Clinical characteristics and prognostic outcomes of gynaecological multiple primary malignant neoplasms

Objective: To investigate the clinical characteristics and the prognostic outcomes of patients with gynaecological multiple primary malignant neoplasms (MPMN). Materials and methods: For a period of ten years, from January 2008 to December 2018, patients with gynaecological MPMN were enrolled for this study. The clinical characteristics and survival outcomes were collected and analyzed. Results: A total of 126 patients with gynaecological MPMN were included, comprising 15 synchronous MPMN and 111 metachronous MPMN. The average age of the patients with gynaecological MPMN was 57.6 ±$\pm$ 10.8 years, and the probability of overall survival (OS) at 1, 2, 3, and 5 years was 88.6%, 82.6%, 76.9% and 68.7%, respectively. The OS of patients with gynaecological cancer as the first neoplasm was worse than those with non-gynaecological cancer as the first neoplasm (HR: 2.2, P = 0.049); the OS of patients accompanied by breast cancer was better than those accompanied by other cancers (HR: 0.346, P = 0.033). Univariate regression analysis showed that “age”, “FIGO stage” and “gynaecological cancer as the first neoplasm” were the factors for poor survival; “Accompanied by breast cancer” and “surgery for first or second neoplasm” were the factors for favourable survival. Conclusions: “Gynaecological cancer as the first neoplasm” is a factor for poor survival in patients with gynaecological MPMN, and “FIGO stage” is the independent risk factor (HR: 2.339, P = 0.001). “Accompanied by breast cancer” and “surgery for the neoplasm” are factors for favourable survival. Mostly, “surgery for the second neoplasm” was the independent protective factor (HR: 0.212, P = 0.005) for gynaecological MPMN.

Gynaecological cancer; Multiple primary malignant neoplasms (MPMN); Breast cancer

[1] Gursel B, Meydan D, Özbek N, Ozdemir O, Odabas E. Multiple primary malignant neoplasms from the black sea region of Turkey. Journal of International Medical Research. 2011; 39: 667–674.

[2] Etiz D, Metcalfe E, Akcay M. Multiple primary malignant neoplasms: a 10-year experience at a single institution from Turkey. Journal of Cancer Research and Therapeutics. 2017; 13: 16–20.

[3] Xu LL, Gu KS. Clinical retrospective analysis of cases with multiple primary malignant neoplasms. Genetics and Molecular Research. 2014; 13: 9271–9284.

[4] Mukaiyama Y, Suzuki M, Morikawa T, Mori Y, Takeshima Y, Fujimura T, et al. Multiple primary malignant neoplasms of the glottis, renal pelvis, urinary bladder, oral floor, prostate, and esophagus in a Japanese male patient: a case report. World Journal of Surgical Oncology. 2014; 12: 294.

[5] Sawaya GF, Smith-McCune K, Kuppermann M. Cervical cancer screening: more choices in 2019. Journal of the American Medical Association. 2019; 321: 2018–2019.

[6] Lheureux S, Braunstein M, Oza AM. Epithelial ovarian cancer: evolution of management in the era of precision medicine. CA: A Cancer Journal for Clinicians. 2019; 9: 280–304.

[7] Njoku K, Chiasserini D, Whetton AD, Crosbie EJ. Proteomic biomarkers for the detection of endometrial cancer. Cancers. 2019; 11: E1572.

[8] PDQ Cancer Genetics Editorial Board. Genetics of Breast and Gynecologic Cancers (PDQ®): health professional version. 2021. In PDQ Cancer Information Summaries. Bethesda (MD): National Cancer Institute (US). 2002.

[9] Shi L, Zhou S, Jiang Y, Wan Y, Ma J, Fu S, et al. Gynecological malignant tumor related multiple primary malignant neoplasms: clinical analysis of 30 cases. Zhonghua Fu Chan Ke Za Zhi. 2014; 49: 199–203. (In Chinese)

[10] Babacan NA, Aksoy S, Cetin B, Ozdemir NY, Benekli M, Uyeturk U, et al. Multiple primary malignant neoplasms: multi-center results from Turkey. Journal of the Balkan Union of Oncology. 2012; 17: 770–775.

[11] Gursel B, Meydan D, Özbek N, Ozdemir O, Odabas E. Multiple primary malignant neoplasms from the black sea region of Turkey. The Journal of International Medical Research. 2011; 39: 667– 674.

[12] Dragoumis K, Zafrakas M, Venizelos I, Kellartzis D, Mikos T, Assimakopoulos E, et al. Synchronous primary neoplasms of the uterine corpus and the ovary: a case report. European Journal of Gynaecological Oncology. 2004; 25: 752–754.

[13] Tiwari AK, Roy HK, Lynch HT. Lynch syndrome in the 21st century: clinical perspectives. Monthly Journal of the Association of Physicians. 2016; 109: 151–158.

[14] Lynch HT, Snyder CL, Shaw TG, Heinen CD, Hitchins MP. Milestones of Lynch syndrome: 1895–2015. Nature Reviews Cancer. 2015; 15: 181–194.

[15] Simpkins F, Zahurak M, Armstrong D, Grumbine F, Bristow R. Ovarian malignancy in breast cancer patients with an adnexal mass. Obstetrics and Gynecology. 2005; 105: 507–513.

[16] Boussios S, Mikropoulos C, Samartzis E, Karihtala P, Moschetta M, Sheriff M, et al. Wise management of ovarian cancer: on the cutting edge. Journal of Personalized Medicine. 2020; 10: 41.

[17] Slade D. PARP and PARG inhibitors in cancer treatment. Genes & Development. 2020; 34: 360–394.

[18] Aydiner A, Karadeniz A, Uygun K, Tas S, Tas F, Disci R, et al. Multiple primary neoplasms at a single institution. American Journal of Clinical Oncology. 2000; 23: 364–370.

[19] Tichansky DS, Cagir B, Borrazzo E, Topham A, Palazzo J, Weaver EJ, et al. Risk of second cancers in patients with colorectal carcinoids. Diseases of the Colon & Rectum. 2002; 45: 91–97.