Abstract
Purpose : In gastric cancer patients, bone metastases are infrequent. However, their presence is associated with a dismal prognosis, and a greatly diminished quality of life due to the pain related to the bone lesion. Therefore, the early diagnosis and treatment of bone metastases are important. Method : Of the 1,084 patients treated for primary gastric cancer from 1991 to 2007, bone metastases were found in 16 patients. The features and prognostic factors present in these 16 patients with bone metastases were studied. Results : The clinicopathological features of these patients included : a relatively younger age, a U (upper) region located in the tumor, a macroscopic type 4 lesion, a poorly differentiated adenocarcinoma with high-grade lymphatic and vascular invasion, and an advanced degree of lymph node metastasis. The mean interval between primary treatment and bone metastasis was 266 (range : 23-1579) days. The median survival time was 102 (range : 8-310) days, and the 6-month survival rate was 42%. Univariate analysis indicated that gender, age, performance status, and chemotherapy significantly affected the prognosis. Multivariate analysis indicated that age, performance satatus, and chemotherapy independently affected the prognosis. The clinicopathological features of the 4 patients who only had bone metastasis, included the presence of high-grade lymph node metastasis, a high rate of macroscopic type 0 lesions which were small in size, and whose depth of invasion was superficial. In 9 cases, initial treatment involved chemotherapy, the median survival of cases which had multi-drug chemotherapy was better than that of patients who did not receive multi-drug chemotherapy. Conclusions : It is important to identify bone metastases in gastric cancer patients early, since the early use of chemotherapy in such patients appears promising.
