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Erschienen in: Annals of Surgical Oncology 3/2014

01.06.2014 | Gastrointestinal Oncology

Is Preoperative Colonoscopy Necessary for Patients Undergoing Gastric Cancer Surgery?

verfasst von: Toshiyasu Ojima, MD, Makoto Iwahashi, MD, Mikihito Nakamori, MD, Masaki Nakamura, MD, Masahiro Katsuda, MD, Takeshi Iida, MD, Keiji Hayata, MD, Katsunari Takifuji, MD, Shunsuke Yamaguchi, MD, Hiroki Yamaue, MD

Erschienen in: Annals of Surgical Oncology | Sonderheft 3/2014

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Abstract

Purpose

The aim of this study was to evaluate the necessity of preoperative colonoscopy (CS) in gastric cancer (GC) patients and to assess the outcomes of different treatments in patients with synchronous GC and colorectal neoplasms (CRN). We also determined the risk factors influencing the comorbidity of colorectal cancer (CRC) in patients with GC.

Methods

This retrospective study included 1891 consecutive GC patients who underwent CS before surgery from January 1, 1999, through June 30, 2012.

Results

There was a high prevalence of concurrent CRN (28.4 %) and CRC (3.2 %) in our patients with GC. Sixty-one patients with GC had synchronous CRC. Twenty-three of the 61 tumors were perioperatively treated by endoscopic resection. The other 38 tumors were treated by simultaneous surgery for the GC and CRC. Surgical complications were not found in either the endoscopic or surgical resection group. The multivariate logistic regression analysis indicated that the prevalence of synchronous CRC in patients with GC was significantly associated with the incidence of multiple GCs [P < 0.0001; odds ratio (OR) 15.3], having anemia (P = 0.002; OR 3.0), and having a smoking history (P = 0.021; OR 1.9).

