J Korean Surg Soc.
1999 Jan;56(1):91-98.
Pulmonary Metastasis of Gastric Cancer
- Affiliations
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- 1Department of General Surgery, College of Medicine, Hanyang University.
Abstract
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BACKGROUND: Gastric cancer is still the leading cause of death in Korea. Pulmonary metastasis(PM) is the second most frequent form of organ metastasis from gastric cancer followed by liver metastasis. However, there have been few reports in Korea dealing with the clinicopathological characteristics of pulmonary metastasis from gastric cancer (PMGC).
METHODS
Six hundread sixty seven surgeries for gastric cancer were performed during the period from June 1992 to August 1997 in our department. Fourteen cases of PMGC were included in this study. The diagnostic methods for PMGC were chest X-ray, chest CT, and CT-guided fine-needle aspiration biopsy or bronchoscopic biopsy (in doubtful cases).
RESULTS
The most common symptoms in PMGC were cough and dyspnea; 4 cases (28.6%) had no symptoms related to PM. There were four types of PM: lymphangitic carcinomatosa (LC), 6 cases; nodular, 5 cases; pleuritis carcinomatosa (PC), 2 cases; and mediastinal lymphadenopathy (ML), 1 case. The mean survival duration after PM was 13.2 months for the nodular type, 2.3 months for the LC type, 2 months for the ML type, and 1.5 months for the PC type. The mean survival time after PM was 12.4 months when the disease- free interval after gastric surgery was longer than 12 months and was 2.1 months when it was less than 12 months. The mean survival durations after PM were 23 months and 6 months (still alive) for the 2 patients operated on for PM lesions and 4.7 months for the 12 not receiving operations. In summary, when the disease free interval was longer, the mean survival duration after PM was also longer. The survival duration in cases with nodular type PM was longer than that for other types of PM.
CONCLUSION
On the basis of this study, we can assume that a pulmonary resection can be carried out in the case of a single metastatic nodule in order to extend the length of survival.