Cancer Res Treat.  2011 Dec;43(4):244-249.

Clinical Outcome of Gastric Cancer Patients with Bone Marrow Metastases

• Kwon JY
• Yun J
• Kim HJ
• Kim KH
• Kim SH
• Lee SC
• Kim HJ
• Bae SB
• Kim CK
• Lee NS
• Lee KT
• Park SK
• Won JH
• Hong DS
• Park HS

Abstract

PURPOSE
The prognosis of gastric cancer patients with bone marrow metastases is extremely poor. The current study was conducted to evaluate the clinical outcomes of advanced gastric cancer patients with bone marrow metastases.
MATERIALS AND METHODS
We retrospectively reviewed the medical records of 26 advanced gastric cancer patients with bone marrow metastases who were treated at Soonchunhyang University Hospital between September 1986 and February 2009.
RESULTS
The median age was 46 years (range, 24 to 61 years). All patients had poorly differentiated adenocarcinoma, including 17 signet ring cell carcinomas. The majority of the patients had thrombocytopenia, anemia, and elevated lactate dehydrogenase levels. Sixteen patients (61.5%) received palliative chemotherapy (median, 4 cycles; range, 1 to 13 cycles). The median overall survival after detection of bone marrow metastases for the cohort of patients was 37 days (95% confidence interval, 12.5 to 61.5 days). The median overall survival after detection of bone marrow involvement was 11 days in the best supportive care group (range, 2 to 34 days) and 121 days (range, 3 to 383 days) in the palliative chemotherapy group (p<0.001). The causes of death were tumor progression (11 patients, 45%), brain hemorrhage (6 patients, 25%), infection (5 patients, 21%), and disseminated intravascular coagulation (1 patient, 4%). There were no chemotherapy-related deaths.
CONCLUSION
Palliative chemotherapy could be considered in advanced gastric cancer patients with bone marrow metastases as a treatment option.

Keyword

Stomach neoplasms; Bone marrow; Neoplasm metastasis; Drug therapy

MeSH Terms

Adenocarcinoma
Anemia
Bone Marrow
Carcinoma, Signet Ring Cell
Cause of Death
Cohort Studies
Disseminated Intravascular Coagulation
Humans
Intracranial Hemorrhages
L-Lactate Dehydrogenase
Medical Records
Neoplasm Metastasis
Prognosis
Retrospective Studies
Stomach Neoplasms
Thrombocytopenia
L-Lactate Dehydrogenase

Figure

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  Fig. 1 Kaplan-Meier estimates of overall survival (OS) in all patients.

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  Fig. 2 Kaplan-Meier estimates of overall survival: chemo-therapy group vs. supportive care group.

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