Strategy and early results of treatment of advanced cervical cancer patients with synchronous cancers observed in PET-CT imaging
Abstract
Objectives: The aim of this study was to present strategy and early results of treatment of advanced cervical cancer patients with synchronous cancers observed in PET-CT imaging, treated at the Greater Poland Cancer Center.
Material and methods: The study included a group of 200 patients with diagnosed stage IIB-IIIB cervical cancer who received PET-CT for the purpose of radiotherapy treatment planning.
Results: Among our study group, four patients (2%) were found to have a synchronous cancer. Two of the cases were diagnosed as breast cancer. However, cancers diagnosed in the other two patients were head and neck malignancies — hypopharyngeal and laryngeal cancer. The choice of an optimal therapeutic approach requires taking into account characteristics of particular malignancies, their stage and histopathology. The whole therapy included radiotherapy of cervical cancer with various combinations of systemic treatment, radiotherapy or surgery of synchronous cancer. According to treatment results, patients diagnosed with breast cancer and hypopharyngeal cancer achieved complete remission of both primary and secondary tumour. Patient diagnosed with laryngeal malignancy, despite achieving complete remission of cervical cancer, finished radiotherapy of the synchronous cancer at a palliative dose.
Conclusions: The growing availability of PET-CT and other imaging methods in cancer diagnosis will increase the number of diagnosed synchronous cancers. Second primary cancers are often detected at an early stage, where radical treatment can be performed for both primary and secondary tumour. However, treatment of such complicated clinical cases as synchronous cancers should be carried out by multidisciplinary teams.
Keywords: cervical cancersynchronous cancersecond primary cancerPET-CT
References
- Howe HL (ed). A Review of the Definition for Multiple Primary Cancers in the United States. Workshop Proceedings From December 4–6, 2002, in Princeton, New Jersey.
- Jensen OM, Parkin DM. Cancer Registration: Principles and Methods. International Agency for Research on Cancer, Lyon 1991: 78–81.
- Wojciechowska U, Didkowska J. Zachorowania i zgony na nowotwory złośliwe w Polsce. Krajowy Rejestr Nowotworów, Centrum Onkologii – Instytut im. Marii Skłodowskiej-Curie. http://onkologia org pl/raporty/ (2016.08.01).
- Coyte A, Morrison DS, McLoone P. Second primary cancer risk – the impact of applying different definitions of multiple primaries: results from a retrospective population-based cancer registry study. BMC Cancer. 2014; 14: 272.
- Ishimori T, Patel PV, Wahl RL. Detection of unexpected additional primary malignancies with PET/CT. J Nucl Med. 2005; 46(5): 752–757.
- Tong SY, Lee YS, Park JS, et al. Clinical analysis of synchronous primary neoplasms of the female reproductive tract. Eur J Obstet Gynecol Reprod Biol. 2008; 136(1): 78–82.
- Takeda T, Sagae S, Koizumi M, et al. Multiple primary malignancies in patients with gynecologic cancer. Int J Gynecol Cancer. 1995; 5(1): 34–39.
- Eser S, Gulhan I, Özdemir R, et al. Synchronous primary cancers of the female reproductive tract in Turkish women. Asian Pac J Cancer Prev. 2011; 12(4): 857–859.
- Babacan NA, Aksoy S, Cetin B, et al. Multiple primary malignant neoplasms: multi-center results from Turkey. J BUON. 2012; 17(4): 770–775.
- Kornafel J, Mądry R. Nowotwory kobiecego układu płciowego. In: Krzakowski M, Warzocha K. ed. Zalecenia postępowania diagnostyczno-terapeutycznego w nowotworach złośliwych. Via Medica, Gdańsk 2013: 265–317.
- Jassem J, Krzakowski M. Rak piersi. In: Krzakowski M, Warzocha K. ed. Zalecenia postępowania diagnostyczno-terapeutycznego w nowotworach złośliwych. Via Medica, Gdańsk 2013: 211–264.
- Kawecki A, Nawrocki S. Nowotwory nabłonkowe narządów głowy i szyi. In: Krzakowski M, Warzocha K. ed. Zalecenia postępowania diagnostyczno-terapeutycznego w nowotworach złośliwych. Via Medica, Gdańsk 2013: 1–32.
- Kleinerman RA, Kosary C, Hildesheim A. New Malignancies Following Cancer of the Cervix Uteri, Vagina, and Vulva. In: Curtis RE, Freedman DM, Ron E, Ries LAG, Hacker DG, Edwards BK, Tucker MA, Fraumeni JF Jr. (eds). New Malignancies Among Cancer Survivors: SEER Cancer Registries, 1973-2000. National Cancer Institute, NIH Publ. No. 05-5302. Bethesda, MD, 2006, 207-229.
- Lin AY, Lu T, Gomez SL. Synchronous cancers: An analysis of SEER registry from 1973 to 2003. J Clin Oncol. 2010; 28(15_suppl): e12018–e12018.
- Agrawal R. Synchronous dual malignancy: successfully treated cases. J Cancer Res Ther. 2007; 3(3): 153–156.
- Kuncman Ł, Danielska J, Kuncman W, et al. [Synchronous occurrence of four malignancies in a 55-year-old woman with uterine cervical cancer. Case report and review of literature]. Ginekol Pol. 2016; 87(4): 314–317.
- Świątoniowski G, Brużewicz S, Kłaniewski T. Radical treatment of patient with three independent malignancies. Onkol Prakt Klin. 2008; 4: 107–109.
- Atasever M, Yilmaz B, Dilek G, et al. Synchronous primary carcinoma in 5 different organs of a female genital tract: an unusual case and review of the literature. Int J Gynecol Cancer. 2009; 19(4): 802–807.
