title: Clinicopathologic characteristics and prognoses of gastric cancer in patients with a positive familial history of cancer.
abstract: BACKGROUND
  There is a significant association between a positive family history of cancer and gastric cancer risk; however, the clinicopathologic characteristics and prognoses of gastric cancer patients with a positive family history of cancer are not clear.
  
  
  OBJECTIVE
  To define the clinicopathologic characteristics and prognoses of gastric cancer patients with a positive family history of cancer.
  
  
  METHODS
  We reviewed 548 patients with pathologically confirmed primary gastric cancer who had undergone a gastrectomy between 1990 and 1996. The average age was 59.7 years, and the male-to-female ratio was 1.7. The familial cancer histories of these patients were reviewed, and the various clinicopathologic characteristics of those patients with a positive family history of cancer were compared with those with a negative history.
  
  
  RESULTS
  Among this cohort, 74 (13.5%) patients had a positive family history of cancer in their primary or secondary relatives. The most common cancer was gastric cancer in 29 patients, followed by colorectal cancer in 10 and lung cancer in 7. Patients with a positive family history of cancer were associated with bigger tumors, and more patients received a total gastrectomy than did patients with a negative family history. Immunopathologic study disclosed a higher rate of p53 overexpression but not of neu or c-met in patients with a positive family history of cancer. There were no differences in the mean age, gender, site, depth of invasion, or TNM stage. The survival curve of patients with a positive family history of malignancy was similar to that of patients without a family cancer history.
  
  
  CONCLUSIONS
  Patients with gastric cancer with a positive family history of cancer appeared to have bigger tumors with a higher rate of p53 overexpression, and more patients required a total gastrectomy compared with those with a negative family history. This study suggests a genetic component in the aggressiveness of gastric cancer and indicates that higher caution should be exercised with people who have a positive family history of cancer.
authors.affiliation: Department of Surgery, En-Chu Kong Hospital and the Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan, ROC.
authors.forename: Wei-Jei
authors.initials: WJ
authors.lastname: Lee
authors.forename: Rey-Long
authors.initials: RL
authors.lastname: Hong
authors.forename: I-Ru
authors.initials: IR
authors.lastname: Lai
authors.forename: Chaung-Nien
authors.initials: CN
authors.lastname: Chen
authors.forename: Po-Huang
authors.initials: PH
authors.lastname: Lee
authors.forename: Ming-Tegh
authors.initials: MT
authors.lastname: Huang
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000235:genetics* / Q000378:metabolism / Q000401:mortality / Q000473:pathology