Kazuto Harada1,2, Hyunsoo Hwang3, Xuemei Wang3, Ahmed Abdelhakeem1, Masaaki Iwatsuki1,2, Mariela A Blum Murphy1, Dipen M Maru4, Brian Weston5, Jeffrey H Lee5, Jane E Rogers6, Allison Trail1, Namita Shanbhag1, Meina Zhao1, Manoop S Bhutani5, Quynh-Nhu Nguyen7, Stephen G Swisher8, Naruhiko Ikoma9, Prajnan Das7, Wayne L Hofstetter8, Brian D Badgwell9, Jaffer A Ajani10. 1. Departments of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA. 2. Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan. 3. Departments of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA. 4. Departments of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA. 5. Departments of Gastroenterology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA. 6. Departments of Pharmacy Clinical Program, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA. 7. Departments of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA. 8. Departments of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA. 9. Departments of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA. 10. Departments of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA. jajani@mdanderson.org.
Abstract
BACKGROUND: As cancer patients are surviving longer, more patients manifest brain metastases (BRMs). However, the rate of BRMs from upper gastrointestinal cancer is unclear. We therefore evaluated the frequency and prognostic effect of BRMs in this setting. METHODS: We analyzed records of 2348 patients who were treated between January 2002 and December 2016 for upper gastrointestinal cancer, including esophageal and gastroesophageal junction adenocarcinoma (EAC; proximal EAC, Siewert types I and II), esophageal squamous cell carcinoma (ESCC), and gastric adenocarcinoma (GAC; Siewert type III and stomach cancer) in our Gastrointestinal Medical Oncology Database. Frequency, risk factors, and survival after BRMs were evaluated. RESULTS: Of 2348 patients, 68 (2.9%) had BRMs upon follow-up. The BRM rates were as follows: proximal EAC, 4.8%; Siewert type I, 5.9%; Siewert type II, 2.2%; Siewert type III, 0.7%; ESCC: 1.2%; and stomach cancer, 0%. Among EAC patients, Siewert type I and lymph node metastases were independent the risk factors for BRMs in the multivariable analysis. The median overall survival (OS) in the 68 patients with BRMs was only 1.16 years (95% CI 0.78-1.61). However, OS for patients who had a solitary BRM, who had BRM but no other distant metastasis, or who underwent surgery or stereotactic radiosurgery favorable. CONCLUSION: Patients with proximally located adenocarcinoma, or with lymph node metastases are at a higher risk for BRMs and patients fare better after treatment of isolated BRM.
BACKGROUND: As cancerpatients are surviving longer, more patients manifest brain metastases (BRMs). However, the rate of BRMs from upper gastrointestinal cancer is unclear. We therefore evaluated the frequency and prognostic effect of BRMs in this setting. METHODS: We analyzed records of 2348 patients who were treated between January 2002 and December 2016 for upper gastrointestinal cancer, including esophageal and gastroesophageal junction adenocarcinoma (EAC; proximal EAC, Siewert types I and II), esophageal squamous cell carcinoma (ESCC), and gastric adenocarcinoma (GAC; Siewert type III and stomach cancer) in our Gastrointestinal Medical Oncology Database. Frequency, risk factors, and survival after BRMs were evaluated. RESULTS: Of 2348 patients, 68 (2.9%) had BRMs upon follow-up. The BRM rates were as follows: proximal EAC, 4.8%; Siewert type I, 5.9%; Siewert type II, 2.2%; Siewert type III, 0.7%; ESCC: 1.2%; and stomach cancer, 0%. Among EAC patients, Siewert type I and lymph node metastases were independent the risk factors for BRMs in the multivariable analysis. The median overall survival (OS) in the 68 patients with BRMs was only 1.16 years (95% CI 0.78-1.61). However, OS for patients who had a solitary BRM, who had BRM but no other distant metastasis, or who underwent surgery or stereotactic radiosurgery favorable. CONCLUSION:Patients with proximally located adenocarcinoma, or with lymph node metastases are at a higher risk for BRMs and patients fare better after treatment of isolated BRM.
Authors: Roopma Wadhwa; Takashi Taketa; Arlene M Correa; Kazuki Sudo; Maria-Claudia Campagna; Mariela A Blum; Ritsuko Komaki; Heath Skinner; Jeffrey H Lee; Manoop S Bhutani; Brian Weston; Dipen M Maru; David C Rice; Stephen Swisher; Wayne L Hofstetter; Jaffer A Ajani Journal: Oncology Date: 2013-09-19 Impact factor: 2.935
Authors: R A Patchell; P A Tibbs; J W Walsh; R J Dempsey; Y Maruyama; R J Kryscio; W R Markesbery; J S Macdonald; B Young Journal: N Engl J Med Date: 1990-02-22 Impact factor: 91.245
Authors: Daniel N Cagney; Allison M Martin; Paul J Catalano; Amanda J Redig; Nancy U Lin; Eudocia Q Lee; Patrick Y Wen; Ian F Dunn; Wenya Linda Bi; Stephanie E Weiss; Daphne A Haas-Kogan; Brian M Alexander; Ayal A Aizer Journal: Neuro Oncol Date: 2017-10-19 Impact factor: 12.300
Authors: Marius Brunner; Dominik Soll; Kathrin Adler; André Sasse; Ute König; Ardian Mekolli; Kristina Lowes; Johanna Reinecke; Volker Ellenrieder; Alexander König Journal: Gastric Cancer Date: 2021-07-23 Impact factor: 7.370