Bone metastasis of gastric cancer.

Twenty-three patients with bone metastasis from gastric cancer which was resected during the ten years from 1970 through 1979 were investigated. The incidence was 1.2 per cent (23/1,945) and was higher in the younger patients. The main symptom was local bone pain. Change on the X-ray appeared a few months after complaints of pain. Consequently, the confirmation was delayed in most cases. All of the laboratory findings were not specific to bone metastasis. Referring to findings at the primary surgery for gastric cancer, this form of metastasis occurred in cases of a high involvement of regional lymph nodes and of a scirrhous type. The results of histological examination showed a high degree of lymphatic permeation in the submucosal layer. Poorly differentiated adenocarcinoma was readily identified. The lumbar and thoracic vertebra were the areas of frequent metastases. The metastasis occurred within two years after the gastric surgery, in most cases. Chemotherapy was ineffective and radiotherapy was effective for palliation of the bone pain. Prognosis was very poor and all but one patient died within a few months after confirmation of the metastasis.