• basosquamous carcinoma
• clear renal cell carcinoma
• hepatocellular carcinoma
• multidisciplinary team
• multiple primary malignant neoplasms
• prostatic adenocarcinoma

• Adenocarcinoma/diagnosis
• Adenocarcinoma/surgery
• Aged
• Biopsy
• Colonic Neoplasms/diagnosis
• Colonic Neoplasms/surgery
• Diagnosis, Differential
• Digestive System Surgical Procedures/methods
• Endoscopy, Digestive System
• Fatal Outcome
• Female
• Humans
• Liver Neoplasms/diagnosis
• Liver Neoplasms/surgery
• Neoplasms, Multiple Primary/diagnosis
• Neoplasms, Multiple Primary/surgery
• Stomach Neoplasms/diagnosis
• Stomach Neoplasms/surgery

AIM: To ascertain the adequacy of the microsatellite instability (MSI) as a prognostic indicator by assessing MSI status of patients with double primary gastric and colorectal cancer (DPGCC).

METHODS: Sixteen patients were studied, all of whom exhibited sporadic DPGCC, and had no family history of hereditary non-polyposis colorectal cancer, according to the Amsterdam criteria. A total of 32 cancers from 16 DPGCC patients, and 216 single primary CRC, were assessed for MSI in 5 microsatellite loci, BAT25, BAT26, D2S123, D5S346, and D17S250.

RESULTS: MSI was observed in 6 (37.5%) of 16 GC and 4 (25.0%) of 16 CRC. Thirty tumors (13.9%) out of 216 single primary CRC and one tumor (16.7%) out of 6 double primary CRC were found to be microsatellite unstable. Of the 6 GC with MSI in DPGCC, 5 (31.3%) were MSI-high and one (6.3%) was MSI-low. In 5 of 16 DPGCC patients, the cancer recurred in or adjacent to the anastomosis or metastasized to the kidney or lung. The MSI-high DPGCC cases were associated with a younger age of onset (47.5 years vs 62.5 years), higher frequency of lymph node metastasis (100% vs 25%), and advanced Dukes stage (C, 100% vs 41.7%), as well as a higher frequency of recurrence or metastasis (100% vs 8.3%). Only recurrence or metastasis showed statistical significance by Fisher’s exact test.

CONCLUSION: Our data suggest that MSI may play an important role in the development of DPGCC, and that it may be used clinically as a molecular predictive marker for recurrence or late metastasis of DPGCC.

• Stomach neoplasms
• Colorectal neoplasms
• Microsatellite instability
• Double primary

• Adult
• Age of Onset
• Aged
• Colorectal Neoplasms/genetics
• Colorectal Neoplasms/pathology
• Female
• Humans
• Male
• Microsatellite Repeats
• Middle Aged
• Predictive Value of Tests
• Prognosis
• Stomach Neoplasms/genetics
• Stomach Neoplasms/pathology
• Treatment Outcome

To explore and investigate the experience of early diagnosis and treatment with multiple primary malignant tumors in the elderly.

Fifty-nine cases of PMPTs patients admitted to our hospital in the period of 1980 to 2002 were studied retrospectively, including early dignosis, the 5-and 10-year survival rates in first and second cancer after endoscopic mucosal resection, resection and radiotherapy, the interval time between sequential tumors and proper treatment.

Eleven (19%) patients had synchronous tumors and 48 (81%) patients had metachronous tumors, of these, double cancer, triple cancer in the gastrointestinal tract were 26 cases and 7 cases, respectively. Early diagnosis in patients with PMPT in double and triple primary cancers in gastrointestinal tract were 58% and 38% respectively. The interval time between the cancers varied between 6 months and 21 years. The median interval time was 48 months, and that between second and third was 60 months. The 5 year survival rates from the date of the treatment of the first cancer were 75%(9/12), for those who had endoscopic mucosal resection, and 67% (14/21), for those who received radical operation and 64%(7/11), for radiotherapy respectively. The 10 year survival rates were 41%(5/12) 38%(8/21) 27% (3/11) respevtively.

Early dignosis of MPT elevated 5-year survival rates. Endoscopic treatment was recommened for early stage carcinomas of the gastrointestinal tract in the elderly.

• N/A