Kim Jung-Wook, Jang Jae-Young, Chang Young Woon, Kim Yong Ho
Jung-Wook Kim, Jae-Young Jang, Young Woon Chang, Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul 130-702, South Korea.
World J Gastroenterol. 2015 Jul 21;21(27):8358-65. doi: 10.3748/wjg.v21.i27.8358.
To investigate the incidence and distribution of second primary cancers (SPCs) in early gastric cancer (EGC) patients who underwent endoscopic resection (ER), compared to advanced gastric cancer (AGC) patients who underwent surgery.
The medical records of 1021 gastric cancer (GC) patients were retrospectively reviewed from January 2006 to December 2010. The characteristics and incidence of SPCs were investigated in those with EGC that underwent curative ER (the EGC group) and those with AGC who underwent curative surgical resection (the AGC group).
We ultimately enrolled 184 patients in the EGC group and 229 patients in the AGC group. A total of 38 of the 413 (9.2%) GC patients had SPCs; the rate was identical in both groups. Of these 38 patients, 18 had synchronous and 20 had metachronous cancers. The most common SPC was lung cancer (18.4%), followed by colorectal cancer (13.2%) and esophageal cancer (13.2%). No significant risk factors were identified for the development of SPCs.
Endoscopists should provide close surveillance and establish follow-up programs to ensure SPC detection in GC patients undergoing curative resection regardless of their clinical characteristics.
研究接受内镜切除术(ER)的早期胃癌(EGC)患者与接受手术的进展期胃癌(AGC)患者中第二原发性癌症(SPC)的发生率和分布情况。
回顾性分析2006年1月至2010年12月期间1021例胃癌(GC)患者的病历。对接受根治性ER的EGC患者(EGC组)和接受根治性手术切除的AGC患者(AGC组)的SPC特征和发生率进行研究。
最终EGC组纳入184例患者,AGC组纳入229例患者。413例GC患者中共有38例(9.2%)发生SPC;两组发生率相同。在这38例患者中,18例为同步癌,20例为异时癌。最常见的SPC是肺癌(18.4%),其次是结直肠癌(13.2%)和食管癌(13.2%)。未发现SPC发生的显著危险因素。
内镜医师应进行密切监测并建立随访计划,以确保对接受根治性切除的GC患者进行SPC检测,无论其临床特征如何。