Clinicopathologic features of metachronous or synchronous gastric cancer patients with three or more primary sites.
OBJECTIVE
We investigated the clinicopathologic information of patients with gastric cancer with multiple primary cancers (GC-MPC) of three or more sites.


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).


CONCLUSIONS
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.
Yonsei Cancer Center, Yonsei Cancer Research Institute, Seoul, Korea.
Joo Hoon
JH
Kim
Sun Young
SY
Rha
Chan
C
Kim
Gun Min
GM
Kim
Sang Hyun
SH
Yoon
Ki Hyang
KH
Kim
Min Jae
MJ
Kim
Joong Bae
JB
Ahn
Hyun Cheol
HC
Chung
Jae Kyung
JK
Roh
Hyo Song
HS
Kim
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