Second Primary Neoplasms: A Clinico-Pathological Analysis from a Sub Himalayan Cancer Centre in India

Background: There is a lifetime risk of developing another de novo malignancy in diagnosed cancer patients. Detection of new primary has increased due to advances in both diagnostic and treatment modalities. This article aims to analyze the pattern of presentation of second primary neoplasm and to review the relevant literature. Materials and Methods: We analyzed patients presenting with histologically proven synchronous or metachronous second primaries from July 2011 to July 2016. Warren and Gate's criteria have been used to designate a case as second primary neoplasm. Various details such as age at diagnosis, sex, whether synchronous or metachronous, site, stage, histopathology, treatment were collected. Results: Over a period of 5 years total 40 cases were observed, out of which 13 were synchronous (33%) and 27 (67%) were metachronous. The median age at the diagnosis of primary malignancy was 65.5 years (range 27-84). Out of the 40 patients, 28 (70%) were males and 12 (30%) were females. The most common site of primary tumor was head and neck and genito-urinary, 11 cases each. Among the second malignancy most common site was gastrointestinal tract (11 cases), followed by genitourinary (10 cases) and lung (9 cases). Conclusion: The likelihood of diagnosis of second malignancy has increased with the advent of newer diagnostic modalities as well as increased compliance to follow up and progress in the management. Appearance of new signs and symptoms should raise a suspicion and early detection of the disease leads to appropriate management.