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Metastatic spread in patients with gastric cancer

Riihimäki, Matias LU ; Hemminki, Akseli; Sundquist, Kristina LU ; Sundquist, Jan LU and Hemminki, Kari LU (2016) In Oncotarget 7(32). p.52307-52316
Abstract

Background: The epidemiology of metastatic gastric cancer is unexplored because cancer registries seldom cover metastatic involvement apart from "present or not". We used a novel approach by utilizing Swedish registers to assess metastatic spread in gastric cancer. To our knowledge, this is the first nationwide description of metastases in gastric cancer. Results: The most common sites of metastasis were liver (in 48% of metastatic cancer patients), peritoneum (32%), lung (15%), and bone (12%). Metastases to the lung, nervous system, and bone were more frequent in cardia cancer and men, whereas non-cardia cancer more frequently metastasized within the peritoneum. Signet ring adenocarcinomas more frequently metastasized within the... (More)

Background: The epidemiology of metastatic gastric cancer is unexplored because cancer registries seldom cover metastatic involvement apart from "present or not". We used a novel approach by utilizing Swedish registers to assess metastatic spread in gastric cancer. To our knowledge, this is the first nationwide description of metastases in gastric cancer. Results: The most common sites of metastasis were liver (in 48% of metastatic cancer patients), peritoneum (32%), lung (15%), and bone (12%). Metastases to the lung, nervous system, and bone were more frequent in cardia cancer and men, whereas non-cardia cancer more frequently metastasized within the peritoneum. Signet ring adenocarcinomas more frequently metastasized within the peritoneum, bone and ovaries, and less frequently to the lungs and liver compared with generic adenocarcinoma. The liver and the peritoneum were commonly single metastases while lung metastases occurred frequently together with liver metastases. The median survival in metastatic gastric cancer was 3 months, worst among those with bone and liver metastases (2 months). Methods: A total of 7,559 patients with gastric cancer were identified. Metastatic patterns and survival depending on sex, age, stage, anatomical location (cardia and non-cardia), and histological type were assessed. Conclusions: The patterns of metastasis differ notably depending on histological type. Cardia cancer exhibits a completely different metastatic behavior than noncardia cancer. Awareness of the differing patterns may guide in tailored diagnosis of metastases. Survivors from cardia cancer would benefit from increased surveillance of extraperitoneal metastases. Bone metastases should be considered in patients with signet ring adenocarcinoma if symptoms emerge.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Epidemiology, Gastric cancer, Metastasis
in
Oncotarget
volume
7
issue
32
pages
10 pages
publisher
Impact Journals, LLC
external identifiers
  • Scopus:84982299764
ISSN
1949-2553
DOI
10.18632/oncotarget.10740
language
English
LU publication?
yes
id
276b7e4e-51a3-4a57-8ebc-acfb8c1288e2
date added to LUP
2016-09-20 16:40:18
date last changed
2016-09-21 03:00:01
@misc{276b7e4e-51a3-4a57-8ebc-acfb8c1288e2,
  abstract     = {<p>Background: The epidemiology of metastatic gastric cancer is unexplored because cancer registries seldom cover metastatic involvement apart from "present or not". We used a novel approach by utilizing Swedish registers to assess metastatic spread in gastric cancer. To our knowledge, this is the first nationwide description of metastases in gastric cancer. Results: The most common sites of metastasis were liver (in 48% of metastatic cancer patients), peritoneum (32%), lung (15%), and bone (12%). Metastases to the lung, nervous system, and bone were more frequent in cardia cancer and men, whereas non-cardia cancer more frequently metastasized within the peritoneum. Signet ring adenocarcinomas more frequently metastasized within the peritoneum, bone and ovaries, and less frequently to the lungs and liver compared with generic adenocarcinoma. The liver and the peritoneum were commonly single metastases while lung metastases occurred frequently together with liver metastases. The median survival in metastatic gastric cancer was 3 months, worst among those with bone and liver metastases (2 months). Methods: A total of 7,559 patients with gastric cancer were identified. Metastatic patterns and survival depending on sex, age, stage, anatomical location (cardia and non-cardia), and histological type were assessed. Conclusions: The patterns of metastasis differ notably depending on histological type. Cardia cancer exhibits a completely different metastatic behavior than noncardia cancer. Awareness of the differing patterns may guide in tailored diagnosis of metastases. Survivors from cardia cancer would benefit from increased surveillance of extraperitoneal metastases. Bone metastases should be considered in patients with signet ring adenocarcinoma if symptoms emerge.</p>},
  author       = {Riihimäki, Matias and Hemminki, Akseli and Sundquist, Kristina and Sundquist, Jan and Hemminki, Kari},
  issn         = {1949-2553},
  keyword      = {Epidemiology,Gastric cancer,Metastasis},
  language     = {eng},
  month        = {08},
  number       = {32},
  pages        = {52307--52316},
  publisher    = {ARRAY(0xb5303e0)},
  series       = {Oncotarget},
  title        = {Metastatic spread in patients with gastric cancer},
  url          = {http://dx.doi.org/10.18632/oncotarget.10740},
  volume       = {7},
  year         = {2016},
}