448 A retrospective study of dual malignancies in a gynecological oncology department of a tertiary care hospital -a ten year experience

Objectives Occurrence of second invasive cancer in a diagnosed case of cancer patient and also in cancer survivors is not uncommon. Advances have been made in diagnostic and therapeutic modalities, leading to improvement in survival of cancer patients, and also, the incidence of second malignancy is on rise.Second malignancy can be synchronous or metachronous. Original studies about dual malignancy are very few. The present study aims to analyze the frequency and types of double malignancies in Gynaec oncology patient. Methods This is a retrospective analysis of patients with synchronous dual cancers, treated from January 2009 to December 2018. The study included 12 patients with dual malignancies. Results Out of 12 patients, 4 (33.3%) were of ovarian and endometrium origin and they were the most common in our study, followed by breast and endometrium (16.6%) ; breast and vulva (16.6%);breast and ovary (16.6%) ; cancer breast with cancer cervix and cancer endometrium with colon cancer were least common (8.3%). Double malignancies involving the female reproductive tract, like cervix and vulva,can be explained by common etiological factors like Human papilloma virus (HPV). The same association has not been seen in our series which could be explained on the basis of small number of patients reported here. Conclusions This study puts a light on the fact that oncologists should remain cognizant of the fact that dual cancer of the female genital tract and elsewhere in the body is not an unknown occurrence and a comprehensive workup is desirable at the time of initial presentation.