Clinical Outcome of Gastric Cancer Patients with Bone Marrow Metastases

Kim, Hyo Song; Yi, Seong Yoon; Jun, Hyun Jung; Lee, Jeeyun; Park, Joon Oh; Park, Young Suk; Jang, Jun-Ho; Kim, Hee Jin; Ko, Young‐Hyeh; Lim, Ho Yeong; Kang, Won Ki

doi:10.1159/000127386

Cited by 99 publications

(115 citation statements)

References 38 publications

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“…The prognosis of patients with solid cancers and bone marrow metastases was dismal in this study, in line with previous reports (Ringenberg et al, 1986;Wang et al, 1987;Ozkalemkas et al, 2005;Kim et al, 2007;Kwon et al, 2011). In addition to the use of antitumor treatment as identified in previous studies, our study identified 3 additional clinical factors predictive of survival in these patients groups: ECOG PS, primary tumor location, and platelet counts.…”

Section: Discussionsupporting

confidence: 90%

“…Yu-Shin Hung 1 , Wen-Chi Chou 1 *, Tai-Di Chen 2 , Tse-Ching Chen 2 , Po-Nan Wang 1 , Hung Chang 1 , Hung-Chih Hsu 1 , Wen-Chi Shen 1 , Wei-Hong Cheng 3 , Jen-Shi Chen 1 * et al, 1992;Trillet-Lenoir et al, 1994;Kim et al, 2007;Kwon et al, 2011;Mehdi et al, 2011).…”

Section: Prognostic Factors In Adult Patients With Solid Cancers and mentioning

confidence: 99%

“…Solid cancer with bone marrow metastases is a rare but lethal condition (Ringenberg et al, 1986;Wang et al, 1987;Papac RJ, 1994;Ozkalemkas et al, 2005;Kim et al, 2007;Kwon et al, 2011). Bone marrow biopsy has been the standard diagnostic modality for overt bone marrow metastases arising from solid cancers since 1958 when McFarland and Dameshek first described a simplified technique for bone marrow biopsy (McFarland et al, 1958).…”

Section: Introductionmentioning

confidence: 99%

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Prognostic Factors in Adult Patients with Solid Cancers and Bone Marrow Metastases

Hung¹,

Chou²,

Chen³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: Solid cancers with bone marrow metastases are rare but lethal. This study aimed to identify clinical factors predictive of survival in adult patients with solid cancers and bone marrow metastases. Methods: A total of 83 patients were enrolled consecutively between January 1, 2000 and December 31, 2012. Bone marrow metastases were confirmed by biopsies. Patient clinical features and laboratory data were analyzed for associations. Results: The median age of the patients was 54 years (range, 23-88 years), and 58% were male. The 3 most common primary tumor locations were the stomach (32 patients, 39%), prostate (16 patients, 19%), and lungs (12 patients, 15%). The median overall survival was 49 days (range, 3-1423 days). Patients with Eastern Cooperative Oncology Group performance status 1, cancers of prostate origin, platelet counts over 50,000/ml, and undergoing antitumor therapies had a significantly better prognosis in the multivariate analysis. The median survival times were 173 and 33 days for patients with 2-3 more favorable parameters (n=24) and those with 0-1 (n=69), respectively (hazard ratio 0.30; 95% CI 0.17-0.52, p<0.001). Conclusions: Solid cancers with bone marrow metastases are dismal and incurable diseases. Understanding prognostic factors to these diseases helps medical personnel to provide appropriate treatments and better inform patients about outcomes. Antitumor therapies may improve outcomes in selected patient cohorts.

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Section: Discussionsupporting

confidence: 90%

Section: Prognostic Factors In Adult Patients With Solid Cancers and mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prognostic Factors in Adult Patients with Solid Cancers and Bone Marrow Metastases

Hung¹,

Chou²,

Chen³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…Gastric cancer cases with bone marrow involvement have very poor prognosis with a survival period ranging from 1.5 to 4 months [8,9]. Prognostic factors for poor survival are low performance status, multiple bone metastases, and elevated tumor markers.…”

Section: Discussionmentioning

confidence: 99%

Pancytopenia and Isolated Bone Marrow Recurrence in a Case of Previously Resected Gastric Carcinoma: A Rare Finding

Sehgal

Kumar

Rastogi

et al. 2014

Indian J Hematol Blood Transfus

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Recurrences in resected cases of gastric carcinomas are well known. However isolated involvement of bone marrow is a rare presentation. We present a previously treated case of gastric carcinoma-signet-ring cell type who had a progressive shortness of breath since 1 month. A hemogram done at this occasion showed pancytopenia and leucoerythroblastic picture. Bone marrow examination revealed infiltration by signet-ring cells. All such patients who presents with unexplained pancytopenia should prompt us to suspect a bone marrow recurrence.

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“…Bone metastases in gastric cancer are rare and they usually appear late in the natural history of the disease; however, micrometastatic seeding in the bone may be evident in the early stage of the disease (5). Nevertheless, when these metastatic lesions occur, the prognosis is poor, as they can cause bone marrow suppression, anemia, cord compression and intravascular coagulation and can quickly lead to mortality (6). In early gastric cancer, a poorly differentiated carcinoma and the presence of signet-cells seem to be associated with bone metastases (7).…”

Section: Introductionmentioning

confidence: 99%

Bone metastases in gastric cancer follow a RANKL-independent mechanism

et al. 2013

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Abstract. Gastric cancer is one of the most common and lethal malignancies worldwide. Bone metastases in gastric cancer are less common than in other solid tumors, but when they occur the prognosis is generally poor. Increased osteoclastogenesis and osteoclast activity are common features in bone metastases caused by different osteotropic cancer. We investigated osteoclastogenesis and its mechanisms in gastric cancer by enrolling 31 newly diagnosed gastric cancer patients and 45 healthy controls. We studied in vitro osteoclastogenesis in the peripheral blood mononuclear cell cultures of patients and controls, showing spontaneous osteoclastogenesis for half of the patients. This osteoclastogenesis was RANKL-and TNF-α-independent. We analyzed primary tumor and bone metastatic tissues of gastric cancer for the expression of genes involved in osteoclastogenesis. The expression of transforming growth factor-β (TGF-β), osteoprotegerin (OPG), IL-7 and dickkopf-1 (DKK-1) was higher in primary tumors than in bone metastases. RANKL was not detectable in primary tumor or in bone metastatic tissue. The serum RANKL level was significantly higher in healthy controls than in patients, and it was not related to osteoclastogenesis, thereby suggesting that RANKL is not involved in the bone metastatic mechanisms in gastric cancer. We hypothesized a role of RANKL in angiogenesis, thus we compared the serum levels of RANKL to those of VEGF, since VEGF is directly related to angiogenesis. Different from RANKL, the VEGF serum levels were higher in gastric patients than in controls, suggesting a block of the angiogenesis inhibition due to RANKL. RANKL and VEGF serum levels were not predictive of overall survival in our cohort of gastric patients.

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Clinical Outcome of Gastric Cancer Patients with Bone Marrow Metastases

Cited by 99 publications

References 38 publications

Prognostic Factors in Adult Patients with Solid Cancers and Bone Marrow Metastases

Prognostic Factors in Adult Patients with Solid Cancers and Bone Marrow Metastases

Pancytopenia and Isolated Bone Marrow Recurrence in a Case of Previously Resected Gastric Carcinoma: A Rare Finding

Bone metastases in gastric cancer follow a RANKL-independent mechanism

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