RESUMEN
PURPOSE: Stomach cancer is the most prevalent extracolonic malignancy of the many primary cancers that occur together with colorectal cancer in Koreans. The purpose of this study was to evaluate the characteristics of patients who present with double primary cancer of the stomach and colorectum. METHODS: From Sep. 1994 to Dec. 2004, in 4,305 patients were diagnosed with colorectal cancer. Among these patients, 51 patients were diagnosed synchronously or metachronously as also having stomach cancer. The mean age these patients was 60.8 years and the median follow up duration was 31.0 months. RESULTS: The incidence of double primary cancer of the stomach and colorectum was 1.2% of the total colorecal cancer patients and they were 0.6% of the total stomach cancer patients. There were 17 (33.3%) metachronous cases and 34 (66.7%) synchronous cases. For the metachronous cases, the mean interval was 15 months (12~98) and detection methods were postoperative CT, symptom of second a cancer, and routine endoscopic examination. In synchronous cases, second cancer was detected by routine endoscopic examination, preoperative radiologic evaluation, and intraoperative exploration. Intraoperatively the detected cancers were all colorectal cancer during the operation for stomach cancer. The stage of the colorectal cancer was higher than that of the stomach cancer in 30 cases. Local or systemic recurrences were seen in 9 cases (17.6%), and 7 cases were recurrence of colorectal cancer. The 5-year disease free survival rates was 55.8%. CONCLUSION: The incidence of cancer arising from colorectum and stomach has been reported to be increasing. Careful attention should always be paid to the possible presence of a second cancer in preoperative or postoperative evaluation of cancer patients.
Asunto(s)
Humanos , Neoplasias del Colon , Neoplasias Colorrectales , Supervivencia sin Enfermedad , Estudios de Seguimiento , Incidencia , Neoplasias Primarias Secundarias , Recurrencia , Neoplasias Gástricas , EstómagoRESUMEN
PURPOSE: To analyze the recurrent rate, time of recurrence, type of recurrence and the relationship between recurrence and histopathologic findings after radical gastrectomy for early gastric cancer and evaluate the usefulness of follow up abdominal computed tomography after surgery. MATERIALS AND METHODS: We retrospectively evaluated 617 abdominal computed tomographic examinations of 144 patients (101 male, 43 female, mean age, 53 years) who underwent radical subtotal gastrectomy for early gastric cancer between July 1994 and July 1997. Follow-up abdominal CT scans were reviewed by three abdominal radiologists for detection of recurrence of early gastric cancer, and endoscopic and pathologic findings were correlated. We also reviewed the surgical pathologic reports for location, size, cell type and depth of invasion of early gastric cancer and lymph node invasion. We analyzed the recurrent rate, time and type of recurrence, and relationship between recurrence rate and pathologic characteristics of early gastric cancer. RESULTS: The recurrent rate was 4.2% (6/144) during 5-7 years after radical subtotal gastrectomy for early gastric cancer. The recurrence was detected on 2-5 years after operation. The types of recurrence were lymph node metastasis (n=5), liver metastasis (n=4), recurrence in the residual stomach or anastomotic site (n=3), adrenal metastasis (n=1), and lung metastasis (n=1). Relationship between recurrence and location, size, depth of invasion and cell type of early gastric cancer and lymph node metastasis was not significant statistically (p>0.4). CONCLUSION: The recurrence rate of early gastric cancer after radical subtotal gastrectomy is very low and occurs after two years. The follow up-CT scans can detect all recurrence of early gastric cancer, so regular follow-up abdominal CT examination is useful.