Abstract 1753
Background
The incidence of synchronous and metachronous gastric cancer is high in esophageal cancer patients.
Methods
113 esophageal cancer (EC) patients with synchronous and metachronous gastric cancer (GC) were analyzed between 1997 and 2016 retrospectively. There were 110 men and 3 women, with a median age of 67 years. 58 had a synchronous gastric cancer (S group) and 55 had a metachronous (M group). In the M group, there were 36 patients with a subsequent esophageal cancer (SEC) and 19 with an antecedent esophageal cancer (AEC).
Results
1) S group: T stage of EC was 1 in 14 patients, 2 in 4, 3 in 25, and 4 in 15. Stage was 0 in 4 patients, I in 6, II in 9, and III in 39. T stage of GC was 1 in 46 patients, 2 in 6, 3 in 4, and 4 in 2. Stage was I in 49 patients, II in 5, and III in 4. 35 underwent esophagectomy (31 gastrectomy and 4 endoscopic treatments) and 23 received definitive chemo-radiotherapy for EC (4 gastrectomy, 3 endoscopic treatments, and 16 observations for gastric cancer). 2) SEC group: The median range between gastrectomy and esophageal treatment was 8.4 years. T stage of EC was 1 in 13 patients, 2 in 6, 3 in 11, and 4 in 6. Stage was I in 3 patients, II in 8, and III in 25. Of the 36 pts, 16 underwent esophagectomy, 18 received definitive (chemo-) radiotherapy, and 2 underwent endoscopic treatment. 3) AEC group: The median range between esophagectomy and gastric treatment was 6.5 years. T stage of EC was 1 in 6 patients, 2 in 1, and 3 in 8, and 4 in 4. Stage was I in 6, II in 6, and III in 7. T stage of GC was 1 in 11 patients, 2 in 4, and 3 in 4. Of 19, 10 underwent endoscopic treatment, 5 underwent gastrectomy, 1 received chemotherapy, and 1 did not receive any anti-cancer treatment. The overall survival rates at 5 years in S group, SEC group, and AEC group were 50%, 45%, and 51%, respectively. There was a significant difference in the overall survival rates between the surgery group (45%) and non-surgery group (36%) in the S group (p = 0.0006). In the SEC group, there was a tendency of long survival in those who underwent surgery (56%), compared to those who did not have surgery (37%) (p = 0.06). Prognosis of patients with gastric tube cancer was 10 years after EC treatment and 4 years after gastric tube cancer treatment.
Conclusions
Patients in the S group who underwent surgery had a good prognosis. Periodic endoscopic examination is necessary for early diagnosis of gastric tube cancer.
Clinical trial identification
Legal entity responsible for the study
Kurume University School of Medicine
Funding
None
Disclosure
All authors have declared no conflicts of interest.