CAJ | 학술논문

目的探讨胃癌合并其他器官恶性肿瘤的发生率、临床病理特征、诊断、治疗和预后.方法回顾分析1996年1月至2007年12月复旦大学附属肿瘤医院外科治疗的74例胃癌合并其他器官原发癌患者的临床病理资料.结果本组74例患者占同期收治胃癌患者的1.7%.同时多原发癌10例;异时多原发癌64例,其中胃癌前异时多原发癌42例,胃癌后异时癌22例.共发生胃癌以外恶性肿瘤80个,以结直肠癌最多,占43.8%(35个),乳腺癌其次,占16.3%(13个).异时癌的发生时间距胃癌诊断前后7～354(平均82.2)个月.胃癌诊断年龄33～84(平均61)岁.全组患者总的5年生存率为42.3%,其中同时多原发癌为15.2%,胃癌前异时多原发癌为42.9%,胃癌后异时癌为51.3%.36例死亡患者中,24例(66.7%)死于胃癌复发或转移,11例死于其他器官癌,1例死于肾脏衰竭.结论胃癌治疗时需注意同时并发其他器官原发癌的可能.胃癌合并其他器官原发癌患者的主要死因可能是胃癌.
목적 탐토위암합병기타기관악성종류적발생솔、림상병리특정、진단、치료화예후.방법 회고분석1996년1월지2007년12월복단대학부속종류의원외과치료적74례위암합병기타기관원발암환자적림상병리자료.결과 본조74례환자점동기수치위암환자적1.7%.동시다원발암10례;이시다원발암64례,기중위암전이시다원발암42례,위암후이시암22례.공발생위암이외악성종류80개,이결직장암최다,점43.8%(35개),유선암기차,점16.3%(13개).이시암적발생시간거위암진단전후7～354(평균82.2)개월.위암진단년령33～84(평균61)세.전조환자총적5년생존솔위42.3%,기중동시다원발암위15.2%,위암전이시다원발암위42.9%,위암후이시암위51.3%.36례사망환자중,24례(66.7%)사우위암복발혹전이,11례사우기타기관암,1례사우신장쇠갈.결론 위암치료시수주의동시병발기타기관원발암적가능.위암합병기타기관원발암환자적주요사인가능시위암.
Objective To study the incidence, clinicopathological characteristics, diagnosis,treatment, and prognosis of synchronous or metachronons primary cancers in patients with gastric cancer.Methods Clinical data of 4426 patients with gastric cancer in our hospital from 1996 to 2007 were reviewed. Results Seventy-four(1.7%) patients had synchronous or metachronous primary cancer of other organ, of whom 10 were synchronous and 64 were metachronous. Colorectal cancer was the most common type of primary cancer in other organs(43.8%), followed by breast cancer(16.3%). The mean time interval between gastric cancer and metachronous primary cancer was 82.2(3-354)months. The mean age at the diagnosis of gastric cancer was 61.2(33-84) years. The 5-year overall survival rate was 42.3%. The 5-year survival rates in patients with synchronous cancer, pre-metachronous cancer or post-metachronous cancer were 15.2%, 42.9% and 51.3%, respectively. Causes of death were primary cancers of other organ in 11 patients, gastric cancer in 24, and renal failure in 1 patient.Conclusions Primary cancer of other organ should be considered in the management of gastric cancer.Aggressive treatment should be used for the second primary cancer. Gastric cancer is the main cause of death in these patients.