Synchronous gastric cancer in primary sporadic colorectal cancer patients in Korea

  • S. B. Lim
  • S. Y. Jeong
  • H. S. Choi
  • D. K. Sohn
  • C. W. Hong
  • K. H. Jung
  • H. J. Chang
  • J. G. ParkEmail author
  • I. J. Choi
  • C. G. Kim
Original Article


Background and aims

Colorectal cancer has been reported to be the malignancy most frequently associated with gastric cancer in Korea. The aim of this study was to define the frequency and clinical characteristics of synchronous gastric cancer detected at preoperative esophagogastroduodenoscopy (EGD) in colorectal cancer patients.

Materials and methods

This prospective study analyzed the EGD results from 1,542 consecutive colorectal cancer patients who underwent surgery from January 2003 to December 2005 at the Center for Colorectal Cancer, National Cancer Center, Korea.


Of the 1,542 cases, 1,155 (74.9%) underwent EGD at our center and 387 underwent EGD at other hospitals within 6 months before surgery. Of the 1,542 cases, synchronous gastric cancers were detected in 31 cases (2.0%). Of these 31 cases, 26 had early gastric cancer (EGC; 83.9%) and 5 had advanced gastric cancer. Ten (38.5%) of the 26 EGC cases were managed using endoscopic mucosal resection. Compared to colorectal cancer patients without synchronous gastric cancer, the group of patients with synchronous gastric cancer was older (65.5 ± 9.6 vs 58.4 ± 11.3 years, p = 0.001) and had a greater proportion of males (77.4 vs 59.4%, p = 0.043).


This study found that 2% of Korean sporadic colorectal cancer patients had synchronous gastric cancer. A preoperative EGD for colorectal cancer patients is likely to greatly assist in the diagnosis of synchronous gastric cancer at an early stage and the implementation of appropriate minimally invasive treatment.


