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Clinicopathologic characteristics and survival rate in patients with synchronous or metachronous double primary colorectal and gastric cancer

  • Park, Ji-Hyeon (Department of Surgery, Gil Medical Center, Gachon University College of Medicine) ;
  • Baek, Jeong-Heum (Department of Surgery, Gil Medical Center, Gachon University College of Medicine) ;
  • Yang, Jun-Young (Department of Surgery, Gil Medical Center, Gachon University College of Medicine) ;
  • Lee, Won-Suk (Department of Surgery, Gil Medical Center, Gachon University College of Medicine) ;
  • Lee, Woon-Kee (Department of Surgery, Gil Medical Center, Gachon University College of Medicine)
  • Received : 2018.07.22
  • Accepted : 2018.12.14
  • Published : 2018.12.31

Abstract

Purpose: Double primary colorectal cancer (CRC) and gastric cancer (GC) represent the most common multiple primary malignant tumors (MPMT) in Korea. The recognition and screening of hidden malignancies other than the primary cancer are critical. This study aimed to investigate the clinicopathologic characteristics and survival rates in patients with synchronous or metachronous double primary CRC and GC. Methods: Between January 1994 and May 2018, 11,050 patients were diagnosed with CRC (n=5,454) or GC (n=5,596) at Gil Medical Center. MPMT and metastatic malignant tumors were excluded from this study. A total of 103 patients with double primary CRC and GC were divided into two groups: the synchronous group (n=40) and the metachronous group (n=63). The incidence, clinicopathologic characteristics, and survival rate of the two groups were analyzed. Results: The incidence of synchronous and metachronous double primary CRC and GC was 0.93%. Double primary CRC and GC commonly occurred in male patients aged over 60 years with low comorbidities and minimal previous cancer history. There were significant differences between the synchronous and metachronous groups in terms of age, morbidity, and overall survival. Metachronous group patients were 6 years younger on average (P=0.009), had low comorbidities (P=0.008), and showed a higher 5-year overall survival rate (94.8% and 61.3%, P<0.001) in contrast to synchronous group. Conclusion: When primary cancer (CRC or GC) is detected, it is important to be aware of the possibility of the second primary cancer (GC or CRC) development at that time or during follow-up to achieve early detection and better prognosis.

