Journal of Gastric Cancer

The Korean Gastric Cancer Association (대한위암학회)
권호 표지

The Clinicopathologic Features of Synchronous and Metachronous Cancer in Patients with Gastric Cancer

위암 환자에 발생한 동시성과 이시성암의 임상병리학적 특성

  • 유영선 (조선대학교 의과대학 외과학교실) ;
  • 최은서 (웰스유외과) ;
  • 김성수 (조선대학교 의과대학 외과학교실) ;
  • 민영돈 (조선대학교 의과대학 외과학교실)
  • Received : 2009.08.10
  • Accepted : 2009.12.11
  • Published : 2009.12.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: With the development of diagnostic techniques, second primary neoplasms such as synchronous or metachronous cancers in gastric cancer patients are being increasingly found. In this study, we investigated the clinicopathological features and clinical significance of gastric neoplasms combined with synchronous and metachronous cancers. Materials and Methods: 1,048 patients who were diagnosed with gastric cancer in Chosun University Hospital from January 1998 to March 2008 were retrospectively reviewed. Results: 38 of the 1,048 patients with gastric cancer (3.6%) had synchronous and metachronous cancers. Of the 38 patients, 16 patients (42.1%) had synchronous cancer and 22 patients (57.9%) had metachronous cancer. The average time interval between gastric cancer and the secondary primary cancer was $27.08{\pm}31.25$ months. The most common second primary neoplasm was lung cancer (8/38, 21.1%), followed by colorectal cancer (8/38, 21.1%). Among the 27 patients who underwent surgical resection for gastric cancer, 5 patients (18.5%) were in the synchronous group and 22 patients (81.5%) were in the metachronous group. The mean survival time of the 38 patients was 49.8 months. The mean survival time was 24.6 months for the synchronous cancer patients and 68.1 month for the metachronous cancer patients. The 3 year survival rate of the synchronous group and the metachronous group was 33.3% and 81.1%, respectively. Conclusion: We must pay attention on the preoperative workup for synchronous cancer and on the postoperative follow-up for metachronous cancer in gastric cancer patients.

목적: 진단 기술의 발전과 함께 위암 환자에서 동시성과 이시성암이 발견되는 빈도가 증가하고 있다. 본 연구에서는 위암에서 발견된 동시성과 이시성암의 임상병리학적 특성과 임상적 의의에 대하여 알아보고자 하였다. 대상 및 방법: 1998년 1월부터 2008년 3월까지 조선대학교병원에서 위암으로 진단된 환자들의 의무기록을 후향적으로 분석하였다. 결과: 1,048명 위암 환자 중 38명(3.6%)에서 동시성과 이시성암이 있었다. 38명 중 16명(42.1%)은 동시성암이었고 22명(57.9%)은 이시성암이었다. 위암과 이차성 원발암 간의 평균 시간간격은 $27.08{\pm}31.25$개월이었다. 가장 흔한 중복암은 폐암(8/38, 21.1%)과 대장암(8/38, 21.1%)이었다. 27명의 환자가 위암에 대하여 수술적 치료를 하였으며 이 중 5명(18.5%)은 동시성암, 22명(81.5%)은 이시성암이었다. 평균 생존 기간은 49.8개월이었으며 동시성암의 경우는 24.6개월 이시성암의 경우는 68.1개월이었고 이들의 3년 생존율은 동시성암, 이시성암 각각 33.3%, 81.1%였다. 결론: 위암에서의 이차성 원발암 진단에 대한 진단에 있어 충분한 수술 전 검사를 통한 동시성암의 발견과 지속적인 추적검사를 통한 이시성암의 발견을 위해 주의를 기울여야 한다.

