Clinical features and risk factors of gastric cancer detected by esophagogastroduodenoscopy in esophageal cancer patients

Renma Ito, Tomohiro Kadota, Tatsuro Murano, Yusuke Yoda, Keisuke Hori, Tatsunori Minamide, Daiki Sato, Yoichi Yamamoto, Kenji Takashima, Kensuke Shinmura, Hiroaki Ikematsu, Tomonori Yano

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Gastric cancer is the most frequent primary cancer-associated with esophageal cancer and is most commonly detected by endoscopic surveillance. However, the clinical features of synchronous or metachronous gastric cancer that could be detected by esophagogastroduodenoscopy in esophageal cancer patients are unknown. Methods: We reviewed the clinical records of all esophageal cancer patients (n = 1379) registered in the cancer registration database who underwent initial treatment between April 2010 and October 2015. We retrospectively analyzed the proportions of synchronous and metachronous gastric cancer cases, the cumulative incidence rate of metachronous gastric cancer in total and by esophageal cancer treatments (endoscopic resection, esophagectomy, and chemoradiotherapy), and the clinical features of esophageal cancer patients with synchronous or metachronous gastric cancer. Results: Overall, 67 (5.3% of 1275) esophageal cancer patients with synchronous gastric cancer and 40 (5.1% of 791) esophageal cancer patients with metachronous gastric cancer were analyzed. The 5-year cumulative incidence rate of metachronous gastric cancer was 5.6% in total, 7.8% after endoscopic resection, 4.7% after esophagectomy, and 4.1% after chemoradiotherapy for esophageal cancer. From the results of multivariate analysis, the risk factors for synchronous gastric cancer were male (odds ratio 13.3) and moderate/severe atrophic gastritis (odds ratio 17.9), and the risk factor of metachronous gastric cancer was moderate/severe atrophic gastritis (hazard ratio 27.6) in patients with esophageal cancer. Conclusions: The incidence rates of synchronous and metachronous gastric cancer with esophageal cancer were both over 5%. Careful endoscopic observation is required for moderate and severe atrophic gastritis at detecting concomitant gastric cancer in esophageal cancer patients.

Original languageEnglish
Pages (from-to)621-628
Number of pages8
JournalEsophagus
Volume18
Issue number3
DOIs
Publication statusPublished - Jul 2021
Externally publishedYes

Keywords

  • Atrophic gastritis
  • Cumulative incidence rate
  • Esophageal cancer
  • Metachronous gastric cancer
  • Synchronous gastric cancer

ASJC Scopus subject areas

  • Gastroenterology

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