Keywords

References

  1. Watson TA. Incidence of multiple cancer. Cancer 1953;6:365-71. https://doi.org/10.1002/1097-0142(195303)6:2<365::AID-CNCR2820060221>3.0.CO;2-B
  2. Ha TK, An JY, Youn HG, Noh JH, Sohn TS, Kim S. Surgical outcome of synchronous second primary cancer in patients with gastric cancer. Yonsei Med J 2007;48:981-7. https://doi.org/10.3349/ymj.2007.48.6.981
  3. Moertel CG. Multiple primary malignant neoplasms: historical perspectives. Cancer 1977;40(4 Suppl):1786-92. https://doi.org/10.1002/1097-0142(197710)40:4+<1786::AID-CNCR2820400803>3.0.CO;2-2
  4. Watanabe S, Kodama T, Shimosato Y, Arimoto H, Sugimura T, Suemasu K, et al. Multiple primary cancers in 5,456 autopsy cases in the National Cancer Center of Japan. J Natl Cancer Inst 1984;72:1021-7.
  5. Bae JS, Lee JH, Ryu KW, Kim YW, Bae JM. Characteristics of synchronous cancers in gastric cancer patients. Cancer Res Treat 2006;38:25-9. https://doi.org/10.4143/crt.2006.38.1.25
  6. Kaibara N, Maeta M, Ikeguchi M. Patients with multiple primary gastric cancers tend to develop second primaries in organs other than the stomach. Surg Today 1993;23:186-8. https://doi.org/10.1007/BF00311241
  7. 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;42:672-6.
  8. Lee JH, Bae JS, Ryu KW, Lee JS, Park SR, Kim CG, et al. Gastric cancer patients at high-risk of having synchronous cancer. World J Gastroenterol 2006;12:2588-92. https://doi.org/10.3748/wjg.v12.i16.2588
  9. Ikeda Y, Saku M, Kawanaka H, Nonaka M, Yoshida K. Features of second primary cancer in patients with gastric cancer. Oncology 2003;65:113-7. https://doi.org/10.1159/000072335
  10. 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;34:533-5. https://doi.org/10.1097/00004836-200205000-00010
  11. Cho I, An JY, Kwon IG, Choi YY, Cheong JH, Hyung WJ, et al. Risk factors for double primary malignancies and their clinical implications in patients with sporadic gastric cancer. Eur J Surg Oncol 2014;40:338-44. https://doi.org/10.1016/j.ejso.2013.10.027
  12. Eom BW, Lee HJ, Yoo MW, Cho JJ, Kim WH, Yang HK, et al. Synchronous and metachronous cancers in patients with gastric cancer. J Surg Oncol 2008;98:106-10. https://doi.org/10.1002/jso.21027
  13. Warren S, Gates O. Multiple primary malignant tumors: a survey of the literature and a statistical study. Am J Cancer 1932;16:1358-414.
  14. Yoon SN, Oh ST, Lim SB, Kim TW, Kim JH, Yu CS, et al. Clinicopathologic characteristics of colorectal cancer patients with synchronous and metachronous gastric cancer. World J Surg 2010;34:2168-76. https://doi.org/10.1007/s00268-010-0623-0
  15. Lee WS, Lee JN, Choi S, Jung M, Baek JH, Lee WK. Multiple primary malignancies involving colorectal cancer: clinical characteristics and prognosis with reference to surveillance. Langenbecks Arch Surg 2010;395:359-64. https://doi.org/10.1007/s00423-009-0553-1
  16. Zhang L, Wu Y, Liu F, Fu L, Tong Z. Characteristics and survival of patients with metachronous or synchronous double primary malignancies: breast and thyroid cancer. Oncotarget 2016;7:52450-9.
  17. Yano K, Yamashita T, Chishiki M, Osaki T, Sugio K, Yasumoto K. Two cases of synchronous superficial double cancers in the esophagus and stomach. J UOEH 2002;24:225-32. https://doi.org/10.7888/juoeh.24.225
  18. Onoue S, Katoh T, Chigira H, Matsuo K, Suzuki M, Shibata Y, et al. Synchronous multiple primary cancers of the stomach and duodenum in aged patients: report of two cases. Surg Today 2000;30:735-8. https://doi.org/10.1007/s005950070087
  19. Sato K, Maekawa T, Yabuki K, Tamasaki Y, Maekawa H, Kudo K, et al. A case of triple synchronous cancers occurring in the gallbladder, common bile duct, and pancreas. J Gastroenterol 2003;38:97-100. https://doi.org/10.1007/s005350300014
  20. Lee HJ, Choi MC, Jang JH, Jung SG, Park H, Joo WD, et al. Clinicopathologic characteristics of double primary endometrial and colorectal cancers in a single institution. J Obstet Gynaecol Res 2018;44:944-50. https://doi.org/10.1111/jog.13603
  21. Lim SB, Jeong SY, Choi HS, Sohn DK, Hong CW, Jung KH, et al. Synchronous gastric cancer in primary sporadic colorectal cancer patients in Korea. Int J Colorectal Dis 2008;23:61-5.
  22. Kim HJ, Kim N, Choi YJ, Yoon H, Shin CM, Park YS, et al. Clinicopathologic features of gastric cancer with synchronous and metachronous colorectal cancer in Korea: are microsatellite instability and p53 overexpression useful markers for predicting colorectal cancer in gastric cancer patients? Gastric Cancer 2016;19:798-807. https://doi.org/10.1007/s10120-015-0552-6
  23. Park DI, Park SH, Yoo TW, Kim HS, Yang SK, Byeon JS, et al. The prevalence of colorectal neoplasia in patients with gastric cancer: a Korean Association for the Study of Intestinal Disease (KASID) Study. J Clin Gastroenterol 2010;44:102-5. https://doi.org/10.1097/MCG.0b013e3181a15849
  24. Suzuki A, Koide N, Takeuchi D, Okumura M, Ishizone S, Suga T, et al. Prevalence of synchronous colorectal neoplasms in surgically treated gastric cancer patients and significance of screening colonoscopy. Dig Endosc 2014;26:396-402. https://doi.org/10.1111/den.12156
  25. Kim JH, Rha SY, Kim C, Kim GM, Yoon SH, Kim KH, et al. Clinicopathologic features of metachronous or synchronous gastric cancer patients with three or more primary sites. Cancer Res Treat 2010;42:217-24. https://doi.org/10.4143/crt.2010.42.4.217