Characteristics of gastrointestinal metastasis in lung cancer: Single-center experience from Eastern India

Abstract

Background: Lung cancer is one of the most common cancers associated with a poor prognosis. Gastrointestinal (GI) metastasis among lung cancer patients is often misdiagnosed or missed as a diagnosis. With a paucity of literature on this theme, we conducted a study to understand the clinicopathological characteristics of GI metastasis in lung cancer patients. Materials and Methods: A retrospective review of 793 primary lung cancer patients registered from January 2018 to December 2018 was done at a tertiary cancer hospital. The present study focused on lung cancer patients with an objective to find out the cases of GI metastasis. GI metastasis was confirmed on radiological imaging in the records and positron emission tomography, magnetic resonance imaging, or computed tomography scans. Quantitative variables were either expressed in terms of mean and standard deviation or categorized and expressed in percentages. Pearson's correlation coefficient was used to find the correlation between different symptom clusters in patients with GI metastasis in lung cancer. Results: Of the 793 lung cancer patients, 31 (3.9%) patients had metastasis to the GI tract, with as high as 70.97% (22/31) patients presenting with peritoneal/omental deposits. Of the 31 patients with GI metastasis, five (16.13%) patients were symptomatic, four patients had intestinal obstruction, and one had intestinal perforation. Due to advanced metastatic cancer and poor performance status, patients were provided palliative care and symptom management as they were deemed unfit for surgical intervention. Conclusion: With the advent of targeted and immunological therapies, patients with metastatic lung cancers are surviving longer. Palliative care specialists must work in close collaboration with oncologists to identify an impending GI complication at an early stage to direct specific interventions to avert the complication.