Synchronous gastric cancer Sporadic colorectal cancer Multiple primary neoplasm 


  1. 1.
    Kobayashi Y, Arimoto H, Watanabe S (1991) Occurrence of multiple primary cancer at the National Cancer Center Hospital, 1962–1989. Jpn J Clin Oncol 21:233–251PubMedGoogle Scholar
  2. 2.
    Tsukuma H, Fujimoto I, Hanai A, Hiyama T, Kitagawa T, Kinoshita N (1994) Incidence of second primary cancers in Osaka residents, Japan, with special reference to cumulative and relative risks. Jpn J Cancer Res 85:339–345PubMedGoogle Scholar
  3. 3.
    Evans HS, Möller H, Robinson D, Lewis CM, Bell CM, Hodgson SV (2002) The risk of subsequent primary cancers after colorectal cancer in southeast England. Gut 50:647–652PubMedCrossRefGoogle Scholar
  4. 4.
    Shin HR, Won YJ, Jung KW, Kong HJ, Yim SH, Lee JK, Noh HI, Lee JK, Pisani P, Park JG (2005) Nationwide cancer incidence in Korea, 1999-2001; First result using the national cancer incidence database. Cancer Res Treat 37:325–331CrossRefGoogle Scholar
  5. 5.
    Kim HC, Kim CN, Jung CS, Yu CS, Kim JC (1998) Multiple primary malignant neoplasm with colorectal cancer. J Korean Cancer Assoc 30:668–674Google Scholar
  6. 6.
    Ueno M, Muto T, Oya M, Ota H, Azekura K, Yamaguchi T (2003) Multiple primary cancer: an experience at the Cancer Institute Hospital with special reference to colorectal cancer. Int J Clin Oncol 8:162–167PubMedCrossRefGoogle Scholar
  7. 7.
    Chiang JM, Yeh CY, Changehien CR, Chen JS, Tang R, Tsai WS, Fan CW (2004) Clinical features of second other-site primary cancers among sporadic colorectal cancer patients-a hospital-based study of 3,722 cases. Hepatogastroenterology 59:1341–1344Google Scholar
  8. 8.
    Kaneko S, Yamaguchi N (1999) Epidemiological analysis of site relationships of synchronous and metachronous multiple primary cancers in the National Cancer Center, Japan, 1962–1996. Jpn J Clin Oncol 29:96–105PubMedCrossRefGoogle Scholar
  9. 9.
    Hisamichi S (1989) Screening for gastric cancer. World J Surg 13:31–37PubMedCrossRefGoogle Scholar
  10. 10.
    Fukao A, Tsubono Y, Tsuji I, HIsamichi S, Sugahara N, Takano A (1995) The evaluation of screening for gastric cancer in Miyagi Prefecture, Japan: a population-based case-control study. Int J Cancer 60:45–48PubMedCrossRefGoogle Scholar
  11. 11.
    Pisani P, Oliver WE, Parkin DM, Alvarez N, Vivas J (1994) Case-control study of gastric cancer screening in Venezuela. Br J Cancer 69:1102–1105PubMedGoogle Scholar
  12. 12.
    Park JG, Vasen HF, Park YJ, Park KJ, Peltomaki P, de Leon MP, Rodriguez-Bigas MA, Lubinski J, Beck NE, Bisgaard ML, Miyaki M, Wijnen JT, Baba S, Lindblom A, Madlensky L, Lynch HT (2002) Suspected HNPCC and Amsterdam criteria II: evaluation of mutation detection rate, an international collaborative study. Int J Colorectal Dis 17:109–114PubMedCrossRefGoogle Scholar
  13. 13.
    Greene FL, Page DL, Fleming ID, Fritz A, Balch CM, Haller DG, Morrow M (2002) AJCC cancer staging manual. Springer, New YorkGoogle Scholar
  14. 14.
    Moertel CG (1977) Multiple primary malignant neoplasms. Historical perspectives. Cancer 40:1786–1792Google Scholar
  15. 15.
    Horii A, Han HJ, Shimada M, Yanagisawa A, Kato Y, Ohta H, Yasui W, Tahara E, Nakamura Y (1994) Frequent replication errors at microsatellite loci in tumors of patients with multiple primary cancers. Cancer Res 54:3373–3375PubMedGoogle Scholar
  16. 16.
    Masubuchi S, Konishi F, Togashi K, Okamoto T, Senba S, Shitoh K, Kashiwagi H, Kanazawa K, Tsukamoto T (1999) The significance of microsatellite instability in predicting the development of metachronous multiple colorectal carcinomas in patients with nonfamilial colorectal carcinoma. Cancer 85:1917–1924PubMedGoogle Scholar
  17. 17.
    Ohtani H, Yashiro M, Onoda N, Nishioka N, Kato Y, Yamamoto S, Fukushima S, Hirakawa-Ys Chung K (2000) Synchronous multiple primary gastrointestinal cancer exhibits frequent microsatellite instability. Int J Cancer 86:678–683PubMedCrossRefGoogle Scholar
  18. 18.
    Park YJ, Shin KH, Park JG (2000) Risk of gastric cancer in hereditary nonpolyposis colorectal cancer in Korea. Clin Cancer Res 6:2994–2998PubMedGoogle Scholar
  19. 19.
    Park JG, Park KJ, Ahn YO, Song IS, Choi KW, Moon HY, Choo SY, Kim JP (1992) Risk of gastric cancer among Korean familial adenomatous polyposis patients. Report of three cases. Dis Colon Rectum 35:996–998PubMedCrossRefGoogle Scholar
  20. 20.
    Kim JP, Park JG (1983) Results of treatment of stomach cancer. J Korean Med Assoc 26:637–642Google Scholar
  21. 21.
    Sano T, Kobori O, Muto T (1992) Lymph node metastasis from early gastric cancer: endoscopic resection of tumor. Br J Surg 79:241–244PubMedCrossRefGoogle Scholar
  22. 22.
    Ono H (2006) Early gastric cancer: diagnosis, pathology, treatment techniques and treatment outcomes. Eur J Gastroenterol Hepatol 18:863–866PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • S. B. Lim
    • 1
  • S. Y. Jeong
    • 1
  • H. S. Choi
    • 1
  • D. K. Sohn
    • 1
  • C. W. Hong
    • 1
  • K. H. Jung
    • 1
  • H. J. Chang
    • 1
  • J. G. Park
    • 1
    • 3
    Email author
  • I. J. Choi
    • 2
  • C. G. Kim
    • 2
  1. 1.Center for Colorectal Cancer, Research Institute and HospitalNational Cancer CenterGoyang-siKorea
  2. 2.Center for Gastric CancerResearch Institute and Hospital, National Cancer CenterGoyang-siKorea
  3. 3.Cancer Research Institute and Cancer Research CenterSeoul National UniversitySeoulKorea

Personalised recommendations