A Retrospective Clinicopathological Analysis for Cases of Double Primary Malignancies

Background and objectives: Double primary malignancies is challenging in
management. Incidence of double primaries is increasing overtime. This study
aims to review clinical, pathologic and treatment outcomes of our observed
cases with double primary tumors. Our primary objective was to measure the
frequency of double primary either synchronous or metachronous and the
secondary objective was to identify demographical data, histopathological types,
survival and treatment used in cases presented at Clinical Oncology Department
in Helwan University hospital, Eldoah Hospital and Health Insurance Hospital
from January 2012 till August 2022.
Methods: The study included Fifty-three cancer patients treated in our centers.
Prospective data of patients were retrospectively analyzed. Data analysis was
done using Statistical package for Social Science (SPSS 25.0.1 for windows;
SPSS Inc, Chicago, IL, 2001). Kolmogorov–Smirnov’s test was used to evaluate
normal distribution of continuous data, Quantitative non-parametric variables
were expressed as mean and SD, Median and Interquartile range (IQR)
according to the distribution of data. Qualitative variables were expressed as
frequencies and percent. Survival rates were estimated and graphed using the
Kaplan-Meier method.
Results: Twenty four case (45.3%) were males, 29 (54.7 %) were females. Ten
cases (18.9%) were synchronous and 43 case (81.1%) were metachronous.
Commonest site of first tumor was breast (32.1%) followed by kidney and
prostate each represented 7.5%. Most common site of second malignant tumor
was colon (17%) of cases followed by lung (11.3%). Breast cancer cases
represents the most common malignant tumor in19 case (35.8%) where in 17
case (32.1%) was the primary malignancy and in 2 cases was the second
malignancy. Most common second diagnoses with breast was thyroid (4 cases)
followed by colon (3 cases). Median overall survival from first diagnosis was 41
months and 12 months from the second diagnosis.
Conclusion: Diagnosis of malignancy increases risk of second malignancies
due to multiple etiologic factors. Proper follow up of cancer patients enables
early diagnosis of second malignancy, improves cure rate and survival.
Meticulous reporting of data of double primaries could identify screening
strategies for patients at high risk.