Outcomes of Gastric Adenocarcinoma after Treatment of Esophageal Squamous Carcinoma

Abstract

We reviewed the clinical outcome of metachronous gastric adenocarcinoma according to the endoscopic interval after curative treatment of squamous esophageal carcinoma by endoscopic resection or surgical resection. Eighteen cases with gastric adenocarcinoma after treatment of esophageal carcinoma at Asan Medical Center between March 1994 and March 2010 were analyzed retrospectively. Median interval between treatment of esophageal cancer and detection of metachronous gastric cancer was 44 months (interquartile range [IQR]=25.5-77.8 months), and median endoscopic interval before finding gastric cancer was 15 months (IQR=12.0-44.8 months). In cases with 12 resectable gastric cancers, the median interval of previous endoscopy before gastric cancer was shorter than that for 6 unresectable cancers (12.0 months, IQR=12-16 months vs. 59.5 months, IQR=37.5-68.5 months, p<0.001) and the rate of death was lower (16.7% [2/12] vs. 83.3% [5/6], p=0.006). Logistic regression showed that a shorter duration of endoscopic interval increased the rate of resectability of gastric cancer (p<0.001) and a higher rate of unresectable gastric cancer and longer duration of endoscopic interval increased death (p=0.029 and p=0.004, respectively). After treatment of esophageal cancer, endoscopic examination at 12-month intervals is important to lower the rate of death due to metachronous gastric cancer.