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EP702 Multiple primaries in gynecological cancer-a retrospective observational study from 1990–2017 in a tertiary cancer centre in eastern india
  1. B Chakrabarti,
  2. NR Mondal,
  3. T Chatterjee and
  4. R Roychowdhuri
  1. Gyne-Oncology, SGCCandRI, Kolkata, India


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.

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