Joseph Sirody1, Amy H Kaji2, Daielle M Hari1, Kathryn T Chen3. 1. Division of Surgical Oncology, Department of Surgery, Harbor-UCLA Medical Center, United States. 2. Department of Emergency Medicine, Harbor-UCLA Medical Center, United States. 3. Division of Surgical Oncology, Department of Surgery, Harbor-UCLA Medical Center, United States. Electronic address: kchen6@dhs.lacounty.gov.
Abstract
BACKGROUND: Literature on the epidemiology of gastric cancer metastasis is limited, although outcomes are known to be poor. We describe patterns of gastric cancer metastasis and treatment in the United States. METHODS: Patients with metastatic gastric adenocarcinoma were identified in the NCDB from 2004 to 2016. We describe univariate associations between sites of metastasis and clinicopathologic characteristics and treatment modalities, using chi-square and Kruskal-Wallis tests. Overall survival was calculated using Kaplan-Meier estimation. RESULTS: 43% (n = 2028) of patients presented with peritoneal metastases, 26% (n = 1228) with liver metastases, 20% (n = 941) with distant nodes, and 11% (n = 552) with bone, brain or lung metastases. Compared to liver metastases, peritoneal metastases were more likely from an antral primary site (28% v. 16%); associated with signet ring histology (34% v. 6%); tumor grade of III/IV (85% vs. 60%) (p < 0.0001 for all). Isolated metastasis to distant lymph nodes had the longest median overall survival (7.6 months, p < 0.0001). CONCLUSIONS: Most patients with metastatic gastric cancer in the USA present with peritoneal disease. Predictors for peritoneal metastases include primary antral site, signet ring histology and higher tumor grades. Published by Elsevier Inc.
BACKGROUND: Literature on the epidemiology of gastric cancer metastasis is limited, although outcomes are known to be poor. We describe patterns of gastric cancer metastasis and treatment in the United States. METHODS: Patients with metastatic gastric adenocarcinoma were identified in the NCDB from 2004 to 2016. We describe univariate associations between sites of metastasis and clinicopathologic characteristics and treatment modalities, using chi-square and Kruskal-Wallis tests. Overall survival was calculated using Kaplan-Meier estimation. RESULTS: 43% (n = 2028) of patients presented with peritoneal metastases, 26% (n = 1228) with liver metastases, 20% (n = 941) with distant nodes, and 11% (n = 552) with bone, brain or lung metastases. Compared to liver metastases, peritoneal metastases were more likely from an antral primary site (28% v. 16%); associated with signet ring histology (34% v. 6%); tumor grade of III/IV (85% vs. 60%) (p < 0.0001 for all). Isolated metastasis to distant lymph nodes had the longest median overall survival (7.6 months, p < 0.0001). CONCLUSIONS: Most patients with metastatic gastric cancer in the USA present with peritoneal disease. Predictors for peritoneal metastases include primary antral site, signet ring histology and higher tumor grades. Published by Elsevier Inc.
Authors: Luai Al-Marzouki; Vivian S Stavrakos; Sanjima Pal; Betty Giannias; France Bourdeau; Roni Rayes; Nicholas Bertos; Sara Najmeh; Jonathan D Spicer; Jonathan Cools-Lartigue; Swneke D Bailey; Lorenzo Ferri; Veena Sangwan Journal: Gastric Cancer Date: 2022-09-04 Impact factor: 7.701