Sindhu N R, Thomas Dhanya Susan, Sebastian Ajit, Thomas Anitha, Chandy Rachel, Daniel Sherin, Thomas Vinotha
Department of Gynaecologic Oncology, Christian Medical College and Hospital, Vellore, Tamil Nadu India.
Department of Pathology, Christian Medical College, Vellore, Tamil Nadu India.
J Obstet Gynaecol India. 2025 Apr;75(Suppl 1):146-151. doi: 10.1007/s13224-024-02041-0. Epub 2024 Aug 29.
This study aims to explore the clinical-pathological profile of gynaecological malignancies occurring as a second cancer and identify their modifiable and non-modifiable risk factors.
This retrospective cohort study included women operated for gynaecological carcinoma following a previous treated malignancy, in the gynaecologic oncology department of a tertiary care hospital, between 1st January 2016 and 31st December 2021. Demographic details, clinical and pathological characteristics of the current malignancy and previous malignancy were obtained from medical records and analysed using descriptive statistics.
During this period, 2370 women with gynaecological malignancies were operated, of whom 27 (1.1%) patients had gynaecological malignancy as a second malignancy. This included 19 (70.3%) endometrial and 8 (29.6%) ovarian cancer patients following a median period of 48 (24-144 months) from the index malignancy. Their median age and BMI were 60 years (37-67) and 27 (17-39.1), respectively. Endometrioid endometrial cancer was most common and was preceded by breast carcinoma in 19 (70.37%) and colorectal in 5 (18.5%). Four patients had previous microsatellite unstable colorectal cancer. Two patients were found to have mismatch repair deficient endometrial cancer on somatic testing. High-grade serous carcinoma was the most common ovarian histology and was preceded by breast cancer in 6 (75%). Four patients underwent germline testing, and one was found to have a (breast cancer gene) BRCA pathogenic mutation.
Breast cancer and colon cancer can precede gynaecologic cancer. Individualization of somatic and genetic testing in colorectal and breast cancers will allow screening and prevention of second gynaecologic malignancies.
本研究旨在探讨作为第二原发癌出现的妇科恶性肿瘤的临床病理特征，并确定其可改变和不可改变的风险因素。
这项回顾性队列研究纳入了2016年1月1日至2021年12月31日期间在一家三级护理医院的妇科肿瘤科，因先前治疗过的恶性肿瘤而接受妇科癌症手术的女性。从医疗记录中获取当前恶性肿瘤和先前恶性肿瘤的人口统计学细节、临床和病理特征，并使用描述性统计进行分析。
在此期间，2370名患有妇科恶性肿瘤的女性接受了手术，其中27名（1.1%）患者的妇科恶性肿瘤为第二原发恶性肿瘤。这包括19名（70.3%）子宫内膜癌患者和8名（29.6%）卵巢癌患者，距索引恶性肿瘤的中位时间为48（24 - 144个月）。她们的中位年龄和BMI分别为60岁（37 - 67岁）和27（17 - 39.1）。子宫内膜样子宫内膜癌最为常见，之前有乳腺癌的为19名（70.37%），有结直肠癌的为5名（18.5%）。4名患者先前患有微卫星不稳定结直肠癌。2名患者经体细胞检测发现存在错配修复缺陷型子宫内膜癌。高级别浆液性癌是最常见的卵巢组织学类型，之前有乳腺癌的为6名（75%）。4名患者进行了种系检测，其中1名被发现有（乳腺癌基因）BRCA致病突变。
乳腺癌和结肠癌可能先于妇科癌症出现。对结直肠癌和乳腺癌进行体细胞和基因检测的个体化将有助于筛查和预防第二原发性妇科恶性肿瘤。
