Eom Bang Wool, Lee Hyuk-Joon, Yoo Moon-Won, Cho Jae Jin, Kim Woo Ho, Yang Han-Kwang, Lee Kuhn Uk
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
J Surg Oncol. 2008 Aug 1;98(2):106-10. doi: 10.1002/jso.21027.
The purpose of this study is to investigate characteristics of synchronous and metachronous cancer in gastric cancer and to suggest appropriate methods of treatment management.
We reviewed 4,593 patients who underwent operations for gastric cancer at Seoul National University Hospital from 1999 to 2005. We selected those patients who had also been diagnosed with another primary cancer and classified patients into three groups according to the date of detection of another primary cancer. We analyzed their clinicopathological features.
The incidence of synchronous or metachronous cancer in addition to gastric cancer was 3.4%. The most common another primary cancer was colorectal cancer (20.1%), followed by lung cancer and liver cancer. The majority of synchronous cancers were operated on at the same time as gastric cancer. Eighty-five percent of the synchronous group and 45% of the post-metachronous group were detected by a routine checkup, without prior symptoms. There was no postoperative mortality and the overall 5-year survival rate was 69.4%.
Synchronous cancer should be considered in the preoperative workup and combined resection should be applied whenever possible. Periodic examination for metachronous cancer is necessary during the postoperative period.
本研究旨在探讨胃癌中同时性和异时性癌的特征，并提出合适的治疗管理方法。
我们回顾了1999年至2005年在首尔国立大学医院接受胃癌手术的4593例患者。我们选择了那些还被诊断患有另一种原发性癌症的患者，并根据另一种原发性癌症的检测日期将患者分为三组。我们分析了他们的临床病理特征。
除胃癌外，同时性或异时性癌的发生率为3.4%。最常见的另一种原发性癌症是结直肠癌（20.1%），其次是肺癌和肝癌。大多数同时性癌与胃癌同时进行手术。85%的同时性癌组和45%的异时性癌后组是通过常规检查发现的，术前没有症状。术后无死亡病例，总体5年生存率为69.4%。
术前检查应考虑同时性癌，尽可能采用联合切除术。术后有必要定期检查异时性癌。
