title: Clinical outcome of gastric cancer patients with bone marrow metastases.
abstract: BACKGROUND
  Gastric cancer with bone marrow metastases is known to pursue a rapidly deteriorating clinical course. We conducted a retrospective analysis to evaluate clinical manifestations and prognosis of gastric cancer patients with bone marrow metastases.
  
  
  METHODS
  Between September 1994 and February 2006, 39 gastric cancer patients with pathologically confirmed bone marrow dissemination were selected.
  
  
  RESULTS
  The majority of the patients showed younger age, poorly differentiated adenocarcinoma or signet ring cell carcinoma, thrombocytopenia, anemia, elevated lactate dehydrogenase and alkaline phosphatase. Poor prognostic factors for survival were serum sodium < or =133 mmol/l [relative risk (RR) 4.57; 95% CI 1.99-10.52; p < 0.001], the presence of lung metastasis (RR 3.47; 95% CI 1.48-8.15; p = 0.007) and the presence of peritoneal seeding (RR 2.17; 95% CI 1.06-4.43; p = 0.036). Median survival durations after bone marrow metastases for patients without any adverse factors (n = 19, 48.7%) and those with 1-3 adverse factors (n = 20, 51.3%) were 67 and 23 days, respectively (p = 0.013). Patients without any adverse factors did benefit from palliative chemotherapy (p = 0.048).
  
  
  CONCLUSIONS
  We suggest that gastric cancer patients with bone marrow metastases should receive more tailored therapies according to different risk factors in order to enhance survival.
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Hyo Song
authors.initials: HS
authors.lastname: Kim
authors.forename: Seong Yoon
authors.initials: SY
authors.lastname: Yi
authors.forename: Hyun Jung
authors.initials: HJ
authors.lastname: Jun
authors.forename: Jeeyun
authors.initials: J
authors.lastname: Lee
authors.forename: Joon Oh
authors.initials: JO
authors.lastname: Park
authors.forename: Young Suk
authors.initials: YS
authors.lastname: Park
authors.forename: Junho
authors.initials: J
authors.lastname: Jang
authors.forename: Hee-Jin
authors.initials: HJ
authors.lastname: Kim
authors.forename: Younghyeh
authors.initials: Y
authors.lastname: Ko
authors.forename: Ho Yeong
authors.initials: HY
authors.lastname: Lim
authors.forename: Won Ki
authors.initials: WK
authors.lastname: Kang
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000401:mortality / Q000556:secondary*; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000378:metabolism*; D001853:Bone Marrow / Q000187:drug effects / Q000473:pathology*; D019046:Bone Marrow Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000556:secondary*; D001859:Bone Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000556:secondary; D018279:Carcinoma, Signet Ring Cell / Q000188:drug therapy / Q000401:mortality / Q000556:secondary*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000556:secondary; D008175:Lung Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000556:secondary; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor