Clinical experience of double primary gastric cancer and hepatocellular carcinoma

Background: With improvements in the prognosis of gastric cancer, the clinical importance of treating patients with both gastric cancer and hepatocellular carcinoma (HCC) is increasing because of the high prevalence of HCC in Taiwan. Patients and Methods: We reviewed the medical records of 5468 patients who received a diagnosis of primary gastric cancer at National Taiwan University Hospital between 1980 and 2010. Of these, we identified 18 patients with HCC. Results: Regarding the double cancer cases, six patients received a diagnosis of synchronous cancers, six patients received a diagnosis of HCC during follow-up for gastric cancer, and six patients had undergone HCC treatment before receiving a gastric cancer diagnosis. All the patients who received an HCC diagnosis after gastric cancer underwent curative therapy, except for one patient who had a large hepatic tumor. By contrast, of the patients who received an HCC diagnosis first, only one received an early gastric cancer diagnosis, and the remaining patients received an advanced gastric cancer diagnosis. Despite the presence of double cancers, surgical mortality did not occur in the patients who underwent curative-intended treatment. Conclusion: The study results suggest the necessity of closely following up patients with gastric cancer or HCC for the early diagnosis and treatment of the other malignancy. Aggressive treatments including surgery and radiofrequency ablation are safe and can prolong survival in some patients.