecology, KIMS ICON Hospitals, Visakhapatnam, Andhra Pradesh, India.
⁵ Department of Medical Oncology, Apollo Proton Cancer Center, Chennai, India.
⁶ Department of Medical Oncology, KIMS ICON Hospitals, Visakhapatnam, Andhra Pradesh, India.

PMID: 34673592
DOI: 10.4103/IJPM.IJPM_1055_20

Abstract

Background: 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.

Materials and methods: This is an observational retrospective study carried out in a single institute with patients registered between 1^st January 2015 and 31^st 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.

Results: 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.

Conclusion: 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.

Keywords: Multidisciplinary management; multiple primary malignancies; second primary.

Publication types

Review

MeSH terms

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