title: Synchronous and metachronous neoplasms in gastric cancer patients: a 23-year study.
abstract: OBJECTIVE
  To determine the prevalence and characteristics of additional primary malignancies in gastric cancer (GC) patients.
  
  
  METHODS
  GC patients (862 total; 570 men, 292 women; mean age 59.8 ± 12.8 years) diagnosed at the Department of Gastroenterology at Pomeranian Medical University over a period of 23 years were included in this retrospective analysis of a prospectively maintained database. Mean follow-up time was 31.3 ± 38.6 mo (range 1-241 mo). The following clinicopathological features of patients with synchronous tumors were compared to those with metachronous tumors: age, sex, symptom duration, family history of cancer, tumor site, stage (early vs advanced), histology, and blood group. GC patients with and without a second tumor were compared in terms of the same clinicopathological features.
  
  
  RESULTS
  Of 862 GC patients, 58 (6.7%) developed a total of 62 multiple primary tumors, of which 39 (63%) were metachronous and 23 (37%) synchronous. Four (6.9%) of the 58 multiple GC patients developed two or more neoplasms. The predominant tumor type of the secondary neoplasms was colorectal (n = 17), followed by lung (n = 9), breast (n = 8), and prostate (n = 7). Age was the only clinicopathological feature that differed between GC patients with synchronous vs metachronous malignancies; GC patients with synchronous neoplasms were older than those with metachronous neoplasms (68.0 ± 10.3 years vs 59.9 ± 11.1 years, respectively, P = 0.008). Comparisons between patients with and without a second primary cancer revealed that the only statistically significant differences were in age and blood group. The mean age of the patients with multiple GC was higher than that of those without a second primary tumor (63.4 ± 11.4 years vs 59.5 ± 13.0 years, respectively, P = 0.026). GC patients with a second primary tumor were more commonly blood group O than those without (56.2% vs 31.6%, respectively, P = 0.002).
  
  
  CONCLUSIONS
  GC patients may develop other primary cancers; appropriate preoperative and postoperative diagnostic modalities are thus required, particularly if patients are older and blood group O.
authors: Małgorzata Ławniczak, Alicja Gawin, Halina Jaroszewicz-Heigelmann, Wiesława Rogoza-Mateja, Andrzej Białek, Teresa Starzyńska, Department of Gastroenterology, Pomeranian Medical University, 71-252 Szczecin, Poland.
authors: Małgorzata
authors: M
authors: Ławniczak
authors: Małgorzata Ławniczak, Alicja Gawin, Halina Jaroszewicz-Heigelmann, Wiesława Rogoza-Mateja, Andrzej Białek, Teresa Starzyńska, Department of Gastroenterology, Pomeranian Medical University, 71-252 Szczecin, Poland.
authors: Alicja
authors: A
authors: Gawin
authors: Małgorzata Ławniczak, Alicja Gawin, Halina Jaroszewicz-Heigelmann, Wiesława Rogoza-Mateja, Andrzej Białek, Teresa Starzyńska, Department of Gastroenterology, Pomeranian Medical University, 71-252 Szczecin, Poland.
authors: Halina
authors: H
authors: Jaroszewicz-Heigelmann
authors: Małgorzata Ławniczak, Alicja Gawin, Halina Jaroszewicz-Heigelmann, Wiesława Rogoza-Mateja, Andrzej Białek, Teresa Starzyńska, Department of Gastroenterology, Pomeranian Medical University, 71-252 Szczecin, Poland.
authors: Wiesława
authors: W
authors: Rogoza-Mateja
authors: Małgorzata Ławniczak, Alicja Gawin, Halina Jaroszewicz-Heigelmann, Wiesława Rogoza-Mateja, Andrzej Białek, Teresa Starzyńska, Department of Gastroenterology, Pomeranian Medical University, 71-252 Szczecin, Poland.
authors: Joanna
authors: J
authors: Raszeja-Wyszomirska
authors: Małgorzata Ławniczak, Alicja Gawin, Halina Jaroszewicz-Heigelmann, Wiesława Rogoza-Mateja, Andrzej Białek, Teresa Starzyńska, Department of Gastroenterology, Pomeranian Medical University, 71-252 Szczecin, Poland.
authors: Andrzej
authors: A
authors: Białek
authors: Małgorzata Ławniczak, Alicja Gawin, Halina Jaroszewicz-Heigelmann, Wiesława Rogoza-Mateja, Andrzej Białek, Teresa Starzyńska, Department of Gastroenterology, Pomeranian Medical University, 71-252 Szczecin, Poland.
authors: Katarzyna
authors: K
authors: Karpińska-Kaczmarczyk
authors: Małgorzata Ławniczak, Alicja Gawin, Halina Jaroszewicz-Heigelmann, Wiesława Rogoza-Mateja, Andrzej Białek, Teresa Starzyńska, Department of Gastroenterology, Pomeranian Medical University, 71-252 Szczecin, Poland.
authors: Teresa
authors: T
authors: Starzyńska
mesh_terms: D000017:ABO Blood-Group System; D000367:Age Factors; D000368:Aged; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary; D016609:Neoplasms, Second Primary; D011044:Poland / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000097:blood / Q000453:epidemiology / Q000473:pathology*; D013997:Time Factors
chemical_list: D000017:ABO Blood-Group System
keywords: Blood groups; Gastric cancer; Metachronous; Multiple primary cancers; Synchronous