SYNCHRONOUS GASTRIC TUMORS ASSOCIATED WITH ESOPHAGEAL CANCER - A RETROSPECTIVE STUDY OF 24 PATIENTS

Objectives: Synchronous gastric tumors (including benign and secondary tumors) associated with esophageal cancer present diagnostic and ther apeutic issues. We investigated this synchronous association, and retr ospectively determined the frequency of the gastric tumors and the cli nical characteristics. Methods: In a series of 208 patients with esoph ageal cancer, we investigated the synchronous gastric tumors, as well as the frequency of association, clinicopathological characteristics, diagnosis, treatment, and the clinical outcome after surgery. Results: Twenty-eight gastric tumors were found in 23 patients. Adenocarcinoma was most frequent. Most of these tumors were located at the upper or middle third of the stomach. Eight gastric tumors in six patients coul d not be detected preoperatively. Six of these tumors including a gast ric remnant cancer were detected in the resected stomach, and two leio myomas were detected during the operation. In one patient in which an endoscope could not pass through the esophagus, a leiomyoma was detect ed in the resected stomach. For the gastric cancers, total gastrectomy or proximal gastrectomy with lymph node dissections was performed. Fo r the benign tumors, partial resection of the stomach was performed, a nd endoscopic resection was performed preoperatively for an adenoma. L n both the postoperative hospital mortality rate and the survival rate after surgery, there were no significant differences between the pati ents with and without gastric tumors. Conclusions: Synchronous gastric tumors associated with esophageal cancer are not rare. When an endosc ope cannot pass through the esophagus before surgery, other techniques must be performed to explore the stomach. For these patients, surgica l treatment should be adapted positively. (C) 1998 by Am. Coll. of Gas troenterology.