Keywords

References

  1. 2005 National Health and Nutrition Survey. Ministry of Health & Welfare. Korea Institute for Health and Social Affairs.
  2. Choi JY, Kim BT. Use of 18F-FDG PET/CT in second primary cancer. Nucl Med Mol Imaging 2007;41:185-193.
  3. Yamamoto M, Yamanaka T, BaBa H, Kakeji Y, Maehara Y. The post operative recurrence and the occurrence of second primary carcinomas in patients with early gastric carcinoma. J Surg Oncol 2008;97:231-235. https://doi.org/10.1002/jso.20946
  4. Moertel CG. Multiple primary malignant neoplasms: historical perspectives. Cancer 1977;40:1786-1792. https://doi.org/10.1002/1097-0142(197710)40:4+<1786::AID-CNCR2820400803>3.0.CO;2-2
  5. Warren S, Gates O. Multiple primary malignant tumors. Survey of literature and statistical study. Am J Cancer 1932;15:1358-1414.
  6. Clearly B, Kazarian KK, Mersheimer WL. Multiple primsary cancer. Thirty patients with three or more primary cancers. AM J Surg 1975;129:686-690. https://doi.org/10.1016/0002-9610(75)90346-3
  7. Kato I, Kito T, Nakazato H, Tomigawa S. Second malignancy in stomach cancer patients and its possible risk factor. Jpn J Clin Oncol 1986;16:373-381.
  8. Kinoshita Y, Tsukuma H, Ajiki W, Kinoshita N, Oshima A, Hiratsuka M, Furukawa H. The risk for second primaries in gastric cnacer patients: Adjuvant therapy and habtual smoking and drinking. J Epidemiol 2000;10:300-304. https://doi.org/10.2188/jea.10.300
  9. Lundegardh G, Hanssson LE, Nyrén O, Adami HO, Krusemo UB. The risk if gastrointestinal and other primary malignant disease following gastric cancer. Acta Oncol 1991;30:1-6.
  10. Yoshino K, Asanuma F, Hanatani Y, Otani Y, Kumai K, Ishibiki K. Multiple primary cancers in the stomach and another organ: frequency and the effects on prognosis. Jpn J Clin Oncol 1985;15:183-190.
  11. Ikeguchi M, Ohfuji S, Oka A, Tsujitani S, Maeda M, Kaibara N. Synchronous and metachronous primary malignancies in organs other than the stomach in patients with early gastric cancer. Hepatogastroenterology 1995;42:672-676.
  12. Ryu DD, Um JW, Son GS, Cho MY, Song TJ, Kim CS, Mok YJ, Kim SJ. Multiple primary malignant tumors in patients with gastric cnacer. J Korean Gastric Cancer Assoc 2003;3:139-144. https://doi.org/10.5230/jkgca.2003.3.3.139
  13. Eom BW, Lee HJ, Yoo MW, Cho JJ, Kim WH, Yang HK, Lee KU. Synchronous and metachronous cancers in patients with gastric cancer. J Surg Oncol 2008;98:106-110. https://doi.org/10.1002/jso.21027
  14. Ikeda Y, Saku M, Kawanaka H, Nonaka M, Yoshida K. Feature of second primary cancer in patients with gastric cancer. Oncology 2003;65:113-117. https://doi.org/10.1159/000072335
  15. Kim JP, Lee JH, Kim SJ, Yu HJ, Yang HK. Clinicopathologic characteristics and prognostic factors in 10 783 patients with gastric cancer. Gastric Cancer 1998;1:125-133. https://doi.org/10.1007/s101200050006
  16. Park YK, Kim DY, Joo JK, Kim JC, Koh YS, Ryu SY, Kim YJ, Kim SK. Clinicopathological features of gastric carcinoma patients with other primary carcinomas. Langenbecks Arch Surg 2005;390:300-305. https://doi.org/10.1007/s00423-004-0525-4
  17. Dinis-ribeiro M, Lomba-viana H, Silva R, Moreira-dias L, Lomba-viana R. Associated primary tumors in patients with gastric cancer. J Clin Gastroenterol 2002;34:533-535. https://doi.org/10.1097/00004836-200205000-00010
  18. Lee JH, Bae JS, Ryu KW, Lee JS, Park SR, Kim CG, Kook MC, Choi IJ, Kim YW, Park JG, et al. Gastric cancer patients at high-risk of having synchronous cancer. World J Gastroenterol 2006;12:2588-2592. https://doi.org/10.3748/wjg.v12.i16.2588