Outcomes of gastric adenocarcinoma after treatment of esophageal squamous carcinoma

摘要

Background/Aims: We reviewed the clinical outcome of metachronous gastric adenocarcinoma according to the endoscopic interval after curative treatment of squamous esophageal carcinoma by endoscopic resection or surgical resection. Methodology: Eighteen cases with gastric adenocarcinoma after treatment of esophageal carcinoma at Asan Medical Center between March 1994 and March 2010 were analyzed retrospectively. Results: Median interval between treatment of esophageal cancer and detection of metachronous gastric cancer was 44 months (interquartile range [IQR]=25.5-77.8 months), and median endoscopic interval before finding gastric cancer was 15 months (IQR=12.0-44.8 months). In cases with 12 resectable gastric cancers, the median interval of previous endoscopy before gastric cancer was shorter than that for 6 unresectable cancers (12.0 months, IQR=12-16 months vs. 59.5 months, IQR=37.5-68.5 months, p<0.001) and the rate of death was lower (16.7% [2/12] vs. 83.3% [5/6], p=0.006). Logistic regression showed that a shorter duration of endoscopic interval increased the rate of resectability of gastric cancer (p<0.001) and a higher rate of unresectable gastric cancer and longer duration of endoscopic interval increased death (p=0.029 and p=0.004, respectively). Conclusions: After treatment of esophageal cancer, endoscopic examination at 12-month intervals is important to lower the rate of death due to metachronous gastric cancer.