Skip to main content
SpringerLink
Log in

Double primary malignancy in colorectal cancer patients—MSI is the useful marker for predicting double primary tumors

  • Original Article
  • Published:
International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Background and aims

The incidence of double primary malignancies (DPM) is known to be higher in colorectal cancer patients than the general population. And, the role of microsatellite instability (MSI) in DPM has been previously studied. We evaluated the clinical features and association between MSI and colorectal cancer patients with DPM.

Materials and methods

From September 1994 to May 2004, we reviewed 2,301 colorectal cancer patients with regard to secondary primary malignancies. A subgroup analysis was performed for MSI after January 2003.

Results

One hundred forty-five patients (6.3%) had a DPM identified. In DPM group, 57 patients had a synchronous DPM (39.3%), and 88 patients had a metachronous malignancy (60.7%). Male gender (p < 0.001) and colon cancer (p < 0.001) were the factors related with the development of the DPM. Most of the second malignancies occurred within 3 years after the primary operation. The common second malignancies were stomach (58 patients, 40%) and lung (21 patients, 14.5%). In the subgroup analysis, there was a higher frequency of DPM in the MSI group when compared to the microsatellite stable group (p = 0.021).

Conclusions

The careful pre- and postoperative evaluation should be paid for detecting DPM as well as for detecting recurrence in colorectal cancer patients. The results of this study suggest that MSI might be a useful marker for the detection of DPM in colorectal cancer patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Reference

  1. Watanabe S, Kodama T, Shimosato Y, Arimoto H, Sugimura T, Suemasu K, Shiraishi M (1984) Multiple primary cancers in 5,456 autopsy cases in the National Cancer Center of Japan. J Natl Cancer Inst 72:1021–1027

    PubMed  CAS  Google Scholar 

  2. Go WS (1932) Multiple primary malignant tumors: a survey of the literature and a statistical study. Am J Cancer 16:1358–1414

    Google Scholar 

  3. 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 54:3373–3375

    PubMed  CAS  Google Scholar 

  4. 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 85:339–345

    Article  PubMed  CAS  Google Scholar 

  5. Evans HS, Moller H, Robinson D, Lewis CM, Bell CM, Hodgson SV (2002) The risk of subsequent primary cancers after colorectal cancer in southeast England. Gut 50:647–652

    Article  PubMed  CAS  Google Scholar 

  6. Lee TK, Barringer M, Myers RT, Sterchi JM (1982) Multiple primary carcinomas of the colon and associated extracolonic primary malignant tumors. Ann Surg 195:501–507

    Article  PubMed  CAS  Google Scholar 

  7. Maruyama H, Hasuike Y, Furukawa J, Naoi M, Takata N, Yayoi E, Okamura J, Okamoto S (1992) Multiple colorectal carcinomas and colorectal carcinoma associated with extracolonic malignancies. Surg Today 22:99–104

    Article  PubMed  CAS  Google Scholar 

  8. 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 8:162–167

    Article  PubMed  Google Scholar 

  9. Yamamoto S, Yoshimura K, Ri S, Fujita S, Akasu T, Moriya Y (2006) The risk of multiple primary malignancies with colorectal carcinoma. Dis Colon Rectum 49:S30–S36

    Article  PubMed  Google Scholar 

  10. Jemal A, Siegel R, Ward E, Murray T, Xu J, Smigal C, Thun MJ (2006) Cancer statistics, 2006. CA Cancer J Clin 56:106–130

    Article  PubMed  Google Scholar 

  11. Ikeda Y, Saku M, Kawanaka H, Nonaka M, Yoshida K (2003) Features of second primary cancer in patients with gastric cancer. Oncology 65:113–117

    Article  PubMed  Google Scholar 

  12. Risinger JI, Berchuck A, Kohler MF, Watson P, Lynch HT, Boyd J (1993) Genetic instability of microsatellites in endometrial carcinoma. Cancer Res 53:5100–5103

    PubMed  CAS  Google Scholar 

  13. Han HJ, Yanagisawa A, Kato Y, Park JG, Nakamura Y (1993) Genetic instability in pancreatic cancer and poorly differentiated type of gastric cancer. Cancer Res 53:5087–5089

    PubMed  CAS  Google Scholar 

  14. Brown SR, Finan PJ, Hall NR, Bishop DT (1998) Incidence of DNA replication errors in patients with multiple primary cancers. Dis Colon Rectum 41:765–769

