title: Clinical outcome of gastric cancer patients with bone marrow metastases.
abstract: OBJECTIVE
  The prognosis of gastric cancer patients with bone marrow metastases is extremely poor. The current study was conducted to evaluate the clinical outcomes of advanced gastric cancer patients with bone marrow metastases.
  
  
  METHODS
  We retrospectively reviewed the medical records of 26 advanced gastric cancer patients with bone marrow metastases who were treated at Soonchunhyang University Hospital between September 1986 and February 2009.
  
  
  RESULTS
  The median age was 46 years (range, 24 to 61 years). All patients had poorly differentiated adenocarcinoma, including 17 signet ring cell carcinomas. The majority of the patients had thrombocytopenia, anemia, and elevated lactate dehydrogenase levels. Sixteen patients (61.5%) received palliative chemotherapy (median, 4 cycles; range, 1 to 13 cycles). The median overall survival after detection of bone marrow metastases for the cohort of patients was 37 days (95% confidence interval, 12.5 to 61.5 days). The median overall survival after detection of bone marrow involvement was 11 days in the best supportive care group (range, 2 to 34 days) and 121 days (range, 3 to 383 days) in the palliative chemotherapy group (p<0.001). The causes of death were tumor progression (11 patients, 45%), brain hemorrhage (6 patients, 25%), infection (5 patients, 21%), and disseminated intravascular coagulation (1 patient, 4%). There were no chemotherapy-related deaths.
  
  
  CONCLUSIONS
  Palliative chemotherapy could be considered in advanced gastric cancer patients with bone marrow metastases as a treatment option.
authors.affiliation: Division of Hematology and Oncology, Department of Internal Medicine, Soonchunhyang University Hospital, Seoul, Korea.
authors.forename: Ji Yeon
authors.initials: JY
authors.lastname: Kwon
authors.forename: Jina
authors.initials: J
authors.lastname: Yun
authors.forename: Han Jo
authors.initials: HJ
authors.lastname: Kim
authors.forename: Kyoung-Ha
authors.initials: KH
authors.lastname: Kim
authors.forename: Se-Hyung
authors.initials: SH
authors.lastname: Kim
authors.forename: Sang-Cheol
authors.initials: SC
authors.lastname: Lee
authors.forename: Hyun Jung
authors.initials: HJ
authors.lastname: Kim
authors.forename: Sang Byung
authors.initials: SB
authors.lastname: Bae
authors.forename: Chan Kyu
authors.initials: CK
authors.lastname: Kim
authors.forename: Nam Su
authors.initials: NS
authors.lastname: Lee
authors.forename: Kyu Taek
authors.initials: KT
authors.lastname: Lee
authors.forename: Seong Kyu
authors.initials: SK
authors.lastname: Park
authors.forename: Jong-Ho
authors.initials: JH
authors.lastname: Won
authors.forename: Dae Sik
authors.initials: DS
authors.lastname: Hong
authors.forename: Hee Sook
authors.initials: HS
authors.lastname: Park