Brain Metastasis after a Gastrectomy for Gastric Cancer

Kim, Yong Il; Lee, Jun Ho; Yun, Seong Hyeon; Noh, Sung Hoon; Min, Jin Sik

Abstract

PURPOSE: The common features of brain metastases from gastric cancer are unknown because brain metastasis is an uncommon pattern of metastasis. The purpose of this study was to investigate the clinical features of and the prognosis for patients with brain metastases after a curative resection for gastric cancer.
MATERIALS AND METHODS
Twenty-one (21) cases of patients with brain metastases of gastric cancer, who had been treated at the Department of Surgery, Yonsei University College of Medicine, were assessed retrospectively.
RESULTS
The mean age was 55.8+/-9.6 years (range: 34~70 years), and the male-to-female ratio was 2.5:1. The most common neurologic symptom was headache (38.5%), and no patient was free from the neurologic symptoms. The incidence of parenchymal metastasis (PM: 76.2%) was higher than that of leptomeningeal metastasis (LM: 19.0%). Patients with gastric cancer and brain metastasis showed high rates of blood and lymphatic vessel invasion (lymphatic vessel invasion: 85.7%; blood vessel invasion: 80.9%). According to Lauren's classification, the incidence of intestinal types was 14/21 (66.7%), that of diffuse types was 3/21 (14.3%) and that of mixed types was 4/21 (19.0%). The mean interval between the gastrectomy and the diagnosis of brain metastasis was 24.7+/-4.0 months (PM: 26.8 months; LM: 20.3 months). The median period of survival after diagnosis of brain metastasis was 2 months for paren chymal metastasis and 0 months for leptomeningeal metastasis.
CONCLUSION
During a follow-up period, patients with neurologic symptoms should be suspected of having brain metastasis. Early diagnosis and treatment is the only hope to prolong survival in such patients.