Clinical outcome and molecular characterization of brain metastases from esophageal and gastric cancer: a systematic review.
The aim of the study was to collect the available data on central nervous system (CNS) metastases from esophageal and gastric cancer. A PubMed, EMBASE, SCOPUS, Web of Science, LILACS, Ovid and Cochrane Library search was performed. Thirty-seven studies including 779 patients were considered. Among the data extracted, treatment of tumor and brain metastases (BMs), time to BMs development, number and subsite, extracerebral metastases rate, median overall survival (OS) and prognostic factors were included. For esophageal cancer, the median OS from diagnosis of BMs was 4.2 months. Prognostic factors for OS included: performance status, multimodal therapy, adjuvant chemotherapy, single BM, brain only disease and surgery. For gastric cancer, median OS was 2.4 months. Prognostic factors for OS included: recursive partitioning analysis class 2, stereotactic radiosurgery (SRT) and use of intrathecal therapy. HER2-positive gastric cancer was shown to be associated with a higher risk and shorter time to CNS relapse. Patients harboring BMs from gastric and esophageal tumors, except cases with single lesions that are treated aggressively, have a poor prognosis. SRT (plus or minus surgery and whole brain radiotherapy) seems to give better results in terms of longer OS after brain relapse.
Oncology Unit, Oncology Department, ASST di Cremona, Ospedale di Cremona, Viale Concordia 1, 26100, Cremona, Italy.
Michele
M
Ghidini
Oncology Unit, Oncology Department, ASST Bergamo Ovest, Ospedale di Treviglio, Piazzale Ospedale 1, 24047, Treviglio, BG, Italy. faupe@libero.it.
Fausto
F
Petrelli
Laboratory of Gastrointestinal Cancer Biology and Genomics, Division of Molecular Pathology, The Institute of Cancer Research, 15 Cotswold Road, Sutton, Surrey, SM25NG, UK.
Jens Claus
JC
Hahne
Oncology Unit, Oncology Department, ASST Dei Sette Laghi, Ospedale di Circolo e Fondazione Macchi, Viale Luigi Borri 57, 21100, Varese, Italy.
Annamaria
A
De Giorgi
Oncology Unit, Oncology Department, ASST di Cremona, Ospedale di Cremona, Viale Concordia 1, 26100, Cremona, Italy.
Laura
L
Toppo
Oncology Unit, Oncology Department, ASST di Cremona, Ospedale di Cremona, Viale Concordia 1, 26100, Cremona, Italy.
Claudio
C
Pizzo
Oncology Unit, Oncology Department, ASST di Cremona, Ospedale di Cremona, Viale Concordia 1, 26100, Cremona, Italy.
Margherita
M
Ratti
Oncology Unit, Oncology Department, ASST Bergamo Ovest, Ospedale di Treviglio, Piazzale Ospedale 1, 24047, Treviglio, BG, Italy.
Sandro
S
Barni
Oncology Unit, Oncology Department, ASST di Cremona, Ospedale di Cremona, Viale Concordia 1, 26100, Cremona, Italy.
Rodolfo
R
Passalacqua
Oncology Unit, Oncology Department, ASST di Cremona, Ospedale di Cremona, Viale Concordia 1, 26100, Cremona, Italy.
Gianluca
G
Tomasello
D001932:Brain Neoplasms / Q000556:secondary* / Q000628:therapy*; D004938:Esophageal Neoplasms / Q000473:pathology* / Q000628:therapy*; D006801:Humans; D011379:Prognosis; D013274:Stomach Neoplasms / Q000473:pathology* / Q000628:therapy*; D016896:Treatment Outcome
Brain metastases; Esophageal cancer; Gastric cancer; Radiotherapy; Stereotactic radiosurgery