Endoscopic resection for synchronous esophageal squamous cell carcinoma and gastric adenocarcinoma in early stage is a possible alternative to surgery

Gut Liver. 2015 Jan;9(1):59-65. doi: 10.5009/gnl13255.

Abstract

Background/aims: We investigated the clinical outcomes according to the method of treatment in synchronous esophageal and gastric cancer.

Methods: Synchronous esophageal squamous cell carcinoma and gastric adenocarcinoma were diagnosed in 79 patients between 1996 and 2010. We divided the patients into four groups according to treatment; Group 1 received surgical resection for both cancers or surgery for gastric cancer with chemoradiotherapy for esophageal cancer (n=27); Group 2 was treated by endoscopic resection with or without additional treatment (n=14); Group 3 received chemoradiotherapy only (n=18); and Group 4 received supportive care only (n=20).

Results: The median survival times in groups 1 and 2 were 86 and 60 months, respectively. The recurrence rate and mortality were 23% and 48%, respectively, in group 1 and 21% and 4%, respectively, in group 2. The median survival time was 12 months in group 3 and 9 months in group 4. Multivariate analysis showed that age (p<0.001) and treatment group (p=0.019) were significantly associated with death. Compared with group 1, treatment in the intensive care unit (p=0.003), loss of body weight (p=0.042), and decrease in hemoglobin (p=0.033) were worse in group 1.

Conclusions: Endoscopic resection for synchronous esophageal and gastric cancer could be considered as a possible alternative to surgery for early-stage cancer.

Keywords: Esophageal neoplasms; Stomach neoplasms; Synchronous.

MeSH terms

  • Adenocarcinoma / mortality
  • Adenocarcinoma / surgery*
  • Adenocarcinoma / therapy
  • Aged
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / surgery*
  • Carcinoma, Squamous Cell / therapy
  • Combined Modality Therapy
  • Endoscopy, Gastrointestinal / methods*
  • Esophageal Neoplasms / mortality
  • Esophageal Neoplasms / surgery*
  • Esophageal Neoplasms / therapy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasms, Multiple Primary / mortality
  • Neoplasms, Multiple Primary / surgery*
  • Neoplasms, Multiple Primary / therapy
  • Nutritional Status
  • Risk Factors
  • Stomach Neoplasms / mortality
  • Stomach Neoplasms / surgery*
  • Stomach Neoplasms / therapy
  • Survival Analysis