Metachronous Double Primary Cancer after Diagnosis of Gastric Cancer

Abstract

PurposeThe pattern of double primary cancers after treatment for gastric cancer is important for a patient's survival.Materials and MethodsWe analyzed the clinicopathologic data of 214 gastric cancer patients from October 1996 to November 2007 with regard to metachronous second primary cancers.ResultsOut of 5,778 patients with gastric cancer, metachronous second primary cancers occurred in 214 patients. The median age was 61.8 years, the number of male and female patients was 140 (65.4%), 74 (34.6%), respectively. The median time to the occurrence of second cancers after diagnosis of the first was 39.2 months (standard deviation, 31.2 months). The most common cancer was colorectal cancer, which occurred in 44 patients (20.6%), and lung cancer in 33 patients (15.4%), hepatocellular carcinoma in 26 patients (12.1%), ovarian cancer in 15 patients (7.0%), cervical cancer in 12 patients (7.0%), breast cancer in 11 patients (5.1%), and esophageal cancer in 11 patients (5.1%). The observed/expected (O/E) ratio showed a significant increase in colorectal (1.25), male biliary (1.60), ovarian (8.72), and cervical cancer (3.33) with primary gastric cancer. After five years from diagnosis of gastric cancer, secondary cancer occurred in 50 patients (23.4%), and breast cancer, prostate cancer, laryngeal cancer, lung cancer, and hepatocellular carcinoma were the most frequent.ConclusionThe O/E ratio showed a significant increase in colorectal, male biliary, ovarian, and cervical cancer with primary gastric cancer, and second primary cancer as the main cause of death for these patients. A follow-up examination for metachronous double primary cancer is needed in order to improve the survival time in patients with gastric cancer.

Prediction of metachronous multiple primary cancers following the curative resection of gastric cancer

“…In the present study, of the 3066 GC patients who underwent curative gastrectomy, 70 patients (2.3%) had been diagnosed with a metachronous or synchronous MPC, which is consistent with results of previous reports that reported a range from 2.0 to 7.6% [7-9,11,23]. Few previous studies have reported the incidence and clinical pattern of MPC in GC patients who underwent curative gastrectomy.…”

“…If we extend the duration of follow-up in future study, it will better characterize the predictive factors of MPCs. To date, there are several reports regarding the development of MPCs in GC survivors [7-9,23]. However, these are not sufficient to justify the routine screening for the detection of MPC in all GC survivors; it is also difficult to address the optimal screening protocol.…”

Risk of second primary cancers among patients with a first primary gastric cancer: A population-based study in North Portugal

“…The risk of metachronous SPCs after the diagnosis of gastric cancer has been estimated in previous studies: in Korea, patients who underwent curative resection of gastric cancer were retrospectively reviewed showing a 5-year cumulative incidence of SPC of 1.4% [27], and in Japan, the occurrence of second tumours at least six months following resection of early gastric cancer was estimated at 5.0% after more than 10 years of follow-up [28]. Another study, from Korea, had an incidence of 3.7% with a median time to the occurrence of metachronous SPC six months or more after diagnosis of the gastric FPC of 3.3 years (standard deviation: 2.6 years) [29]. Our overall cumulative incidence of metachronous SPCs more than two months after the FPC was 3.1 and 4.8% at 5-and 10-years, respectively; corresponding estimates using a six month cut-off to define SPCs were 3.3 and 5.4%, respectively.…”

Second primary malignancy risk among patients with gastric cancer: a nationwide population-based study in Taiwan

“…There are a number of reasons for the increased survival of gastric cancer patients, for instance more hygienic strategies for food conservation, increased screening using upper gastrointestinal panendoscopy, better surgical techniques, improved lymph node dissection, and advances in adjuvant chemotherapy and radiotherapy [6]. However, the risk of second primary malignancy (SPM) is of concern because patients with SPMs present lower survival rates than those without [7][8][9]. Several single institutes in Asia have reported that SPMs occur in gastric cancer patients at incidences of 0.9-3.4 % [9][10][11].…”