Brain metastases in patients with upper gastrointestinal cancer is associated with proximally located adenocarcinoma and lymph node metastases.
Adenocarcinoma
/ pathology
Brain Neoplasms
/ secondary
Esophageal Neoplasms
/ pathology
Esophagogastric Junction
/ pathology
Female
Follow-Up Studies
Gastrointestinal Neoplasms
/ pathology
Humans
Lymphatic Metastasis
Male
Middle Aged
Prognosis
Retrospective Studies
Stomach Neoplasms
/ pathology
Survival Rate
Brain metastases
Esophageal adenocarcinoma
Esophageal squamous-cell carcinoma
Gastric adenocarcinoma
Gastroesophageal junction adenocarcinoma
Journal
Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association
ISSN: 1436-3305
Titre abrégé: Gastric Cancer
Pays: Japan
ID NLM: 100886238
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
received:
17
02
2020
accepted:
13
04
2020
pubmed:
30
4
2020
medline:
29
6
2021
entrez:
30
4
2020
Statut:
ppublish
Résumé
As cancer patients are surviving longer, more patients manifest brain metastases (BRMs). However, the rate of BRMs from upper gastrointestinal cancer is unclear. We therefore evaluated the frequency and prognostic effect of BRMs in this setting. We analyzed records of 2348 patients who were treated between January 2002 and December 2016 for upper gastrointestinal cancer, including esophageal and gastroesophageal junction adenocarcinoma (EAC; proximal EAC, Siewert types I and II), esophageal squamous cell carcinoma (ESCC), and gastric adenocarcinoma (GAC; Siewert type III and stomach cancer) in our Gastrointestinal Medical Oncology Database. Frequency, risk factors, and survival after BRMs were evaluated. Of 2348 patients, 68 (2.9%) had BRMs upon follow-up. The BRM rates were as follows: proximal EAC, 4.8%; Siewert type I, 5.9%; Siewert type II, 2.2%; Siewert type III, 0.7%; ESCC: 1.2%; and stomach cancer, 0%. Among EAC patients, Siewert type I and lymph node metastases were independent the risk factors for BRMs in the multivariable analysis. The median overall survival (OS) in the 68 patients with BRMs was only 1.16 years (95% CI 0.78-1.61). However, OS for patients who had a solitary BRM, who had BRM but no other distant metastasis, or who underwent surgery or stereotactic radiosurgery favorable. Patients with proximally located adenocarcinoma, or with lymph node metastases are at a higher risk for BRMs and patients fare better after treatment of isolated BRM.
Sections du résumé
BACKGROUND
As cancer patients are surviving longer, more patients manifest brain metastases (BRMs). However, the rate of BRMs from upper gastrointestinal cancer is unclear. We therefore evaluated the frequency and prognostic effect of BRMs in this setting.
METHODS
We analyzed records of 2348 patients who were treated between January 2002 and December 2016 for upper gastrointestinal cancer, including esophageal and gastroesophageal junction adenocarcinoma (EAC; proximal EAC, Siewert types I and II), esophageal squamous cell carcinoma (ESCC), and gastric adenocarcinoma (GAC; Siewert type III and stomach cancer) in our Gastrointestinal Medical Oncology Database. Frequency, risk factors, and survival after BRMs were evaluated.
RESULTS
Of 2348 patients, 68 (2.9%) had BRMs upon follow-up. The BRM rates were as follows: proximal EAC, 4.8%; Siewert type I, 5.9%; Siewert type II, 2.2%; Siewert type III, 0.7%; ESCC: 1.2%; and stomach cancer, 0%. Among EAC patients, Siewert type I and lymph node metastases were independent the risk factors for BRMs in the multivariable analysis. The median overall survival (OS) in the 68 patients with BRMs was only 1.16 years (95% CI 0.78-1.61). However, OS for patients who had a solitary BRM, who had BRM but no other distant metastasis, or who underwent surgery or stereotactic radiosurgery favorable.
CONCLUSION
Patients with proximally located adenocarcinoma, or with lymph node metastases are at a higher risk for BRMs and patients fare better after treatment of isolated BRM.
Identifiants
pubmed: 32347396
doi: 10.1007/s10120-020-01075-3
pii: 10.1007/s10120-020-01075-3
pmc: PMC7442686
mid: NIHMS1588777
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
904-912Subventions
Organisme : NCI NIH HHS
ID : P30 CA016672
Pays : United States
Organisme : NCI NIH HHS
ID : CA138671
Pays : United States
Organisme : NCI NIH HHS
ID : CA172741
Pays : United States
Organisme : NCI NIH HHS
ID : R21 CA129906
Pays : United States
Organisme : Japan Society for the Promotion of Science
ID : Overseas Research Fellowships and Program for Advancing Strategic International Networks to Accelerate the Circulation of Talented Researchers
Pays : International
Organisme : NCI NIH HHS
ID : R21 CA127672
Pays : United States
Organisme : NCI NIH HHS
ID : CA129906
Pays : United States
Organisme : NCI NIH HHS
ID : CA127672
Pays : United States
Organisme : U.S. Department of Defense
ID : CA162445
Pays : International
Organisme : U.S. Department of Defense
ID : CA150334
Pays : International
Organisme : NCI NIH HHS
ID : R01 CA172741
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA138671
Pays : United States
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