The clinical features and prognostic factors for survival in gastric cancer patients with brain metastasis

초록

Background: Brain metastasis from gastric cancer is exceedingly rare. The purpose of this study was to analyze the clinical features of gastric cancer with brain metastasis and the prognostic factors for patient survival. Methods: The medical records were reviewed from January 1996 through July 2013 to identify patients who were diagnosed with gastric cancer and developed brain metastasis during the study period. Twelve cases of histologically comfirmed advanced gastric cancer with brain metastases were analyzed retrospectively. Results: The half of the patients had poorly differentiated adenocarcinoma. The median survival after the detection of brain metatases was 12 weeks. Univariate analysis revealed that poor survival was associated with increased levels of serum lactate dehydrogenase (p=0.005), unfavorable perfoemance status (p=0.021), and worsening neurological function after treatment for brain metastasis (p=0.007). In multivariate analysis, worsening neurological function after treatment for brain lesions (hazard ratio 5.5, 95% confidence interval 1.49-20.5, p=0.011) was confirmed as significant prognostic factor for poor survival. Conclusions: Deterioration in neurological function after treatment for brain metasiasis was an unfavorable prognostic factor for survival. The optimal treatment stategy needs to be defined for this subset of patients in clinical trials in the future.