Abstract
15668 Background: Metastasis of advanced gastric adenocarcinoma to the brain is very rare and its incidence is low. However, little has been known regarding proper evaluation and treatment of these patients. Therefore, we reviewed our experience with brain metastasis of gastric adenocarcinoma to evaluate the efficacy of the treatment used. Methods: We analyzed 67 patients with brain metastasis of advanced gastric adenocarcinoma who were treated at the Severance Hospital Yonsei University College of Medicine between 1987 and 2006. The clinicopathological characteristics of 67 patients were assessed by medical record review retrospectively. Results: The median age was 59 years and the male-to-female ratio was 3.3:1. The most common cell types and the site included poorly differentiated (35.8%), and the distal body of the stomach (47.8%), respectively. The median interval between the diagnosis of advanced gastric cancer and the diagnosis of brain metastasis was 425 days. The median survival after brain metastasis was 105 days. When the patient had leptomeningeal seeding, the survival was 24 days which was shorter than 112 days of the peranchymal metastasis. Twelve patients treated with an operation or gamma knife surgery lived 186 days. Thirty five patients treated with whole brain radiation lived 112 days. Contrast with these patients, 136 patients received only supportive care showed the median survival of 26 days. The predicted probability of the survival correlated positively with only ECOG performance status and the treatment (P < 0.01). Conclusion: The outcome of the treated group was much better than that of the nontreatment group. ECOG performance status at the diagnosis of brain metastasis is a determinant of the survival.When the patient performance is favorable, early intervention is the only hope to prolong the survival in such patients. No significant financial relationships to disclose.
Published Version
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