Incidence, clinicopathological characteristics, and therapeutic strategy for gastric cancer patients with metastasis to the central nervous system.

Abstract

AIM:

This study aimed to analyze the clinicopathologic features and treatment outcomes of central nervous system (CNS) metastasis from gastric cancer.

METHODS:

A total of 419 patients diagnosed with unresectable advanced or recurrent gastric cancer at Kochi Medical School between January 2007 and December 2021 were evaluated. Data of patients were reviewed, and clinicopathological information and survival outcomes of those with CNS metastases were compared to patients without CNS metastases.

RESULTS:

In total, 12/419 (2.9%) patients (median age: 66.5 years [range, 41-82 years]) were diagnosed with CNS metastasis from gastric cancer. Eleven had diffuse-type gastric cancer which was significantly more common than in those without CNS metastasis (91% vs. 61%, p = .034). Human epidermal growth factor receptor 2 status was positive in one of the 12 patients. The median survival time was significantly lower for patients with CNS metastasis than for those without CNS metastasis (1.8 months vs. 11.4 months, p < .001). The median survival time for patients who underwent surgical resection, radiation, or chemotherapy for CNS metastasis was significantly higher than those who received only best supportive care (3.5 months vs. .6 months; p = .007).

CONCLUSIONS:

CNS metastasis was found in 2.9% (12/419) of patients with unresectable advanced or recurrent gastric cancer. Diffuse-type histology was a risk factor for CNS metastasis. Multidisciplinary treatment, including surgical resection, radiation treatment, or chemotherapy, for CNS metastasis from gastric cancer may benefit selected patients.

• Authors: Tsutomu Namikawa, Akira Marui, Keiichiro Yokota, Yasuhiro Kawanishi, Masaya Munekage, Sunao Uemura, Hiromichi Maeda, Hiroyuki Kitagawa, Michiya Kobayashi, Kazuhiro Hanazaki
• Journal: Asia-Pacific journal of clinical oncology (Asia Pac J Clin Oncol) Vol. 19 Issue 5 Pg. e195-e201 (Oct 2023) ISSN: 1743-7563 [Electronic] Australia
• PMID: 35791882 (Publication Type: Journal Article)
• Copyright: © 2022 John Wiley & Sons Australia, Ltd.

Topics

• Humans
• Aged
• Stomach Neoplasms (pathology)
• Incidence
• Neoplasm Recurrence, Local
• Treatment Outcome
• Central Nervous System Neoplasms (epidemiology, therapy)
• Central Nervous System (pathology)
• Retrospective Studies
• Prognosis