Clinical Outcome of Gastric Cancer Patients with Bone Marrow Metastases

Abstract

BACKGROUND: Gastric cancer with bone marrow metastases is known to pursue a rapidly deteriorating clinical course. We conducted a retrospective analysis to evaluate clinical manifestations and prognosis of gastric cancer patients with bone marrow metastases. METHODS: Between September 1994 and February 2006, 39 gastric cancer patients with pathologically confirmed bone marrow dissemination were selected. RESULTS: The majority of the patients showed younger age, poorly differentiated adenocarcinoma or signet ring cell carcinoma, thrombocytopenia, anemia, elevated lactate dehydrogenase and alkaline phosphatase. Poor prognostic factors for survival were serum sodium < or =133 mmol/l [relative risk (RR) 4.57; 95% CI 1.99-10.52; p < 0.001], the presence of lung metastasis (RR 3.47; 95% CI 1.48-8.15; p = 0.007) and the presence of peritoneal seeding (RR 2.17; 95% CI 1.06-4.43; p = 0.036). Median survival durations after bone marrow metastases for patients without any adverse factors (n = 19, 48.7%) and those with 1-3 adverse factors (n = 20, 51.3%) were 67 and 23 days, respectively (p = 0.013). Patients without any adverse factors did benefit from palliative chemotherapy (p = 0.048). CONCLUSION: We suggest that gastric cancer patients with bone marrow metastases should receive more tailored therapies according to different risk factors in order to enhance survival.