Bone Metastasis after a Curative Resection for Gastric Cancer

Kim, Jin Jo; Song, Kyo Young; Chin, Hyung Min; Kim, Wook; Chun, Hae Myung; Park, Cho Hyun; Park, Seung Man; Park, Woo Bae; Lim, Keun Woo; Kim, Seung Nam

Abstract

PURPOSE
Bone metastasis is not a common event in patients with gastric cancer. Therefore, most studies of bone metastasis in such patients have been in the form of case reports, so the clinical features of the bone metastasis are not well understood. To clarify metastatic patterns, the efficacy of radiation or chemotherapy, and the prognosis, we analyzed 29 cases of patients with bone metastases after curative surgery for gastric cancer.
MATERIALS AND METHODS
Twenty-nine (29) gastric cancer patients with bone metastasis who underwent curative resection from January 1989 to December 2002 at the Departments of Surgery, Kangnam St. Mary's Hospital and Our Lady of Mercy's Hospital, The Catholic University of Korea, were analyzed.
RESULTS
Nineteen (19) patients were males and, 10 patients were females. The mean age of the patients was 53+/-12 years. There were more Borrmann type-3 and type-4 cancers and more undifferentiated histologic types. Most of the original cancers were stage III or IV. The most frequently involved bone was the spine. Treatment after recurrence was done in 16 patients (55.2%). The median survival time after recurrence of the patients who received treatment was seven (7) months (0~75 months in range), which was significantly longer than that of the patients who did not received treatment (P=0.019). However, there was no difference according to the treatment modality (P=0.388).
CONCLUSION
Bone metastasis after a curative resection of gastric cancer tends to occur in Borrmann type-3 and type-4 cancers, cancers with undifferentiated histology and, in stage III/IV disease. The prognosis of bone metastasis is dismal, and aggressive treatment is the only way to prolong survival.