Conclusions

We recommend preoperative CS screening for GC patients. In particular, preoperative CS screening is indispensable for patients with multiple GCs. In addition, simultaneous treatments for patients with synchronous GC and CRN are safe and feasible procedures.
Literatur
1.
Zurück zum Zitat Ojima T, Iwahashi M, Nakamori M, Nakamura M, Naka T, Katsuda M, et al. Association of allogeneic blood transfusions and long-term survival of patients with gastric cancer after curative gastrectomy. J Gastrointest Surg. 2009;13:1821–30.PubMedCrossRef Ojima T, Iwahashi M, Nakamori M, Nakamura M, Naka T, Katsuda M, et al. Association of allogeneic blood transfusions and long-term survival of patients with gastric cancer after curative gastrectomy. J Gastrointest Surg. 2009;13:1821–30.PubMedCrossRef
2.
Zurück zum Zitat Sung JJ, Lau JY, Young GP, Sano Y, Chiu HM, Byeon JS, et al. Asia Pacific consensus recommendations for colorectal cancer screening. Gut. 2008;57:1166–76.PubMedCrossRef Sung JJ, Lau JY, Young GP, Sano Y, Chiu HM, Byeon JS, et al. Asia Pacific consensus recommendations for colorectal cancer screening. Gut. 2008;57:1166–76.PubMedCrossRef
3.
Zurück zum Zitat Dinis-Ribeiro M, Lomba-Viana H, Silva R, Moreira-Dias L, Lomba-Viana R. Associated primary tumors in patients with gastric cancer. J Clin Gastroenterol. 2002;34:533–5.PubMedCrossRef Dinis-Ribeiro M, Lomba-Viana H, Silva R, Moreira-Dias L, Lomba-Viana R. Associated primary tumors in patients with gastric cancer. J Clin Gastroenterol. 2002;34:533–5.PubMedCrossRef
5.
Zurück zum Zitat Tokunaga M, Hiki N, Fukunaga T, Kuroyanagi H, Miki A, Akiyoshi T, et al. Laparoscopic surgery for synchronous gastric and colorectal cancer: a preliminary experience. Langenbecks Arch Surg. 2010;395:207–10.PubMedCrossRef Tokunaga M, Hiki N, Fukunaga T, Kuroyanagi H, Miki A, Akiyoshi T, et al. Laparoscopic surgery for synchronous gastric and colorectal cancer: a preliminary experience. Langenbecks Arch Surg. 2010;395:207–10.PubMedCrossRef
6.
Zurück zum Zitat Matsui H, Okamoto Y, Ishii A, Ishizu K, Kondoh Y, Igarashi N, et al. Laparoscopy-assisted combined resection for synchronous gastric and colorectal cancer: report of three cases. Surg Today. 2009;39:434–9.PubMedCrossRef Matsui H, Okamoto Y, Ishii A, Ishizu K, Kondoh Y, Igarashi N, et al. Laparoscopy-assisted combined resection for synchronous gastric and colorectal cancer: report of three cases. Surg Today. 2009;39:434–9.PubMedCrossRef
7.
Zurück zum Zitat Kim HO, Hwang SI, Yoo CH, Kim H. Preoperative colonoscopy for patients with gastric adenocarcinoma. J Gastroenterol Hepatol. 2009;24:1740–4.PubMedCrossRef Kim HO, Hwang SI, Yoo CH, Kim H. Preoperative colonoscopy for patients with gastric adenocarcinoma. J Gastroenterol Hepatol. 2009;24:1740–4.PubMedCrossRef
8.
Zurück zum Zitat Saito S, Hosoya Y, Togashi K, Kurashina K, Haruta H, Hyodo M, et al. Prevalence of synchronous colorectal neoplasms detected by colonoscopy in patients with gastric cancer. Surg Today. 2008;38:20–5.PubMedCrossRef Saito S, Hosoya Y, Togashi K, Kurashina K, Haruta H, Hyodo M, et al. Prevalence of synchronous colorectal neoplasms detected by colonoscopy in patients with gastric cancer. Surg Today. 2008;38:20–5.PubMedCrossRef
9.
Zurück zum Zitat Lee KJ, Kim JH, Kim SI, Jang JH, Lee HH, Hong SN, et al. Clinical significance of colonoscopic examination in patients with early stage of gastric neoplasm undergoing endoscopic submucosal dissection. Scand J Gastroenterol. 2011;46:1349–54.PubMedCrossRef Lee KJ, Kim JH, Kim SI, Jang JH, Lee HH, Hong SN, et al. Clinical significance of colonoscopic examination in patients with early stage of gastric neoplasm undergoing endoscopic submucosal dissection. Scand J Gastroenterol. 2011;46:1349–54.PubMedCrossRef
10.
Zurück zum Zitat Park DI, Park SH, Yoo TW, Kim HS, Yang SK, Byeon JS, et al. The prevalence of colorectal neoplasia in patients with gastric cancer: a Korean Association for the Study of Intestinal Disease (KASID) Study. J Clin Gastroenterol. 2010;44:102–5.PubMedCrossRef Park DI, Park SH, Yoo TW, Kim HS, Yang SK, Byeon JS, et al. The prevalence of colorectal neoplasia in patients with gastric cancer: a Korean Association for the Study of Intestinal Disease (KASID) Study. J Clin Gastroenterol. 2010;44:102–5.PubMedCrossRef
11.
Zurück zum Zitat Byeon JS, Yang SK, Kim TI, Kim WH, Lau JY, Leung WK, et al. Colorectal neoplasm in asymptomatic Asians: a prospective multinational multicenter colonoscopy survey. Gastrointest Endosc. 2007;65:1015–22.PubMedCrossRef Byeon JS, Yang SK, Kim TI, Kim WH, Lau JY, Leung WK, et al. Colorectal neoplasm in asymptomatic Asians: a prospective multinational multicenter colonoscopy survey. Gastrointest Endosc. 2007;65:1015–22.PubMedCrossRef
12.
Zurück zum Zitat Kudo S, Tamegai Y, Yamano H, Imai Y, Kogure E, Kashida H. Endoscopic mucosal resection of the colon: the Japanese technique. Gastrointest Endosc Clin N Am 2001; 11:519-35.PubMed Kudo S, Tamegai Y, Yamano H, Imai Y, Kogure E, Kashida H. Endoscopic mucosal resection of the colon: the Japanese technique. Gastrointest Endosc Clin N Am 2001; 11:519-35.PubMed
14.
