Synchronous gastric and colon cancers: Important to consider hereditary syndromes and chronic inflammatory disease associations

Abstract

In this editorial we comment on the manuscript, describing management and surveillance strategies in synchronous and metachronous, gastric and colon cancers. Synchronous or metachronous primary malignancies at different sites of the gastrointestinal tract pose a unique diagnostic and therapeutic challenge. Multidisciplinary services and strategies are required for the management of multiple site primary malignancies, to provide the best oncological outcomes. Although this study highlights the dual cancers in 76 sporadic cases, the authors excluded 55 patients due to combination of factors which includes; incomplete clinical data, genetic syndrome, gastric stump cancers. In addition, the authors did not elaborate if any patients presented with signet ring cell morphology, E-cadherin mutations or presence of inflammatory bowel disease. Genetic and mutational errors and epithelial field defects from chronic inflammatory diseases of the gastrointestinal tract are important when considering synchronous gastric and colonic cancers. We will briefly discuss these in this editorial.

Keywords: Synchronous gastric, Colon cancers, Gene mutation, Chronic inflammation

Core Tip: Certain genetic polyposis syndromes and inflammatory familial diseases are associated with increased risks for multiple site gastrointestinal cancer, specifically gastroduodenal and colon cancers. These include familial adenomatous polyposis, Lynch syndromes, Hereditary diffuse gastric cancer, Peutz-Jeghers syndrome, Crohn’s disease. Mutations in APC gene, MMR genes, CDH1 gene and STK11 gene respectively. Generally, cancers associated with genetic mutations progress through adenoma carcinoma sequence while inflammatory bowel disease progress to malignancy through dysplasia-carcinoma sequence.