Phenomenon of hormone-dependent polyneoplasia of the female reproductive system

Abstract

BACKGROUND: Primary multiplicity of malignant tumors of the female reproductive system is the least studied area of clinical oncology. In addition, the steady rise in the number of patients and various localizations of polyneoplasia with lesions of the female reproductive organs necessitate a detailed study of this problem.

AIM: This study aimed to determine the incidence and risk factors and describe the clinical aspects of polyneoplasia of the female reproductive system for 2010–2021 in women seen at the Medical and Rehabilitation Center of the Ministry of Health of Russia, Moscow, and the University Clinical Hospital No. 4 of the I.M. Sechenov First Moscow State Medical University.

MATERIALS AND METHODS: We conducted a retrospective analysis of the case records of 147 patients with a confirmed diagnosis of polyneoplasia of the female reproductive system for 2010–2021, which accounted for 3.6% of all newly diagnosed neoplasms of the female reproductive system in the above medical institutions. Moreover, a continuous sampling method was used.

RESULTS: Breast cancer was the most frequent first tumor, combined with cancer of the contralateral breast in 27 (42.1%) patients, cancer of the uterine body in 4 (6.25%) patients, ovarian cancer in 4 (6.25%) patients, colon cancer in 4 (6.25%) patients, and thyroid cancer in 1 (1.5%) patient. Cancer of the uterine body was combined with breast cancer in 10 (35.7%) patients, ovarian cancer in 2 (7.1%) patients, thyroid cancer in 2 (7.1%) patients, and colon cancer in 3 (11.1%) patients. Endometrioid adenocarcinoma, pathogenic variant I was determined in 20 (71.4%) cases according to the histological structure. Thyroid cancer was detected in 7 (5.6%) cases; in all cases, it developed metachronously, and it was combined as the initial tumor with breast cancer in 1 (14.3%) case, uterine body cancer in 2 (28.5%) cases, and ovarian cancer in 1 (14.3%) case. As the second tumor, it was also combined with uterine body cancer in 2 (28.5%) cases and ovarian cancer in 1 (14.3%) case. The risk factors assessment led to the identification of several factors that are common in patients with hormone-dependent forms of primary multiple cancer, including obesity, diabetes mellitus, irregular menstrual cycle, history of proliferative diseases of the mammary glands, intake of thyroid drugs, uterine hyperplastic processes, and hypothyroidism.

CONCLUSIONS: Understanding the different aspects of the development and course of hormone-dependent polyneoplasia of the female reproductive system will help in developing approaches for follow-up monitoring of women who have been treated for a primary tumor and are at risk of developing a subsequent tumor of hormone-dependent organs, to prevent the recurrence of the disease and predict the subsequent tumor and ensure its timely detection.

Keywords

primary multiple cancer / mammary cancer / endometrial cancer / ovarian cancer / thyroid cancer / hormone-dependent polyneoplasia

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