    Article  PubMed  CAS  Google Scholar 

  15. Kim HS, Cho NB, Yoo JH, Shin KH, Park JG, Kim YI, Kim WH (2001) Microsatellite instability in double primary cancers of the colorectum and stomach. Mod Pathol 14:543–548

    Article  PubMed  CAS  Google Scholar 

  16. Vasen HF, Mecklin JP, Khan PM, Lynch HT (1991) The International Collaborative Group on Hereditary Non-Polyposis Colorectal Cancer (ICG-HNPCC). Dis Colon Rectum 34:424–425

    Article  PubMed  CAS  Google Scholar 

  17. DeVita VT HS, Rosenberg SA (eds) (2001) Cancer: principles and practice of oncology, 6th edn. Lippincott, Williams & Wilkins, Philadelphia

  18. Dong C, Hemminki K (2001) Multiple primary cancers of the colon, breast and skin (melanoma) as models for polygenic cancers. Int J Cancer 92:883–887

    Article  PubMed  CAS  Google Scholar 

  19. Liu YY, Chen YM, Yen SH, Tsai CM, Perng RP (2002) Multiple primary malignancies involving lung cancer—clinical characteristics and prognosis. Lung Cancer 35:189–194

    Article  PubMed  Google Scholar 

  20. Hemminki K, Boffetta P (2004) Multiple primary cancers as clues to environmental and heritable causes of cancer and mechanisms of carcinogenesis. IARC Sci Publ 157:289–297

    PubMed  Google Scholar 

  21. Heard A, Roder D, Luke C (2005) Multiple primary cancers of separate organ sites: implications for research and cancer control (Australia). Canc Causes Contr 16:475–481

    Article  Google Scholar 

  22. Ahmed F, Goodman MT, Kosary C, Ruiz B, Wu XC, Chen VW, Correa CN (2006) Excess risk of subsequent primary cancers among colorectal carcinoma survivors, 1975–2001. Cancer 107:1162–1171

    Article  PubMed  Google Scholar 

  23. asubuchi 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 85:1917–1924

    PubMed  CAS  Google Scholar 

  24. 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 86:678–683

    Article  PubMed  CAS  Google Scholar 

  25. Liu B, Parsons R, Papadopoulos N, Nicolaides NC, Lynch HT, Watson P, Jass JR, Dunlop M, Wyllie A, Peltomaki P, de la Chapelle A, Hamilton SR, Vogelstein B, Kinzler KW (1996) Analysis of mismatch repair genes in hereditary non-polyposis colorectal cancer patients. Nat Med 2:169–174

    Article  PubMed  CAS  Google Scholar 

  26. Gonzalez-Aguilera JJ, Nejda N, Fernandez FJ, Medina V, Gonzalez-Hermoso F, Barrios Y, Moreno Azcoita M, Fernandez-Peralta AM (2003) Genetic alterations and MSI status in primary, synchronous, and metachronous tumors in a family with hereditary nonpolyposis colorectal cancer (HNPCC). Am J Clin Oncol 26:386–391

    PubMed  CAS  Google Scholar 

  27. Boland CR, Thibodeau SN, Hamilton SR, Sidransky D, Eshleman JR, Burt RW, Meltzer SJ, Rodriguez-Bigas MA, Fodde R, Ranzani GN, Srivastava S (1998) A National Cancer Institute Workshop on Microsatellite Instability for cancer detection and familial predisposition: development of international criteria for the determination of microsatellite instability in colorectal cancer. Cancer Res 58:5248–5257

    PubMed  CAS  Google Scholar 

  28. Kang GH, Yoon GS, Lee HK, Kwon YM, Ro JY (1999) Clinicopathologic characteristics of replication error-positive gastric carcinoma. Mod Pathol 12:15–20

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Ilwon-dong 50, Gangnam-gu, Seoul, 135-710, South Korea

    H. R. Yun, L. J. Yi, Y. K. Cho, J. H. Park, Y. B. Cho, S. H. Yun, H. C. Kim, H. K. Chun & W. Y. Lee

Authors
  1. H. R. Yun
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. L. J. Yi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Y. K. Cho
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. H. Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Y. B. Cho
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. S. H. Yun
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. H. C. Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. H. K. Chun
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. W. Y. Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to W. Y. Lee.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Yun, H.R., Yi, L.J., Cho, Y.K. et al. Double primary malignancy in colorectal cancer patients—MSI is the useful marker for predicting double primary tumors. Int J Colorectal Dis 24, 369–375 (2009). https://doi.org/10.1007/s00384-008-0541-x

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00384-008-0541-x

Keywords

Search

Navigation