Prevalence of synchronous colorectal neoplasms in surgically treated gastric cancer patients and significance of screening colonoscopy

Dig Endosc. 2014 May;26(3):396-402. doi: 10.1111/den.12156. Epub 2013 Aug 23.

Abstract

Background and aim: The existence of other primary tumors during the treatment and management of gastric cancer (GC) is an important issue. The present study investigated the prevalence and management of synchronous colorectal neoplasms (CRN) in surgically treated GC patients.

Methods: Of 381 surgically treated GC patients, 332 (87.1%) underwent colonoscopy to detect CRN before surgery or within a year after surgery.

Results: CRN were synchronously observed in 140 patients (42.2%). Adenoma was observed in 131 patients (39.4%). Endoscopic resection was done in 18 patients with adenoma. Colorectal cancer (CRC) was observed in 16 patients (4.8%), superficial CRC in 13 and advanced CRC in three patients. Endoscopic resection of superficial CRC was carried out in seven patients, whereas simultaneous surgical resection of CRC was done in nine patients. CRN were more frequently observed in men. CRC was more frequently observed in GC patients with distant metastasis, albeit without significance. The overall survival of GC patients with CRN or CRC was poorer than that of patients without CRN or CRC.

Conclusion: Synchronous CRN were commonly associated with GC and screening colonoscopy should be offered to patients with GC.

Keywords: colonoscopy; colorectal adenoma; colorectal cancer; gastric cancer.

MeSH terms

  • Adenoma / epidemiology
  • Adenoma / pathology
  • Adenoma / surgery
  • Aged
  • Cohort Studies
  • Colonoscopy / methods*
  • Colorectal Neoplasms / diagnosis
  • Colorectal Neoplasms / epidemiology*
  • Colorectal Neoplasms / secondary*
  • Confidence Intervals
  • Early Detection of Cancer / methods
  • Female
  • Follow-Up Studies
  • Gastrectomy / methods
  • Humans
  • Japan
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasms, Multiple Primary / diagnosis
  • Neoplasms, Multiple Primary / epidemiology*
  • Neoplasms, Multiple Primary / secondary*
  • Prevalence
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Assessment
  • Stomach Neoplasms / epidemiology
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / surgery*
  • Survival Analysis
  • Treatment Outcome