title: Clinicopathological features and outcomes of gastric cancer patients with pulmonary lymphangitis carcinomatosa.
abstract: OBJECTIVE
  Breast, gastric and lung cancers are the most common cancers that cause pulmonary lymphangitis carcinomatosa. However, little is known about the clinical features of pulmonary lymphangitis carcinomatosa in advanced gastric cancer.
  
  
  METHODS
  We retrospectively reviewed the data throughout the clinical courses of 33 patients with gastric cancer who developed pulmonary lymphangitis carcinomatosa. Pulmonary lymphangitis carcinomatosa was confirmed by both a pulmonologist and a diagnostic radiologist on the basis of computed tomography findings of interstitial patterns such as thickening or irregularity of interlobular septa and bronchovascular bundles.
  
  
  RESULTS
  The median age of the 33 patients was 55 years old (range, 25-73 years). The percentages of female patients, those with performance status 3 or 4, and those with respiratory symptoms at diagnosis were 70, 36 and 76%, respectively. The histologically diffuse type of gastric cancer accounted for 85% of cases. Mediastinal lymph node, peritoneal and bone metastases were found in 64, 61 and 39% of patients, respectively. Disseminated intravascular coagulation was noted in 21% of patients. The median survival time of the 18 chemotherapy-naïve patients treated with chemotherapy was 5.7 months (range, 0.4-37.0 months). Two patients obtained symptomatic relief, and one patient treated with S-1 + cisplatin + sunitinib survived >3 years.
  
  
  CONCLUSIONS
  Pulmonary lymphangitis carcinomatosa caused by gastric cancer has some specific clinicopathological features. While the prognosis of gastric cancer patients with pulmonary lymphangitis carcinomatosa is extremely poor, some patients may have survival benefit from chemotherapy.
authors: Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Nagaizumi-tyo Department of Clinical Oncology, Kyoto University Hospital Cancer Center, Kyoto tarofun@kuhp.kyoto-u.ac.jp.
authors: Taro
authors: T
authors: Funakoshi
authors: Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Nagaizumi-tyo.
authors: Hirofumi
authors: H
authors: Yasui
authors: Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki.
authors: Narikazu
authors: N
authors: Boku
authors: Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Nagaizumi-tyo.
authors: Akira
authors: A
authors: Fukutomi
authors: Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Nagaizumi-tyo.
authors: Kentaro
authors: K
authors: Yamazaki
authors: Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Nagaizumi-tyo.
authors: Nozomu
authors: N
authors: Machida
authors: Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Nagaizumi-tyo.
authors: Akiko
authors: A
authors: Todaka
authors: Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Nagaizumi-tyo.
authors: Takahiro
authors: T
authors: Tsushima
authors: Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Nagaizumi-tyo.
authors: Tomoya
authors: T
authors: Yokota
authors: Division of Clinical Oncology, Shizuoka Cancer Center, Nagaizumi-tyo.
authors: Yusuke
authors: Y
authors: Onozawa
authors: Division of Thoracic Oncology, Shizuoka Cancer Center, Nagaizumi-tyo.
authors: Hirotsugu
authors: H
authors: Kenmotsu
authors: Division of Diagnostic Radiology, Shizuoka Cancer Center, Nagaizumi-tyo, Japan.
authors: Masahiro
authors: M
authors: Endo
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007211:Indoles / Q000008:administration & dosage; D053208:Kaplan-Meier Estimate; D008171:Lung Diseases / Q000209:etiology*; D008205:Lymphangitis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D008207:Lymphatic Metastasis / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D010094:Oxonic Acid / Q000008:administration & dosage; D011758:Pyrroles / Q000008:administration & dosage; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000150:complications* / Q000188:drug therapy* / Q000473:pathology; D000077210:Sunitinib; D005641:Tegafur / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D004338:Drug Combinations; D007211:Indoles; D011758:Pyrroles; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D002945:Cisplatin; D000077210:Sunitinib
keywords: chemotherapy; disseminated intravascular coagulation; gastric cancer; lymphangitis