Department of Radiation Oncology, Homi Bhabha Cancer Hospital and Research Centre, Aganampudi, Visakhapatnam, Andhra Pradesh, India.
Department of Pathology, Homi Bhabha Cancer Hospital and Research Centre, Aganampudi, Visakhapatnam, Andhra Pradesh, India.
Indian J Pathol Microbiol. 2021 Oct-Dec;64(4):725-731. doi: 10.4103/IJPM.IJPM_1055_20.
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.
多原发恶性肿瘤（MPM）定义为同时或异时发生两种或两种以上的原发性恶性肿瘤。随着癌症负担的增加和治疗期间对指数原发性恶性肿瘤（IPM）的精细筛查，预计第二原发性恶性肿瘤（SPM）的发病率将会增加。本研究旨在分析 MPM 的发病率、最常见的相关性、治疗策略和临床结局。
这是一项在单家医院进行的观察性回顾性研究，纳入了 2015 年 1 月 1 日至 2019 年 8 月 31 日期间登记的患者。采用国际癌症登记协会和国际癌症研究机构（IACR/IARC）的定义来识别 IPM 和 SPM。同步 SPM 定义为在 IPM 诊断后 6 个月内发生的恶性肿瘤。
在研究期间登记的 16461 例患者中，发现 44 例（0.26%）患有 MPM。其中 31 例（70.5%）为女性，13 例（29.5%）为男性。IPM 首发时的中位年龄为 48 岁，SPM 的中位年龄为 56 岁，两次首发之间的中位时间为 38 个月。7 例（15.9%）患者患有同步恶性肿瘤。妇科肿瘤是 IPM 最常见的首发部位（n=14，31.8%），其次是乳腺（n=09，20.5%）和头颈部肿瘤（n=07，15.9%）。最常见的 SPM 是妇科肿瘤（n=12，27.3%），其次是胃肠道恶性肿瘤（n=10，23.3%）。88%的 IPM 患者和 70%的 SPM 患者接受了治愈性治疗。在中位随访 365 天后，21 例（47.72%）患者无疾病，6 例（13.6%）死于疾病，9 例（20.5%）失访。
该研究强调了由于诊断和筛查程序的改进而发现 SPM 的重要性。临床医生应该意识到这一点，并提供多学科管理。
Zotero 插件