Dual primary gastric and colorectal cancer: A complex challenge in surgical oncology

Abstract

The intricate interplay of colorectal cancer (CRC) and gastric cancer (GC) as dual primary malignancies presents a significant challenge in surgical oncology. CRC is the most common secondary malignancy in GC patients, and vice versa, evidence highlighted by advances in diagnostic procedures and therapy modalities that impact patient survival. A recent study titled “Features of synchronous and metachronous dual primary gastric and colorectal cancer” explores this enigmatic dual malignancy, uncovering crucial insights into the clinical characteristics and prognostic distinctions between synchronous and metachronous presentations. Notably, metachronous cases with a second primary cancer discovered more than six months after the first diagnosis have a better outcome, emphasizing the importance of early detection and treatment. This study underscores the prognostic role of GC stage in patient outcomes. It also sheds light on the complexities faced by synchronous cases, often presenting with unresectable CRC. Surgery-related procedures, like gastrectomy and colon resection, stand out as important predictors of increased survival, necessitating a reevaluation of current therapeutic approaches. A tailored and patient-centered strategy, considering the health of each patient individually and the feasibility of radical treatments, is essential. Continuous follow-up and monitoring are crucial as most second primary cancers arise within five years. In conclusion, early diagnosis, surgical intervention, and watchful surveillance are pivotal in managing dual primary gastric and colorectal cancer patients. Since the incidence of gastric and colorectal cancers continues to rise, the imperative need for further research, ideally with larger sample sizes, becomes evident in our pursuit of comprehensive insights that will refine clinical approaches for this intricate dual malignancy.

Keywords: Multiple primary cancers; Colorectal cancer; Gastric cancer; Dual primary cancers; Synchronous cancers; Metachronous cancers

Core Tip: This editorial explores the complex landscape of dual primary gastric and colorectal cancer (DPGCC), investigating synchronous and metachronous cases. It uncovers a clear prognostic gap, emphasizing the need of early detection. The research underlines the pivotal role of surgical interventions, with gastric cancer stage significantly impacting patient outcomes. It also highlights the need for regular follow-up due to the majority of second primary cancers occurring within five years. The current literature provides guidance for individualized therapeutic approaches, enhancing patient prognoses, and underscores the intricate and multifaceted character of managing DPGCC.