Outcomes of gastric adenocarcinoma after treatment of esophageal squamous carcinoma.
OBJECTIVE
We reviewed the clinical outcome of metachronous gastric adenocarcinoma according to the endoscopic interval after curative treatment of squamous esophageal carcinoma by endoscopic resection or surgical resection.


METHODS
Eighteen cases with gastric adenocarcinoma after treatment of esophageal carcinoma at Asan Medical Center between March 1994 and March 2010 were analyzed retrospectively.


RESULTS
Median interval between treatment of esophageal cancer and detection of metachronous gastric cancer was 44 months (interquartile range [IQR]=25.5-77.8 months), and median endoscopic interval before finding gastric cancer was 15 months (IQR=12.0-44.8 months). In cases with 12 resectable gastric cancers, the median interval of previous endoscopy before gastric cancer was shorter than that for 6 unresectable cancers (12.0 months, IQR=12-16 months vs. 59.5 months, IQR=37.5-68.5 months, p<0.001) and the rate of death was lower (16.7% [2/12] vs. 83.3% [5/6], p=0.006). Logistic regression showed that a shorter duration of endoscopic interval increased the rate of resectability of gastric cancer (p<0.001) and a higher rate of unresectable gastric cancer and longer duration of endoscopic interval increased death (p=0.029 and p=0.004, respectively).


CONCLUSIONS
After treatment of esophageal cancer, endoscopic examination at 12-month intervals is important to lower the rate of death due to metachronous gastric cancer.
Department of Gastroenterology, University of Ulsan College of Medicine, Seoul, Korea.
Ji Yong
JY
Ahn
Hwoon-Yong
HY
Jung
Ji Young
JY
Choi
Mi-Young
MY
Kim
Jeong Hoon
JH
Lee
Kwi-Sook
KS
Choi
Do Hoon
DH
Kim
Kee Don
KD
Choi
Ho June
HJ
Song
Gin-Hyung
GH
Lee
Jin-Ho
JH
Kim
Seungbong
S
Han
D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000473:pathology*; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery; D013997:Time Factors