Multiple primary malignancies--epidemiological analysis at a single tertiary institution

A literature review on 1,104 269 cancer patients concluded that the prevalence of multiple primary malignancies (MPM) is between 0.73% and 11.7%. MPMs seem to have higher incidence than that influenced by hazard only.

The purpose of this study was to investigate clinically useful information for effective screening for synchronous and metachronous second primary cancers and to identify a potential surveillance protocol.

Using statistical and epidemiological indicators we evaluated the patients with MPMs (double locations) admitted to the Institute of Oncology "Prof. Dr. Ion Chiricuţă", Cluj-Napoca between 2001 and 2004.

Out of the 63 cases, 22 cases (34.9%) were synchronous tumors while 41 cases (65.1%) were metachronous tumors, the occurrence interval ranging from 6.2 to 254 months, with an average of 34.6 months for the entire group. Almost half of the metachronous tumors (20 cases) occurred between 6.2 and 24 months while 14 cases (20%) were detected after a 5-year interval. The most frequent malignant associations were ovary-colon, ovary-breast, breast-breast. Both primary and secondary tumors tended to be in an advanced stage explained by the low compliance of the patients to follow-up.

The possibility that MPMs exist must always be considered during pretreatment evaluation. Screening procedures are especially useful for the early detection of associated tumors, whereas careful monitoring of patients treated for primary cancer and a good communication between patients and medical care team would ensure an early detection for secondary tumors, and, subsequently, an appropriate management.