EP702 Multiple primaries in gynecological cancer-a retrospective observational study from 1990–2017 in a tertiary cancer centre in eastern india. (1st November 2019)

• Record Type: Journal Article
• Authors: Chakrabarti, B; Mondal, NR; Chatterjee, T; Roychowdhuri, R
• Is Part Of: International journal of gynecological cancer. Volume 29(2019)Supplement 4
• Page Start: A399
• Page End: A399
• Publication Date: 2019-11-01
• Subjects: Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1136/ijgc-2019-ESGO.756
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : Introduction/Background: Life expectancy in malignancy has increased in recent years.Patients suffering from malignant tumours can expect much longer period of disease-free survival or even cure. Patients may develop second or third primay malignancies.If 2nd.primary is discovered at the same time it isconcurrent, if within 6 months synchronous, any time after 6 months is metachronous. The term´multiple primary malignant tumour " was first used by Billroth in1889 and the first paper describing multiple primary malignancy was published in1932 by Warren&Gates. Methodology: Warren & Gate criteria has been followed. a) Histological confirmation of malignancy in both index & 2nd. primary. b) If concurrent there should be at least 2 cm. of normal mucosa between the tumours. If the tumours are in the same location they should be separated by time by at least 5 yrs. c) Probability of one being metastatic of other must be excluded. Incusion criteria: i) All histologically proven.ii) At least one of the sites of malignancy should be female genital tract. Exclusion criteria: i) Metastatic disease ii) Recurrence iii) Multifocal/multicentral malignancies. iv) No clear histological confirmation of tumour. iv) Hematological tumour. Results: Synchronous 10 cases (37%) metachronous 17 (63%). Of 10 synchronous cases7 were concurrent.cervix&breast-3, cervix&tonsil-1, cervix&endometrium.-1, cervix &ovary, cervix &gestational tumour-1.Rest3 had 2nd primary with in 6 months.cervix followed by ovary-1, cervix followed by kidney-1, cervix followed by breast-1.Of the 17 metachronous-first primary in breast 9, cervix-5, gall bladder-2, ovary-1, 2nd primary in ovary-3, endometrium-3, cervix-4, vulva-3, thyroid-1, lungs-1, vagina-1, scalp-1.One patient with primary breast developed 2nd.&3rd.primary in cervix &scalp. Age of1st.primary-28-74 yrs (median 51 yrs).age of 2nd.primary34-94(median 53 yrs).occurance interval in metachronous (11–161) months, median 51 months. Conclusion: Approximately 10%of patients develop a 2nd.cancer (Lynch-Seer data 1973–1999)Causal mechanism include genes, environment, iatrogenic(radiation), treatment effects&combination of all.Most common hereditary cancer syndrome related to gynecological cancer include hereditary breast&ovarian syndrome, Lynch syndrome, etc.Treatment schedule for the first maligncy may result in damage of DNA leading to tumouregenesis Microsatelite instability(MSI) is most common in multiple primaries.Peutz-Leghers syndrome(PJS) is an inherited condition that puts people at increased risk for developing hamartomatous polyp in the digestive tract as well as cancer of breast, colon, rectum, pancreas, stomah.testicles, ovaries, lungs, cervix.Multicentric study inTurkey(2012) indicate most common cancer pairs in female are breast-gynecological cancer.(BabacanNA.) Disclosure: Nothing to disclose.