title: Leptomeningeal carcinomatosis associated with gastric cancer.
abstract: BACKGROUND
  Leptomeningeal carcinomatosis (LMC) is a rare but devastating complication of gastric cancer.
  
  
  METHODS
  The subjects were 12 gastric cancer patients who were diagnosed as having LMC at the Shizuoka Cancer Center between October 2002 and March 2009. We conducted a retrospective survey of the medical records of the study subjects and collected data on the clinical features, treatment modalities employed/outcomes, and survival of the patients.
  
  
  RESULTS
  Of the 12 patients, 9 (75%) were male, and the median age was 63 years. Histopathologically, the majority of the patients (83%) had diffuse-type adenocarcinoma. At the time of diagnosis of the LMC, the other major sites of metastasis were the peritoneum (75%) and lymph nodes (50%). The median duration from the diagnosis of gastric cancer to the diagnosis of LMC was 15.6 months. While the treatment strategy changed with time, intrathecal chemotherapy (n = 10), followed by whole brain irradiation (n = 7) and subsequent ventriculo-peritoneal shunt (n = 3) was performed in 10 of the patients. Improvement of neurological functions was observed in 6 of the 10 patients. The median overall survival time from the diagnosis of LMC in all the 12 patients was 60 days. One patient survived for a considerably long period of 532 days.
  
  
  CONCLUSIONS
  Multidisciplinary treatment, including ventriculo-peritoneal shunt for LMC secondary to gastric cancer, may benefit selected patients, but further accumulation of clinical cases is necessary.
authors.affiliation: Division of Gastrointestinal Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan. mbhtmt08.g88@auone.jp
authors.forename: Hideharu
authors.initials: H
authors.lastname: Tomita
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Yasui
authors.forename: Narikazu
authors.initials: N
authors.lastname: Boku
authors.forename: Yoko
authors.initials: Y
authors.lastname: Nakasu
authors.forename: Koichi
authors.initials: K
authors.lastname: Mitsuya
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Onozawa
authors.forename: Akira
authors.initials: A
authors.lastname: Fukutomi
authors.forename: Kentaro
authors.initials: K
authors.lastname: Yamazaki
authors.forename: Nozomu
authors.initials: N
authors.lastname: Machida
authors.forename: Keisei
authors.initials: K
authors.lastname: Taku
authors.forename: Akiko
authors.initials: A
authors.lastname: Todaka
authors.forename: Hiroya
authors.initials: H
authors.lastname: Taniguchi
authors.forename: Takahiro
authors.initials: T
authors.lastname: Tsushima
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology / Q000556:secondary / Q000628:therapy; D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D055756:Meningeal Carcinomatosis / Q000175:diagnosis / Q000473:pathology / Q000556:secondary / Q000628:therapy; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects; D008875:Middle Aged; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000628:therapy; D016019:Survival Analysis; D017287:Ventriculoperitoneal Shunt
chemical_list: D008727:Methotrexate