Synchronous and metachronous neoplasms in gastric cancer patients: A 23-year study
Synchronous and metachronous neoplasms in gastric cancer patients: A 23-year study
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DOI：
10.3748/wjg.v20.i23.7480
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发表时间：
2014-06-21
影响因子：
4.3
通讯作者：
Starzynska, Teresa
中科院分区：
文献类型：
--
作者：
Lawniczak, Malgorzata;Gawin, Alicja;Starzynska, Teresa
方法：对23年来在博美拉尼亚医科大学消化内科确诊的胃癌患者(共862例，男性570例，女性292例，平均年龄59.8±12.8岁)进行回顾性分析。平均随访时间31.3±38.6mo(范围1~241mo)。对同时性肿瘤患者和异时性肿瘤患者的以下临床病理特征进行比较：年龄、性别、症状持续时间、癌症家族史、肿瘤部位、分期(早期与晚期)、组织学和血型。结果：在862例胃癌患者中，58例(6.7%)发展为62个多原发瘤，其中39个(63%)是异时性的，23个(37%)是同步的。在58例多发性胃癌患者中，4例(6.9%)发展为两种或两种以上肿瘤。继发肿瘤类型以结直肠为主(n=17)，其次为肺(n=9)、乳腺(n=8)、前列腺(n=7)。年龄是同时性与异时性恶性肿瘤患者唯一不同的临床病理特征，同时性肿瘤患者年龄高于异时性肿瘤患者(68.0±10.3岁vs59.9±11.1岁，P=0.008)。对患有和不患有第二原发癌的患者进行比较，发现唯一有统计学意义的差异是年龄和血型。多原发癌患者的平均年龄高于无第二原发癌患者(63.4±11.4岁vs59.5±13.0岁，P=0.026)。有第二原发癌的胃癌患者的O型血比例高于无O型血的患者(分别为56.2%和31.6%，P=0.002)。结论：胃癌患者可能会发生其他原发肿瘤；因此需要适当的术前和术后诊断方法，特别是当患者年龄较大且O型血时。(C)2014年白石登出版集团。
AIM: 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).CONCLUSION: 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. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.