Gut Liver.
2015 Jan;9(1):59-65. 10.5009/gnl13255.
Endoscopic Resection for Synchronous Esophageal Squamous Cell Carcinoma and Gastric Adenocarcinoma in Early Stage Is a Possible Alternative to Surgery
- Affiliations
-
- 1Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, and Asan Digestive Disease Research Institute, Seoul, Korea. hyjung@amc.seoul.kr
- 2Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, and Asan Digestive Disease Research Institute, Seoul, Korea.
- KMID: 2380783
- DOI: http://doi.org/10.5009/gnl13255
Abstract
- BACKGROUND/AIMS
We investigated the clinical outcomes according to the method of treatment in synchronous esophageal and gastric cancer.
METHODS
Synchronous esophageal squamous cell carcinoma and gastric adenocarcinoma were diagnosed in 79 patients between 1996 and 2010. We divided the patients into four groups according to treatment; Group 1 received surgical resection for both cancers or surgery for gastric cancer with chemoradiotherapy for esophageal cancer (n=27); Group 2 was treated by endoscopic resection with or without additional treatment (n=14); Group 3 received chemoradiotherapy only (n=18); and Group 4 received supportive care only (n=20).
RESULTS
The median survival times in groups 1 and 2 were 86 and 60 months, respectively. The recurrence rate and mortality were 23% and 48%, respectively, in group 1 and 21% and 4%, respectively, in group 2. The median survival time was 12 months in group 3 and 9 months in group 4. Multivariate analysis showed that age (p<0.001) and treatment group (p=0.019) were significantly associated with death. Compared with group 1, treatment in the intensive care unit (p=0.003), loss of body weight (p=0.042), and decrease in hemoglobin (p=0.033) were worse in group 1.
CONCLUSIONS
Endoscopic resection for synchronous esophageal and gastric cancer could be considered as a possible alternative to surgery for early-stage cancer.
Keyword
MeSH Terms
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Adenocarcinoma/mortality/*surgery/therapy
Aged
Carcinoma, Squamous Cell/mortality/*surgery/therapy
Combined Modality Therapy
Endoscopy, Gastrointestinal/*methods
Esophageal Neoplasms/mortality/*surgery/therapy
Female
Humans
Male
Middle Aged
Neoplasms, Multiple Primary/mortality/*surgery/therapy
Nutritional Status
Risk Factors
Stomach Neoplasms/mortality/*surgery/therapy
Survival Analysis
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