Clinicopathological Characteristics of Synchronous Multiple Gastric Cancers in Chinese:An Analysis of 44 Cases

Objective： To investigate the clinicopathologic characteristics of the primary synchronous multiple gastric cancers （SMGC） in Chinese. Methods： Clinicopathologic data of patients with histologically confirmed gastric cancer who received surgical operations in our department between 1993 and 2002 were retrospectively collected and analyzed. Clinicopathologic characteristics including gender, age, tumor location, differentiation and staging between patients with SMGC and those with solitary gastric cancer （SGC） were compared. Synchronous multiple and solitary gastric cancers were diagnosed and classified based on radiography upper endoscopy and histology. All the cases were followed up after the operation and 5-year survival rate between the two groups was compared. Results： A total of 871 patients with gastric cancer were included. Synchronous multiple gastric cancers were found in 44 （5.1%） of these cases. More of the diagnose in the early stage to SMGC than to SGC. SMGC were more likely to be located at the lower third stomach and of a low grade differentiation, compared to SGC. However, there were no significant differences in the rates of lymph node metastasis and lymphatic vessel invasion between multiple and solitary gastric cancers. In addition, the 5-year survival rate did not difference between the two groups. Conclusion： The whole stomach should be detected carefully to avoid missing out the multiple gastric cancers. Concerning the treatment of multiple gastric cancer, the sufficient extent of the stomach wall resection was necessary, and the extent of lymphadenectomy was supposed to follow the operation for the solitary gastric cancer according to the staging of the cancer lesions.

Clinicopathological features and impact of adjuvant chemotherapy on the long-term survival of patients with multiple gastric cancers:a propensity score matching analysis

Background:Little is known about the correlation between the clinicopathological features,postoperative treatment,and prognosis of multiple gastric cancers(MGCs).In this study,we aimed to investigate the correlation between these features and the impact of postoperative adjuvant chemotherapy on the long-term survival of patients with MGC.Methods:The clinical and pathological data of patients diagnosed with gastric adenocarcinoma who had radical gastrectomy from January 2007 to December 2016 were analyzed.Using propensity score matching,the prognostic differences,and the impact of postoperative adjuvant chemotherapy between those with MGC and solitary gastric cancers(SGC)were compared.Results:Among the 4107 patients investigated,the incidence of MGC was 3.2%(133/4107).Before matching,patients with MGC and SGC had disparities in the type of gastrectomy,pathological tumor stage(pT),pathological node stage(pN),and pathological tumor-node-metastasis stage(pTNM).After a 1:4 ratio matching,the clinical data of 133 cases of MGC and 532 cases of SGC were found to be comparable.The 5-year overall survival(OS)rate was 56.6%in the entire matched cohort,48.1%in the MGC group,and 58.7%in the SGC group(P=0.013).Multivariate analysis revealed that MGC,age,pT stage,pN stage,and adjuvant chemotherapy were independent predictors of OS(all P<0.05).Stratified analyses demonstrated that for the cohort of advanced gastric cancer(AGC)patients who did not had adjuvant chemotherapy,the 5-year OS rate of advanced cases of MGC was inferior than that of SGC patients(34.0%vs.46.1%,respectively;P=0.025)but there were no significant difference in the 5-year OS rate between advanced MGC and SGC patients who had adjuvant chemotherapy(48.0%vs.53.3%,respectively;P=0.292).Further,we found that the 5-year OS rate of advanced MGC who had adjuvant chemotherapy was significantly higher than those who did not had adjuvant chemotherapy(48.0%vs.34.0%,P=0.026).Conclusions:Patients with advanced MGC was identified as having a poorer survival as to SGC patients,but the implementation of postoperative adjuvant chemotherapy showed that it had the potential to significantly improve the long-term prognoses of MGC patients.