A Retrospective Analysis of Double Malignancies in a Tertiary Care Hospital: A Case Series

Abstract

Background: In recent days with the advent of advanced diagnostic and treatment modalities, the survival of cancer patients has improved but there is rise in multiple primary cancers, the most common are double primary malignancies. The present analysis was to report our observed frequency of double malignancies among the cancer patients. Material and Methods: This is a retrospective study among the patients diagnosed with histologically proven double malignancies (synchronous and metachronous) from January 2009 to July 2014 from our hospital based cancer registry. Results: A total of 104 patients with double malignancies either synchronous or metachronous were identified during our study period. 40 patients (38%) had synchronous and 64 patients (62%) had metachronous malignancies. The most common site for first malignancy was head and neck and female genital tract which constituted about 29% each followed by breast, gastrointestinal tract. Most common second site of malignancy was gastrointestinal tract followed by breast and brain. In metachronous malignancy mean time for diagnosing second malignancy was 6.67 years. The 5 year overall survival was 61% in metachronous malignancy. Median overall survival was 6.21 years. In synchronous malignancy median overall survival was 51 days. Only 2 patients survived more than 2 years. Overall metachronous malignancy had better prognosis than synchronous malignancy. Conclusion: It is imperative that patients with a primary tumor should be thoroughly, closely and regularly followed. Genetic counseling, risk estimation, cancer screening and chemoprevention must be emphasized.