A clinicopathological study of synchronous multiple gastric cancer

Mitsudomi, Tetsuya; Watanabe, Akihiro; Matsusaka, T; Fujinaga, Y; Fuchigami, Takeshi; Iwashita, Akinori

doi:10.1002/bjs.1800760308

Cited by 50 publications

(46 citation statements)

References 8 publications

(1 reference statement)

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“…The present study provided evidence that approximately 13% of our total population of elderly patients with gastric cancer had two or more cancers within the stomach, which is consistent with previous reports [5,11,15,21]. Although the incidence of multiple colorectal cancers was not significantly different among the age groups [13,22,23], multiple gastric cancers increased with advancing age [15,21,24].…”

Section: Discussionsupporting

confidence: 92%

Pathologic characteristics of gastric cancer in the elderly: a retrospective study of 994 surgical patients

Arai

Esaki²,

Inoshita

et al. 2004

Gastric Cancer

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Background. The clinicopathologic features of gastric carcinoma in elderly people have been reported previously. The present study examined the patterns and distribution of gastric carcinomas in the elderly, especially in patients aged 85 and older. Methods. A retrospective study of 994 consecutive Japanese patients aged 65 years or older was performed. In this group, a total of 1147 lesions were analyzed. Pathological findings in the very old group (older than 85 years; n ‫؍‬ 126) were compared with those in younger groups (65-74 years [young-old group]; n ‫؍‬ 356) and (75-84 years [middle-old group]; n ‫؍‬ 512). Results. While the male-to-female ratio significantly decreased with advancing age, the relative odds of gastric cancer in men were higher than those in women in all age groups. In the very old group, cancer of the lower third of the stomach tended to increase with advancing age, and accounted for 43.7% of cases. In the population overall, differentiated-type adenocarcinoma accounted for 89.6% in the early cancers and 50.3% in the advanced cancers. The proportion of cases involving differentiated-type carcinoma significantly increased with advancing age in early cancer and female advanced cancer cases, whereas no significant change was found in male advanced-cancer patients. In the very old group, lymph node metastasis was found in 5.4% of early cancers and 72.7% in advanced cancers. Multiple cancers significantly increased with advancing age (P < 0.05; 10.7% in the younger-old group, 12.7% in the middle-old group, and 19.0% in the very old group). Conclusion. These results indicate that, in the very old group, gastric cancers showed a distal shift with predominantly differentiated-type carcinoma in the early stages and increased undifferentiated-type carcinomas in advanced stages. These results suggest increased histologic diversity with tumor growth. These findings have important implications for the screening and diagnosis of gastric cancer in the elderly. Offprint requests to: T. Arai

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Section: Discussionsupporting

confidence: 92%

Pathologic characteristics of gastric cancer in the elderly: a retrospective study of 994 surgical patients

Arai

Esaki²,

Inoshita

et al. 2004

Gastric Cancer

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“…We thus felt it necessary to publish our data on gastric cancer patients which, have been collected in a standardized way, including data on accompanying precancerous lesions and present additional data on expression of various tumour-associated genetic changes. Our rate of multiplicity of 3.7% is similar to that found by Rohde et al (1991) and Mitsudomi et al (1989). A clinical study by Kodera et al (1995) of 2790 patients reported MSCs in 160 cases (5.7%).…”

Section: Discussionsupporting

confidence: 89%

Multiple simultaneous gastric carcinomas

Wittekind

Klimpfinger²,

Hermanek³

et al. 1997

Br J Cancer

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“…With regard to the incidence of multiple synchronous gastric carcinomas, several studies have demonstrated that they are more prevalent among elderly patients and M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT 6 that their incidence increases with advancing age [24][25][26]. In elderly patients, multiple gastric carcinomas account for almost 8%-15% of cases [24][25][26].…”

Section: Synchronous Carcinomasmentioning

confidence: 99%

“…In elderly patients, multiple gastric carcinomas account for almost 8%-15% of cases [24][25][26]. They are predominantly located in the lower third of the stomach, they are of elevated, welldifferentiated histological type and they present a tendency to collide and form single giant lesions [17,[24][25][26]. Although their high prevalence in elderly patients has not fully been explained yet, a number of investigators have attributed it to the high incidence of intestinal type gastric cancer observed in that age group [24].…”

Section: Synchronous Carcinomasmentioning

confidence: 99%

Gastric cancer in the elderly: An overview

Saif

Makrilia

Zalonis

et al. 2010

European Journal of Surgical Oncology (EJSO)

138

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Aims: Gastric cancer in the elderly represents a distinct entity with specific clinicopathological characteristics and the majority of affected patients belong to this age group. Subtotal or total gastrectomy with radical lymph node dissection, adjuvant chemo-radiotherapy or perioperative chemotherapy represent the only potentially curative treatment options and seem to be performed with acceptable morbidity and mortality rates in selected elderly patients. Published research is very limited due to the strict selection and under-representation of elderly patients in clinical trials. A review of current recommendations and practice was performed.Methods: A comprehensive literature review was performed searching Medline for articles published since 1974, using "gastric cancer", "elderly" and "treatment" as key words.Observations: The data suggest that elderly patients that fulfill the inclusion criteria of clinical trials experience the same advantages and toxicities from chemotherapy as younger patients. Fit elderly patients with operable gastric cancer should be canndidates for the standard surgical resection provided that pre-operative comorbidities are taken into account. Peri-operative chemotherapy or post-operative chemoradiotherapy should be added in case of locally advanced disease. Palliative systemic chemotherapy seems to prolong survival in recurrent and metastatic disease.Conclusions: Chronological age alone is not sufficient reason to withhold curative or palliative treatment from an elderly gastric cancer patient. Performance status does not suffice in order to estimate the general condition of elderly patients and cofactors regarding their functional, social and mental status have to be considered.Word count (abstract): 234

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A clinicopathological study of synchronous multiple gastric cancer

Cited by 50 publications

References 8 publications

Pathologic characteristics of gastric cancer in the elderly: a retrospective study of 994 surgical patients

Pathologic characteristics of gastric cancer in the elderly: a retrospective study of 994 surgical patients

Multiple simultaneous gastric carcinomas

Gastric cancer in the elderly: An overview

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