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Multiple primary gynecologic neoplasms.

P G Rose, E E Herterick, J G Boutselis

    American Journal of Obstetrics and Gynecology
    |August 1, 1987
    PubMed
    Summary
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    Some patients develop multiple gynecologic cancers. This study found a higher incidence of lower genital tract cancers occurring together, supporting a multicentric origin theory.

    Area of Science:

    • Gynecologic Oncology
    • Cancer Epidemiology
    • Tumor Biology

    Background:

    • Patients can develop more than one gynecologic neoplasm.
    • Understanding the risk and patterns of multiple gynecologic tumors is crucial for patient management.
    • The concept of multicentricity suggests a common origin for certain gynecologic cancers.

    Purpose of the Study:

    • To evaluate the incidence of synchronous or metachronous gynecologic neoplasms.
    • To investigate the theory of multicentric cancer of the lower genital tract.
    • To assess the association between prior radiation therapy and the development of second gynecologic malignancies.

    Main Methods:

    • Analysis of 130 cases of multiple gynecologic tumors from 5967 patients.
    • Data collected from The Ohio State University Gynecologic Tumor Registry (1939-1983).

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  • Calculation of expected second malignancy incidences using the person-years method based on primary tumor site and invasiveness.

    • Main Results:

    • A second malignancy of the lower genital tract was observed in 1.6% of cervical, 4.3% of vulvar, and 9.6% of vaginal cancer patients.
    • These findings support the theory of multicentric cancer development in the lower genital tract.
    • Prior radiation therapy showed a low association with increased second gynecologic malignancies (4.9%).
    • Four patients were identified as having three distinct gynecologic tumors.

    Conclusions:

    • The study supports the theory of multicentricity for cancers of the lower genital tract.
    • The risk of developing a second gynecologic malignancy varies by primary tumor site.
    • Radiation therapy appears to have a limited role in the development of subsequent gynecologic malignancies.