Zurück zum Zitat Ojima T, Iwahashi M, Nakamori M, Nakamura M, Naka T, Ishida K, et al. Influence of overweight on patients with gastric cancer after undergoing curative gastrectomy: an analysis of 689 consecutive cases managed by a single center. Arch Surg. 2009;144:351–8.PubMedCrossRef Ojima T, Iwahashi M, Nakamori M, Nakamura M, Naka T, Ishida K, et al. Influence of overweight on patients with gastric cancer after undergoing curative gastrectomy: an analysis of 689 consecutive cases managed by a single center. Arch Surg. 2009;144:351–8.PubMedCrossRef
15.
Zurück zum Zitat Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A. AJCC cancer staging manual. 7th ed. New York: Springer; 2009. Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A. AJCC cancer staging manual. 7th ed. New York: Springer; 2009.
16.
Zurück zum Zitat Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.PubMedCentralPubMedCrossRef Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.PubMedCentralPubMedCrossRef
17.
Zurück zum Zitat Naito Y, Uchiyama K, Kinoshita Y, Fukudo S, Joh T, Suzuki H,et al. A questionnaire-based survey on screening for gastric and colorectal cancer by physicians in East Asian countries in 2010. Digestion. 2012;86:94–106.PubMedCrossRef Naito Y, Uchiyama K, Kinoshita Y, Fukudo S, Joh T, Suzuki H,et al. A questionnaire-based survey on screening for gastric and colorectal cancer by physicians in East Asian countries in 2010. Digestion. 2012;86:94–106.PubMedCrossRef
18.
Zurück zum Zitat Goddard AF, James MW, McIntyre AS, Scott BB. Guidelines for the management of iron deficiency anaemia. Gut. 2011;60:1309–16.PubMedCrossRef Goddard AF, James MW, McIntyre AS, Scott BB. Guidelines for the management of iron deficiency anaemia. Gut. 2011;60:1309–16.PubMedCrossRef
19.
Zurück zum Zitat Uchino S, Tsuda H, Noguchi M, Yokota J, Terada M, Saito T, et al. Frequent loss of heterozygosity at the DCC locus in gastric cancer. Cancer Res. 1992;52:3099–102.PubMed Uchino S, Tsuda H, Noguchi M, Yokota J, Terada M, Saito T, et al. Frequent loss of heterozygosity at the DCC locus in gastric cancer. Cancer Res. 1992;52:3099–102.PubMed
20.
Zurück zum Zitat Vogelstein B, Fearon ER, Hamilton SR, Kern SE, Preisinger AC, Leppert M, et al. Genetic alterations during colorectal-tumor development. N Engl J Med. 1988;319:525–32.PubMedCrossRef Vogelstein B, Fearon ER, Hamilton SR, Kern SE, Preisinger AC, Leppert M, et al. Genetic alterations during colorectal-tumor development. N Engl J Med. 1988;319:525–32.PubMedCrossRef
21.
Zurück zum Zitat Ohtani H, Yashiro M, Onoda N, Nishioka N, Kato Y, Yamamoto S, et al. Synchronous multiple primary gastrointestinal cancer exhibits frequent microsatellite instability. Int J Cancer. 2000;86:678–83.PubMedCrossRef Ohtani H, Yashiro M, Onoda N, Nishioka N, Kato Y, Yamamoto S, et al. Synchronous multiple primary gastrointestinal cancer exhibits frequent microsatellite instability. Int J Cancer. 2000;86:678–83.PubMedCrossRef
23.
Zurück zum Zitat Miyoshi E, Haruma K, Hiyama T, Tanaka S, Yoshihara M, Shimamoto F, et al. Microsatellite instability is a genetic marker for the development of multiple gastric cancers. Int J Cancer. 2001;95:350–3.PubMedCrossRef Miyoshi E, Haruma K, Hiyama T, Tanaka S, Yoshihara M, Shimamoto F, et al. Microsatellite instability is a genetic marker for the development of multiple gastric cancers. Int J Cancer. 2001;95:350–3.PubMedCrossRef
24.
Zurück zum Zitat Botteri E, Iodice S, Raimondi S, Maisonneuve P, Lowenfels AB. Cigarette smoking and adenomatous polyps: a meta-analysis. Gastroenterology. 2008;134:388–95.PubMedCrossRef Botteri E, Iodice S, Raimondi S, Maisonneuve P, Lowenfels AB. Cigarette smoking and adenomatous polyps: a meta-analysis. Gastroenterology. 2008;134:388–95.PubMedCrossRef
25.
Zurück zum Zitat Trédaniel J, Boffetta P, Buiatti E, Saracci R, Hirsch A. Tobacco smoking and gastric cancer: review and meta-analysis. Int J Cancer. 1997;72:565–73.PubMedCrossRef Trédaniel J, Boffetta P, Buiatti E, Saracci R, Hirsch A. Tobacco smoking and gastric cancer: review and meta-analysis. Int J Cancer. 1997;72:565–73.PubMedCrossRef
26.
Zurück zum Zitat Zhao YS, Wang F, Chang D, Han B, You DY. Meta-analysis of different test indicators: Helicobacter pylori infection and the risk of colorectal cancer. Int J Colorectal Dis. 2008;23:875–82.PubMedCrossRef Zhao YS, Wang F, Chang D, Han B, You DY. Meta-analysis of different test indicators: Helicobacter pylori infection and the risk of colorectal cancer. Int J Colorectal Dis. 2008;23:875–82.PubMedCrossRef
27.
Zurück zum Zitat Sonnenberg A, Genta RM. Helicobacter pylori is a risk factor for colonic neoplasms. Am J Gastroenterol. 2013;108:208–15.PubMedCrossRef Sonnenberg A, Genta RM. Helicobacter pylori is a risk factor for colonic neoplasms. Am J Gastroenterol. 2013;108:208–15.PubMedCrossRef
Metadaten
Titel
Is Preoperative Colonoscopy Necessary for Patients Undergoing Gastric Cancer Surgery?
verfasst von
Toshiyasu Ojima, MD
Makoto Iwahashi, MD
Mikihito Nakamori, MD
Masaki Nakamura, MD
Masahiro Katsuda, MD
Takeshi Iida, MD
Keiji Hayata, MD
Katsunari Takifuji, MD
Shunsuke Yamaguchi, MD
Hiroki Yamaue, MD
Publikationsdatum
01.06.2014
Verlag
Springer US
Erschienen in
Annals of Surgical Oncology / Ausgabe Sonderheft 3/2014
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-014-3580-2

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