Clinicopathological features of multiple primary gastric carcinoma.

The clinicopathological features of multiple primary gastric carcinoma in 107 patients who had undergone gastrectomy between 1972 and 1992 were studied and compared with those of single gastric carcinoma in 1,456 patients. The incidence of occurrence of multiple primary gastric carcinoma was 6.8% of patients who had gastrectomy for gastric cancer. Such carcinoma was detected less often in patients <49 years of age. Dominant findings involved an elevated gross appearance, papillary or well-differentiated adenocarcinoma in the histology, and invasion to the depth of mucosa. When multiple primary gastric carcinoma was classified by main and concomitant lesions based on the stage of the disease, concomitant lesions were detected more often in the lower third of the stomach and at the distal site of main lesions located in the upper or middle third of the stomach. These results indicate that the lower third of the stomach and the distal site of the main lesion must be investigated carefully to ensure that incidental concomitant lesions are not overlooked, especially when a patient has the clincopathological features described above.