Clinicopathologic Features and Prognosis of Synchronous Multiple Gastric Carcinomas

Abstract

Objective : The study of synchronous multiple gastric carcinoma is of the utmost importance in the management of carcinoma of the gastric remnant and in the epidemiology and histogenesis of gastric carcinoma. We compared the clinicopathologic features and outcome of patients with synchronous multiple gastric carcinoma (SMGC) to those of patients with single gastric carcinoma.

Methods : Of the 3,320 patients diagnosed with gastric carcinoma who underwent surgery in our hospital, 188 patients (5.7%) were diagnosed with SMGCs.

Results : Early carcinomas were more frequently observed in patients with SMGCs than in patients with single gastric carcinoma (p < 0.001). In addition, lymph node metastasis was less common in patients with SMGCs than in patients with single gastric carcinomas (p < 0.05). Regarding the operative procedures, total gastrectomy was more frequently performed in patients with SMGC (32.5 vs. 20.2%; p < 0.001). The 5-year survival rate of patients with SMGCs was higher than that of patients with single gastric carcinoma (69.3% vs. 54.1%, p < 0.001). Multivariate analysis showed that lymph node metastasis, serosal invasion, and curative resection were significant prognostic factors for the survival of patients with SMGCs.

Conclusion : More recently, endoscopic or laparoscopic resection for early gastric carcinoma has frequently been performed. Careful preoperative and intraoperative evaluation and postoperative follow-ups are essential to detect any missed lesions in the remnant stomach, particularly in elderly patients with early gastric carcinoma.

Additional information

Notes on contributors

D.Y. Kim

D. Y. Kim, M.D., Ph.D. Division of Gastroenterologic Surgery, Department of Surgery Chonnam National University Medical School 8, Hakdong, Dongku Gwangju, 501–757, Korea Tel.: [phone] Fax: [phone] E-mail: [email protected]