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Risk factors for double primary malignancies and their clinical implications in patients with sporadic gastric cancer

 I. Cho  ;  J.Y. An  ;  I.G. Kwon  ;  Y.Y. Choi  ;  J.H. Cheong  ;  W.J. Hyung  ;  S.H. Noh 
 EJSO, Vol.40(3) : 338-344, 2014 
Journal Title
Issue Date
Adult ; Age Factors ; Aged ; Biopsy, Needle ; Cohort Studies ; Colorectal Neoplasms/mortality ; Colorectal Neoplasms/pathology* ; Colorectal Neoplasms/surgery ; Disease-Free Survival ; Female ; Humans ; Immunohistochemistry ; Lung Neoplasms/mortality ; Lung Neoplasms/pathology* ; Lung Neoplasms/surgery ; Middle Aged ; Neoplasm Invasiveness/pathology ; Neoplasm Staging ; Neoplasms, Multiple Primary/mortality ; Neoplasms, Multiple Primary/pathology* ; Neoplasms, Multiple Primary/surgery ; Prognosis ; Retrospective Studies ; Risk Assessment ; Sex Factors ; Stomach Neoplasms/mortality ; Stomach Neoplasms/pathology* ; Stomach Neoplasms/surgery ; Survival Analysis ; Thyroid Neoplasms/mortality ; Thyroid Neoplasms/pathology* ; Thyroid Neoplasms/surgery ; Treatment Outcome
Double primary malignancy ; Gastric cancer ; Microsatellite instability ; Prognosis
AIMS: We carried out a large scale study to identify the risk factors for double primary malignancy (DPM) development in gastric cancer patients and to evaluate the clinical implications for these patients. METHODS: A total of 2593 patients who underwent gastrectomy for primary gastric cancer from January 2005 to November 2010 were reviewed with regard to DPM. We compared the clinicopathological characteristics, risk factors for developing DPM, and prognosis between the DPM+ group and the DPM- group. RESULTS: Of the 2593 patients, 152 (5.9%) were diagnosed with DPM. The most common accompanying malignancies were colorectal, lung and thyroid. Multivariate analysis indicated that age (p = 0.016) and MSI status (p = 0.002) were associated with a higher frequency of DPM. 30.3% of patients were diagnosed with DPM within 1 year around perioperative period and 53.3% of patients had DPM detected during 5 years of post-operative follow up periods. Although there was no significant difference in overall survival between the DPM+ and DPM- group, DPM+ patients had a worse prognosis than DPM- patients in stage I gastric cancer. CONCLUSIONS: Gastric cancer patients over the age of 60 or with a MSI-high status had an increased risk for developing DPM. Further, in stage I gastric cancer, the presence of DPM was associated with a worse prognosis. Therefore, careful pre- and postoperative surveillance is especially important in these patients.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kwon, In Gyu(권인규) ORCID logo https://orcid.org/0000-0002-1489-467X
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Cheong, Jae Ho(정재호) ORCID logo https://orcid.org/0000-0002-1703-1781
Cho, In(조인)
Choi, Yoon Young(최윤영) ORCID logo https://orcid.org/0000-0002-2179-7851
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
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