title: Endoscopic resection for synchronous esophageal squamous cell carcinoma and gastric adenocarcinoma in early stage is a possible alternative to surgery.
abstract: OBJECTIVE
  We investigated the clinical outcomes according to the method of treatment in synchronous esophageal and gastric cancer.
  
  
  METHODS
  Synchronous esophageal squamous cell carcinoma and gastric adenocarcinoma were diagnosed in 79 patients between 1996 and 2010. We divided the patients into four groups according to treatment; Group 1 received surgical resection for both cancers or surgery for gastric cancer with chemoradiotherapy for esophageal cancer (n=27); Group 2 was treated by endoscopic resection with or without additional treatment (n=14); Group 3 received chemoradiotherapy only (n=18); and Group 4 received supportive care only (n=20).
  
  
  RESULTS
  The median survival times in groups 1 and 2 were 86 and 60 months, respectively. The recurrence rate and mortality were 23% and 48%, respectively, in group 1 and 21% and 4%, respectively, in group 2. The median survival time was 12 months in group 3 and 9 months in group 4. Multivariate analysis showed that age (p<0.001) and treatment group (p=0.019) were significantly associated with death. Compared with group 1, treatment in the intensive care unit (p=0.003), loss of body weight (p=0.042), and decrease in hemoglobin (p=0.033) were worse in group 1.
  
  
  CONCLUSIONS
  Endoscopic resection for synchronous esophageal and gastric cancer could be considered as a possible alternative to surgery for early-stage cancer.
authors.affiliation: Departments of Gastroenterology and Clinical Epidemiology and Biostatistics, Asan Medical Center, Seoul, Korea.
authors.forename: Se Jeong
authors.initials: SJ
authors.lastname: Park
authors.affiliation: Departments of Gastroenterology and Clinical Epidemiology and Biostatistics, Asan Medical Center, Seoul, Korea.
authors.forename: Ji Yong
authors.initials: JY
authors.lastname: Ahn
authors.affiliation: Departments of Gastroenterology and Clinical Epidemiology and Biostatistics, Asan Medical Center, Seoul, Korea.
authors.forename: Hwoon Yong
authors.initials: HY
authors.lastname: Jung
authors.affiliation: Departments of Gastroenterology and Clinical Epidemiology and Biostatistics, Asan Medical Center, Seoul, Korea.
authors.forename: Shin
authors.initials: S
authors.lastname: Na
authors.affiliation: Departments of Gastroenterology and Clinical Epidemiology and Biostatistics, Asan Medical Center, Seoul, Korea.
authors.forename: So Eun
authors.initials: SE
authors.lastname: Park
authors.affiliation: Departments of Gastroenterology and Clinical Epidemiology and Biostatistics, Asan Medical Center, Seoul, Korea.
authors.forename: Mi Young
authors.initials: MY
authors.lastname: Kim
authors.affiliation: Departments of Gastroenterology and Clinical Epidemiology and Biostatistics, Asan Medical Center, Seoul, Korea.
authors.forename: Kwi Sook
authors.initials: KS
authors.lastname: Choi
authors.affiliation: Departments of Gastroenterology and Clinical Epidemiology and Biostatistics, Asan Medical Center, Seoul, Korea.
authors.forename: Jeong Hoon
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Departments of Gastroenterology and Clinical Epidemiology and Biostatistics, Asan Medical Center, Seoul, Korea.
authors.forename: Do Hoon
authors.initials: DH
authors.lastname: Kim
authors.affiliation: Departments of Gastroenterology and Clinical Epidemiology and Biostatistics, Asan Medical Center, Seoul, Korea.
authors.forename: Kee Don
authors.initials: KD
authors.lastname: Choi
authors.affiliation: Departments of Gastroenterology and Clinical Epidemiology and Biostatistics, Asan Medical Center, Seoul, Korea.
authors.forename: Ho June
authors.initials: HJ
authors.lastname: Song
authors.affiliation: Departments of Gastroenterology and Clinical Epidemiology and Biostatistics, Asan Medical Center, Seoul, Korea.
authors.forename: Gin Hyug
authors.initials: GH
authors.lastname: Lee
authors.affiliation: Departments of Gastroenterology and Clinical Epidemiology and Biostatistics, Asan Medical Center, Seoul, Korea.
authors.forename: Jin Ho
authors.initials: JH
authors.lastname: Kim
authors.affiliation: University of Ulsan College of Medicine, and Asan Digestive Disease Research Institute, Seoul, Korea.
authors.forename: Seungbong
authors.initials: S
authors.lastname: Han
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D003131:Combined Modality Therapy; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004938:Esophageal Neoplasms / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D009752:Nutritional Status; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D016019:Survival Analysis
keywords: Esophageal neoplasms; Stomach neoplasms; Synchronous