Title: Analysis of Multiple Primary Malignant Neoplasms: A Report from a Tertiary Cancer Centre in South India
Authors: Kannan Jayaraman, Ramya Rangarajan
Aim: Epidemiological studies have reported a 2 – 17% incidence of double malignancies. Cancer predisposition syndromes, common environmental exposure, late effects of radiotherapy and chemotherapy can lead to the development of second primary malignancies. The aim of our study is to report the prevalence of multiple pimary malignant neoplasms in our setting and to review the relevant literature.
Materials and Methods: Details of patients presenting with histologically proven synchronous or metachronous double malignancies between January 2016 and May 2017 were collected. Details like age at the time of presentation, gender, location of the first and second primary malignancy, histopathology of both the malignant neoplasms and treatment given for both the malignant neoplasms were recorded.
Results: The incidence of multiple primary malignant neoplasms was 1.25%. 68.75% of patients developed metachronous double primary malignancy and 31.25% of patients had synchronous double malignancy. The duration between the development of first and second malignancy ranged between 1 to 30 years. 53.12% of patients who developed second primary malignancy were males, whereas 46.88% were females. Head and neck cancer was the most common first and second primary malignant neoplasm. The common histopathologies of the double malignancy were squamous cell carcinoma, adenocarcinoma, transitional cell carcinoma and sarcoma.
Conclusion: A regular follow up, a strong clinical suspicion and thorough evaluation could detect most of the metachronous second malignancies at an earlier stage. An individualised treatment approach is warranted for patients with multiple malignancies. The prognosis of these patients depends on the individual tumor biology and the stage of presentation of the individual tumor.