Three Cases of Aggressively Treated Brain Metastasis after Surgery for Gastric Cancer

Abstract

Brain metastasis of gastric cancer is comparatively rare and has been reported to carry poor prognosis. Recently we have experienced three cases of brain metastasis after surgery for gastric cancer in which aggressive treatments were performed. The patients included one man and two women, with the median age at the surgery for gastric cancer of 61. As for the progression of gastric cancer, two patients had pStage IIIC gastric cancer and one had pStage IV with liver metastasis. The time from the surgery for gastric cancer to brain metastasis was more than 12 months in all three cases. The number of brain lesions was solitary in one case, or multiple in two cases. The treatments for the brain metastases included stereotactic radiation therapy in two cases and surgery in one case. All three patients died of cancer, including two of cerebral hernia associated with progression of the brain lesion and one of progression of a lung lesion. The surviving time after brain metastasis was 27 days, eight months, or nine months, respectively.

Contrary to our understanding that the prognosis after brain metastasis of gastric cancer is poor, comparatively long-term survival was gained in our three patients. Control of the brain lesion might be important, and hence we should aggressively consider and employ available treatments if it is treatable.