Exploring the Trends of Multiple Primary Malignancies - An Institutional Study from a Tertiary Care Cancer Centre in North Kerala
TL;DR
The increasing proportion of multiple primary malignancies should raise the suspicion of second primaries while evaluating and following up patients with malignancies, so that a curative treatment can be offered.
Abstract
Background Multiple primary malignancies (MPM) are the subsequent malignancies occurring in an individual with an already diagnosed malignancy. This study was conducted to determine the proportion, clinicopathological characteristics, treatment intent and overall survival of MPMs detected in patients at a tertiary care cancer centre in North Kerala, India. Materials & Methods The case records of 11250 patients who presented to our institution between January 2021 and December 2022 were retrospectively evaluated for the presence of MPMs. The MPMs were defined by the IARC/IACR criteria. The patient details were recorded from archives. Descriptive statistics were used for categorical variables. The patients were followed up for a minimum period of 2 years and overall survival was calculated. Results Out of the 11250 patients who presented to our institution between January 2021 and December 2022, 121 patients had MPMs (1.08%). 115 (95%) patients were found to have double primary malignancies. Triple primary malignancies were identified in 6 (5%) patients. 38 patients were found to have SyPMs (33%) and 77 with McPMs (67%). Breast was the most common index primary malignancy (41; 35.6%) followed by colon (15; 13%) and gynecologic malignancies (14; 12.2%). The patients with McPM had better overall survival than SyPMs. Conclusion The increasing proportion of multiple primary malignancies should raise the suspicion of second primaries while evaluating and following up patients with malignancies. Efforts must be made to diagnose the second primaries in the earlier stage so that a curative treatment can be offered.