40 Multiple primary malignancies involving gynaecological tract: a review from tertiary cancer institute of North East India

• Published in: International journal of gynecological cancer Vol. 33; no. Suppl 3; p. A215
• Main Authors: Eshwarya, Jessy Kaur, Barmon, Debabrata, Baruah, Upasana, Begum, Dimpy
• Format: Journal Article
• Language: English
• Published: Oxford BMJ Publishing Group LTD 01.09.2023
• Subjects: Cervical cancer; Cervix; Endometrium; Gynecology; Ovaries
• ISSN: 1048-891X; 1525-1438
• DOI: 10.1136/ijgc-2023-ESGO.445

Introduction/BackgroundPatients with pre-existing cancer have higher than usual risk of developing second malignancy, and multiple primary malignancies (MPMs) are expected to increase with the increasing cancer survivors.MethodologyHospital based, retrospective cohort study, approved by institutional ethics board. Conducted at Dr B Borooah Cancer Institute, Guwahati, from January 2017 to December 2021. Aim of study was to investigate clinico-pathological factors of MPMpatients attending Gynaecologic Oncology OPD at our institute.Patients with multiple primary malignancies involving at least one gynaecological site were included. Those with ambiguous origin, incomplete treatment. and lost to follow up were excluded.Abstract #40 Figure 1Distribution of second primary malignancies after Cervix as first primary. All patients have received prior Chemoradiation[Figure omitted. See PDF]ResultsTotal 57 patients were included, however 8 patients were excluded with ambiguous primary sites and suspicion of metastasis. Incidence of metachronous, and synchronous malignancies was 59.18% (n=29) and 40.81% (n=20), respectively. Median onset age of first primary was 47 years (range: 23–74) as compared to 52 years (range: 30–77) for second primary (SD:9.828, p= <0.001).Cervix was most common site (26.5%, n=13) of first malignancy, followed by Endometrium (20.4%, n=10), while Ovary was more commonly diagnosed second malignancy (38.77%, n=19), followed by Endometrium (14.28%, n=7), with 1 case of triple primary seen as well (figure 1). Observed median time to development of second malignancy was 48 months (Range: 24–336 months). 88.89% Malignancies following Cervical cancer treatment were located within the pelvis (figure 1).Only 6.12% patients presented with a positive family history of malignancy, while common embryonal origin was seen in 24.4% cases. Endometrium and Ovary were most common synchronous malignancies (40%,n=8) observed, with low grade endometroid histology predominating (87.5%).ConclusionOur study highlights the need for protracted follow up Cervical cancer survivours receiving Chemoradiation. High incidence of synchronous tumors warrants a comprehensive evaluation of organs with similar embryonal and hormone receptor status, and these patients constitute the unmet need for genetic testing in LMICs.DisclosuresNone to disclose.