Clinical outcome of gastric cancer patients with bone marrow metastases.
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.
Kim
Hyo Song
HS
Division of Hematology/Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Yi
Seong Yoon
SY
Jun
Hyun Jung
HJ
Lee
Jeeyun
J
Park
Joon Oh
JO
Park
Young Suk
YS
Jang
Junho
J
Kim
Hee-Jin
HJ
Ko
Younghyeh
Y
Lim
Ho Yeong
HY
Kang
Won Ki
WK
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
D014408:Biomarkers, Tumor