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Prediction of metachronous multiple primary cancers following the curative resection of gastric cancer

 Chan Kim  ;  Hong Jae Chon  ;  Beodeul Kang  ;  Kiyeol Kim  ;  Hei-Cheul Jeung  ;  Hyun Cheol Chung5  ;  Sung Hoon Noh  ;  Sun Young Rha 
 BMC CANCER, Vol.13 : 394, 2013 
Journal Title
Issue Date
Adenocarcinoma/mortality ; Adenocarcinoma/pathology ; Adenocarcinoma/surgery* ; Adenocarcinoma, Mucinous/mortality ; Adenocarcinoma, Mucinous/pathology ; Adenocarcinoma, Mucinous/surgery* ; Aged ; Carcinoma, Signet Ring Cell/mortality ; Carcinoma, Signet Ring Cell/pathology ; Carcinoma, Signet Ring Cell/surgery* ; Female ; Follow-Up Studies ; Gastrectomy/adverse effects* ; Humans ; Incidence ; Male ; Middle Aged ; Neoplasm Staging ; Neoplasms, Multiple Primary/diagnosis* ; Neoplasms, Multiple Primary/epidemiology ; Neoplasms, Multiple Primary/etiology ; Neoplasms, Multiple Primary/mortality ; Nomograms ; Postoperative Complications/diagnosis ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Postoperative Complications/mortality ; Prognosis ; Retrospective Studies ; Stomach Neoplasms/mortality ; Stomach Neoplasms/pathology ; Stomach Neoplasms/surgery* ; Survival Rate
Multiple primary cancer ; Gastric cancer ; Nomogram ; Predictive factor
BACKGROUND: Due to improved survival rate, gastric cancer (GC) patients have an increased risk of developing multiple primary cancer (MPC). The purpose of this study is to evaluate the clinicopathological features of MPC and to generate useful tools for the prediction of metachronous MPC following gastrectomy. METHODS: 3066 patients who underwent curative resection of GC were reviewed retrospectively, based on the clinical information and the medical record. RESULTS: The 5-year incidence of MPC was 2.5%. Of these, 54.3% had a metachronous MPC, while 45.7% had a synchronous MPC. The most prevalent site of metachronous MPC was the colorectum (26.3%), followed by lung (23.7%) and liver (18.4%). Multivariate logistic regression analysis revealed that old age at the time of GC diagnosis (>=60 years), early stage of GC (stage I and II), and multiplicity of GC at the time of gastrectomy were independent predictive factors for metachronous MPC. GC patients with either metachronous or synchronous MPC showed poorer survival than patients without MPC. In addition, patients with a metachronous MPC showed late survival disadvantage, while patients with a synchronous MPC showed early survival disadvantage. Furthermore, we were able to develop and internally validate a nomogram to predict the metachronous MPC after curative gastrectomy (C-index = 0.72). CONCLUSION: Patients at high risk of developing metachronous MPC after curative resection of GC were identified. Individual risk of developing metachronous MPC could be predicted by a novel nomogram. Further external validation with independent patient cohorts is required to improve the accuracy of prediction.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
5. Research Institutes (연구소) > Oral Cancer Research Institute (구강종양연구소) > 1. Journal Papers
Yonsei Authors
Kang, Beodeul(강버들) ORCID logo https://orcid.org/0000-0001-5177-8937
Kim, Ki Yeol(김기열) ORCID logo https://orcid.org/0000-0001-5357-1067
Kim, Chan(김찬)
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Rha, Sun Young(라선영) ORCID logo https://orcid.org/0000-0002-2512-4531
Chon, Hong Jae(전홍재)
Chung, Hyun Cheol(정현철) ORCID logo https://orcid.org/0000-0002-0920-9471
Jeung, Hei Cheul(정희철) ORCID logo https://orcid.org/0000-0003-0952-3679
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