DOUBLE PRIMARY – THE PATTERN OF CARE, AND EPIDEMIOLOGY: EXPERIENCE FROM A TERTIARY CANCER CARE CENTER
DOI:
https://doi.org/10.22159/ajpcr.2022.v15i9.45261Keywords:
Synchronous, Metachronous, Double primaryAbstract
Objectives: The importance and relevance of double primary are increasing with time as the increasing use of advanced diagnostic investigation and an increasing number of cancer survivors lead to an increase in double primary malignancy.
Methods: We have collected data retrospectively from our own departmental patient’s record section from January 2011 to December 2021. All the details such as histopathology of both the malignancy, site of primary and secondary cancer, the time gap between the two cancer, clinical stage, and treatment received, along with demographic details have been recorded. Patients are divided into two categories either synchronous or metachronous when a second tumor develops either simultaneously or within 6 months of the diagnosis of the first tumor or 6 months after the diagnosis of the primary malignancy, respectively.
Results: The total number of registered cases in one decade at our institute was 25,638 and among them were 41 double primary cases (0.16%). Twenty-two cases were metachronous (59%) and 19 cases (41%) were synchronous double primary. The most common site of double primary site was the head and neck region (38 %) followed by the lung, and esophagus (13% each), and the least common site was the colon (<1%). In the case of metachronous double primary, the mean time interval (the time gap between two cancer devolvement) was 7.4 years with a range of 2–19 years. The majority of the patients are treated with curative intention.
Conclusions: The incidence of double primary is increasing over time. The management of double primary should be supervised by a multidisciplinary tumor board and more research is needed in the areas of epidemiology and treatment.
Downloads
References
Vogt A, Schmid S, Heinimann K, Frick H, Herrmann C, Cerny T, et al. Multiple primary tumors: Challenges and approaches, a review. ESMO Open 2017;2:e000172. doi: 10.1136/esmoopen-2017-000172, PMID 28761745
Warren S, Gates O. Multiple primary malignant tumors: A survey of the literature and statistical study. Am J Cancer 1932;16:1358-414.
Suzuki T, Takahashi H, Yao K, Inagi K, Nakayama M, Makoshi T, et al. Multiple primary malignancies in the head and neck: A clinical review of 121 patients. Acta Otolaryngol Suppl 2002;547:88-92. doi: 10.1080/000164802760057662, PMID 12212604
Amer MH. Multiple neoplasms, single primaries, and patient survival. Cancer Manag Res 2014;6:119-34. doi: 10.2147/CMAR.S57378, PMID 24623992
Koubková L, Hrstka R, Dobes P, Vojtesek B, Vyzula R. Second primary cancers causes, incidence and the future. Klin Onkol 2014;27:11-7. doi: 10.14735/amko201411, PMID 24635432
Chowdary T, Sivaraj SM, Rao GV, Thirunavukkarasu S. Dual malignancies: do they have a worse prognosis than their individual counterparts. Arch Int Surg 2015;5:29-32. doi: 10.4103/2278- 9596.153151
Hauben EI, Arends J, Vandenbroucke JP, Van Asperen CJ, Van Marck E, Hogendoorn PC. Multiple primary malignancies in osteosarcoma patients. Incidence and predictive value of osteosarcoma subtype for cancer syndromes related with osteosarcoma. Eur J Hum Genet 2003;11:611-8. doi: 10.1038/sj.ejhg.5201012, PMID 12891382
Rosso S, De Angelis R, Ciccolallo L, Carrani E, Soerjomataram I, Grande E, et al. Multiple tumors in survival estimates. Eur J Cancer 2009;45:1080-94. doi: 10.1016/j.ejca.2008.11.030, PMID 19121933
Buiatti E, Crocetti E, Acciai S, Gafà L, Falcini F, Milandri C, et al. Incidence of second primary cancers in three Italian population-based cancer registries. Eur J Cancer 1997;33:1829-34. doi: 10.1016/s0959- 8049(97)00173-1, PMID 9470841
Coyte A, Morrison DS, McLoone P. Second primary cancer risk the impact of applying different definitions of multiple primaries: Results from a retrospective population-based cancer registry study. BMC Cancer 2014;14:272. doi: 10.1186/1471-2407-14-272, PMID 24742063
Kim YS. Reirradiation of head and neck cancer in the era of intensity-modulated radiotherapy: Patient selection, practical aspects, and current evidence. Radiat Oncol J 2017;35:1-15. doi: 10.3857/roj.2017.00122, PMID 28395502
Morris LG, Sikora AG, Hayes RB, Patel SG, Ganly I. Anatomic sites at elevated risk of second primary cancer after an index head and neck cancer. Cancer Causes Control 2011;22:671-9. doi: 10.1007/s10552- 011-9739-2, PMID 21327458
Manthri RG, Jeepalem SM, Mohan VS, Bhargavi D, Hulikal N, Kalawat T. Metachronous second primary malignancies in known breast cancer patients on 18F-fluoro-2-deoxyglucose positron emission tomography-computerized tomography in a tertiary care center. Indian J Nucl Med 2019;34:284-9. doi: 10.4103/ijnm.IJNM_78_19, PMID 31579206
Vogel VG. Identifying and screening patients at risk of second cancers. Cancer Epidemiol Biomarkers Prev 2006;15:2027-32. doi: 10.1158/1055-9965.EPI-06-0416, PMID 17057026
Zhang Z, Gao S, Mao Y, Mu J, Xue Q, Feng X, et al. Surgical outcomes of synchronous multiple primary non-small cell lung cancers. Sci Rep 2016;6:23252. doi: 10.1038/srep23252, PMID 27254665
Lacouture ME, O’Reilly K, Rosen N, Solit DB. Induction of cutaneous squamous cell carcinomas by RAF inhibitors: Cause for concern? J Clin Oncol 2012;30:329-30. doi: 10.1200/JCO.2011.38.2895, PMID 22067405
Published
How to Cite
Issue
Section
Copyright (c) 2022 DR. SHATARUPA DUTTA, DR SAPTARSHI BANERJEE, DR. ANJAN BERA, PROF. SRIKRISHNA MANDAL, DR. CHANDRIMA BANERJEE
This work is licensed under a Creative Commons Attribution 4.0 International License.
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.
