title: Role of surgical intervention in managing gastrointestinal metastases from lung cancer.
abstract: OBJECTIVE
  To investigate the clinicopathological characteristics of late-stage lung cancer patients with gastrointestinal (GI)-tract metastases, focusing on therapeutic options and outcomes.
  
  
  METHODS
  Our institution (the National Taiwan University Hospital) diagnosed 8159 patients with lung cancer between 1987 and 2008, of which 21 developed symptomatic GI metastases. This study reviewed all of the patients' information, including survival data, pathological reports, and surgical notes.
  
  
  RESULTS
  The most common histological type of lung cancer was adenocarcinoma, and 0.26% of patients with lung cancer developed GI metastases. The median duration from lung cancer diagnosis to GI metastases was three months (range, 0-108 mo), and the average time from diagnosis of GI metastasis to death was 2.8 mo. Most patients with symptomatic gastric and/or duodenal metastases exhibited GI bleeding and were diagnosed by panendoscopy. In contrast, small bowel metastases typically presented as an acute abdomen and were not diagnosed until laparotomy. All patients with small bowel or colonic metastases underwent surgical intervention, and their perioperative mortality was 22%. Our data revealed a therapeutic effect in patients with solitary GI metastasis and a favorable palliative effect on survival when metastases were diagnosed preoperatively. In patients with multiple GI metastases, the presentation varied according to the locations of the metastases.
  
  
  CONCLUSIONS
  Surgical treatment is worthwhile in a select group of patients with bowel perforation or obstruction. Physicians should be more alert to symptoms or signs indicating GI metastases.
authors.affiliation: Department of Trauma, National Taiwan University Hospital and College of Medicine, Taipei 10002, Taiwan, China.
authors.forename: Po-Chu
authors.initials: PC
authors.lastname: Lee
authors.forename: Chiao
authors.initials: C
authors.lastname: Lo
authors.forename: Ming-Tsan
authors.initials: MT
authors.lastname: Lin
authors.forename: Jin-Tung
authors.initials: JT
authors.lastname: Liang
authors.forename: Been-Ren
authors.initials: BR
authors.lastname: Lin
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery*; D000077192:Adenocarcinoma of Lung; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000556:secondary* / Q000601:surgery*; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D015996:Survival Rate; D013624:Taiwan; D016896:Treatment Outcome
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