title: Clinical presentation, endoscopic features, treatment and prognosis of synchronous upper gastrointestinal malignancies.
abstract: OBJECTIVE
  To study the clinical presentation, endoscopic features and prognosis of patients with synchronous upper gastrointestinal (GI) cancers.
  
  
  METHODS
  A prospective database review of consecutive patients with synchronous upper GI malignancies was performed in a tertiary university hospital endoscopy unit. Gender, age, symptoms and cancer sites, endoscopic and pathological findings, as well as the long-term survival of these patients were analyzed.
  
  
  RESULTS
  A total of 64 patients with a median age of 56 years were included, in which 81.3% were male, 71.9% presented with notable features, 68.8% had familial history of cancer, 56.3% of gastric cancers were at the gastric body, 92.9% of the duodenal malignancies at the duodenal bulb, all esophageal cancers at the middle and lower part of esophagus and a significant proportion of tumors in the synchronous malignancies group were poorly differentiated. In all patients, 20 underwent curative surgical treatment and the 5-year survival rate was only 20%.
  
  
  CONCLUSIONS
  Patients with synchronous upper GI cancers are mainly male and present with different anatomic distribution and endoscopic features. They carry a poor prognosis as compared with single primary cancer patients. This case series describes the clinical profiles and emphasizes the necessity of a thorough examination for additional cancers before treatment of upper GI cancer.
authors.affiliation: Digestive Endoscopy Center, Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Bai
authors.forename: Duo Wu
authors.initials: DW
authors.lastname: Zou
authors.forename: Zhao Shen
authors.initials: ZS
authors.lastname: Li
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000628:therapy; D002288:Adenocarcinoma, Mucinous / Q000401:mortality / Q000473:pathology / Q000628:therapy; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D016208:Databases, Factual / Q000706:statistics & numerical data; D004379:Duodenal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy; D016145:Endoscopy, Digestive System; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy; D006801:Humans; D008223:Lymphoma / Q000401:mortality / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000401:mortality / Q000473:pathology / Q000628:therapy; D018307:Neoplasms, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000628:therapy; D011379:Prognosis; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy; D055815:Young Adult