Cancer Res Treat.  2010 Dec;42(4):217-224.

Clinicopathologic Features of Metachronous or Synchronous Gastric Cancer Patients with Three or More Primary Sites

• Kim JH
• Rha SY
• Kim C
• Kim GM
• Yoon SH
• Kim KH
• Kim MJ
• Ahn JB
• Chung HC
• Roh JK
• Kim HS

Abstract

PURPOSE
We investigated the clinicopathologic information of patients with gastric cancer with multiple primary cancers (GC-MPC) of three or more sites.
MATERIALS AND METHODS
Between 1995 and 2009, 105,908 patients were diagnosed with malignancy at Severance Hospital, Yonsei University Health System. Of these, 113 (0.1%) patients with MPC of three or more sites were registered, and 41 (36.3%) of these were GC-MPC. We retrospectively reviewed the clinical data and overall survival using the medical records of these 41 GC-MPC patients. We defined synchronous cancers as those occurring within 6 months of the first primary cancer, while metachronous cancers were defined as those occurring more than 6 months later.
RESULTS
Patients with metachronous GC-MPC were more likely to be female (p=0.003) and young than patients with synchronous GC-MPC (p=0.013). The most common cancer sites for metachronous GC-MPC patients were the colorectum, thyroid, lung, kidney and breast, while those for synchronous GC-MPC were the head and neck, esophagus, lung, and kidney. Metachronous GC-MPC demonstrated significantly better overall survival than synchronous GC-MPC, with median overall survival durations of 4.7 and 14.8 years, respectively, and 10-year overall survival rates of 48.2% and 80.7%, respectively (p<0.001).
CONCLUSION
Multiplicity of primary malignancies itself does not seem to indicate a poor prognosis. The early detection of additional primary malignancies will enable proper management with curative intent.

Keyword

Neoplasms; Multiple primary; Stomach neoplasms

MeSH Terms

Breast
Esophagus
Female
Head
Humans
Kidney
Lung
Medical Records
Neck
Prognosis
Retrospective Studies
Stomach Neoplasms
Survival Rate
Thyroid Gland

Figure

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  Fig. 1 Site distribution of gastric cancer with multiple primary cancer (GC-MPC) of whole 41 patients (A) and metachronous/synchronous distribution (B).

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  Fig. 2 Site distribution according to gender differences (A), site distribution of metachronous multiple primary cancers (MPC) (B) and synchronous MPC (C) based on gender differences.

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  Fig. 3 Ten year overall survival difference between synchronous and metachronous gastric cancer with multiple primary cancer (GC-MPC).

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