Brain metastasis in patients with upper gastrointestinal cancer is associated with proximally located adenocarcinoma and lymph node metastasis
| Autor: | Masaaki Iwatsuki, Brian D. Badgwell, Ahmed Abdelhakeem, Jeffrey H. Lee, Jaffer A. Ajani, Jane E. Rogers, Brian Weston, Kazuto Harada, Quynh Nhu Nguyen, Stephen G. Swisher, Allison Trail, Mariela A. Blum Murphy, Namita Shanbhag, Naruhiko Ikoma, Manoop S. Bhutani, Prajnan Das, Meina Zhao, Wayne L. Hofstetter, Xuemei Wang, Dipen M. Maru, Hyunsoo Hwang |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
Cancer Research medicine.medical_specialty animal structures Esophageal Neoplasms medicine.medical_treatment Gastroesophageal Junction Adenocarcinoma Adenocarcinoma Gastroenterology Radiosurgery Article 03 medical and health sciences 0302 clinical medicine Surgical oncology Stomach Neoplasms Internal medicine medicine Humans Stomach cancer Lymph node Gastrointestinal Neoplasms Retrospective Studies business.industry Brain Neoplasms Cancer General Medicine Middle Aged medicine.disease Prognosis Survival Rate medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis Lymphatic Metastasis 030211 gastroenterology & hepatology Female Esophagogastric Junction business Abdominal surgery Follow-Up Studies |
| Zdroj: | Gastric Cancer |
| Popis: | BACKGROUND: As cancer patients are surviving longer, more patients manifest brain metastases (BRM). However, the rate of BRM from upper gastrointestinal cancer is unclear. We therefore evaluated the frequency and prognostic effect of BRM in this setting. METHODS: We analyzed records of 2,348 patients who were treated between January 2002 and December 2016 for upper gastrointestinal cancer, including esophageal and gastroesophageal junction adenocarcinoma (EAC; proximal EAC, Siewert types I and II), esophageal squamous cell carcinoma (ESCC), and gastric adenocarcinoma (GAC; Siewert type III and stomach cancer) in our Gastrointestinal Medical Oncology Database. Frequency, risk factors, and survival after BRM were evaluated. RESULTS: Of 2,348 patients, 68 (2.9%) had BRM upon follow-up. The BRM rates were as follows: proximal EAC, 4.8%; Siewert type I, 5.9%; Siewert type II, 2.2%; Siewert type III, 0.7%; ESCC: 1.2%; and stomach cancer, 0%. Among EAC patients, Siewert type I and lymph node metastasis were independent risk factors for BRM in the multivariable analysis. Median overall survival (OS) in the 68 patients with BRM was only 1.16 years (95% CI: 0.78–1.61). However, OS for patients who had a solitary brain metastasis, who had BRM but no other distant metastasis, or who underwent surgery or stereotactic radiosurgery were favorable. CONCLUSION: Patients with proximally located adenocarcinoma, or with lymph node metastases are at a higher risk for BRMs and patients fare better after treatment of isolated BRM. |
| Databáze: | OpenAIRE |
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