Multiple Primary Malignancies: A Clinicopathological Profile of Patients at a Tertiary Center of North India—A Retrospective Hospital-Based Observational Study

Abstract

Abstract Introduction The incidence, prevalence, as well as survival of cancer patients, is increasing day by day due to the use of screening and improved diagnostic modalities. Simultaneously, the development of multiple primary malignancies (MPMs) in cancer survivors is not uncommon in recent years, because of an improved understanding of biology and effective management of cancer in the form of local (i.e., surgery/radiotherapy) and systemic (chemotherapy/targeted therapy) treatment, leading to improved survival and subsequent development of more malignancies. The study was conducted to describe the clinicopathological profile of patients diagnosed with MPMs. Objective To study the clinicopathological profile of MPMs and to look for treatment patterns of these patients. Materials and Methods This was a retrospective hospital-based observational study. Medical records of 73 patients with MPMs, who were registered in the department of medical and surgical oncology between January 2016 and December 2018, were enrolled in the study. The statistical analysis was done by using IBM SPSS Statistics for Windows from IBM Corp. Categorical data were expressed in the form of frequencies and percentages. Results Out of the total 73 patients, 2 patients were diagnosed to have triple malignancies and were excluded from the study for discussion purposes. Among 71 patients with double malignancies, 19 patients had synchronous and 52 had metachronous malignancies with synchronous to metachronous ratio of 1:2.73. The study included 39 men and 32 women with a male to female ratio of 1.21:1. Gastrointestinal system was the most common system involved in first primary as well as in second primary malignancy. Squamous cell carcinoma and adenocarcinoma equally were the most common histologies seen in primary, whereas adenocarcinoma was the most common histology seen in second primary malignancy. Conclusions The phenomenon of MPMs is not an uncommon presentation due to longer survival and side effects of treatment (radiotherapy/chemotherapy). It should always be kept in consideration in any cancer survivor during surveillance in order to detect it and treat at the earliest.