Department of Gastroenterology, Gastrointestinal Oncology and Endocrinology, University Medical Center Göttingen, Göttingen, Germany.
Department of Endocrinology and Metabolism, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Gastric Cancer. 2022 Jan;25(1):161-169. doi: 10.1007/s10120-021-01219-z. Epub 2021 Jul 23.
Brain metastases represent a severe complication in many gastrointestinal malignancies especially those arising from the upper gastrointestinal tract, including cancer of the esophagus, gastroesophageal junction, and stomach (GEC). However, there is little knowledge about the onset or potential risk factors for brain metastases (BRMs) in upper gastrointestinal cancers resulting in a lack of screening guidelines for BRMs.
We analyzed 827 patients from our cancer registry suffering from gastroesophageal cancer (GEC) and treated at the University Medical Center Göttingen between January 2013 and December 2019 for the presence of BRMs.
From 827 patients with GEC we found 54 patients with BRMs, resulting in an incidence of 6.5%. BRMs are more frequent in male patients (90.74% vs 9.26%, p = 0.0051) and in adenocarcinomas (90.74% vs 9.26%, p = 0.0117). Mean duration for the onset of BRMs from initial cancer diagnoses was 20.9 months in limited disease (curative approach) and 9.3 months in advanced disease (palliative approach) (p = 0.0026). However, early detection of BRMs is a prognostic factor since patients with successful resection of BRMs have a better prognosis compared to those with unresectable BRMs (5.93 vs 2.07 months, p = 0.0091).
In this single-center retrospective study, brain metastases (BRMs) occur with a high frequency (6.5%) in gastroesophageal cancer (GEC), significantly more often in male patients and adenocarcinomas. Since survival of these patients considerably correlates with successful BRMs resection, our observations propose further prospective trails to validate our hypothesis and ultimately the implementation of routine screening procedures to detect asymptomatic brain metastases.
脑转移是许多胃肠道恶性肿瘤的严重并发症，特别是起源于上胃肠道的肿瘤，包括食管癌、胃食管交界处癌和胃癌（GEC）。然而，对于导致脑转移（BRMs）的上胃肠道癌症的发病机制或潜在危险因素知之甚少，因此缺乏 BRMs 的筛查指南。
我们分析了来自癌症登记处的 827 名在哥廷根大学医学中心接受治疗的 GEC 患者，以确定是否存在 BRMs。
在 827 名 GEC 患者中，我们发现 54 名患者存在 BRMs，发生率为 6.5%。BRMs 在男性患者中更为常见（90.74% vs 9.26%，p=0.0051），在腺癌患者中更为常见（90.74% vs 9.26%，p=0.0117）。从初始癌症诊断到 BRMs 发病的平均时间在局限性疾病（治愈性方法）中为 20.9 个月，在晚期疾病（姑息性方法）中为 9.3 个月（p=0.0026）。然而，BRMs 的早期发现是一个预后因素，因为成功切除 BRMs 的患者的预后明显优于无法切除 BRMs 的患者（5.93 个月 vs 2.07 个月，p=0.0091）。
在这项单中心回顾性研究中，脑转移（BRMs）在上胃肠道癌（GEC）中发生率较高（6.5%），在男性患者和腺癌患者中更为常见。由于这些患者的生存与成功切除 BRMs 密切相关，我们的观察结果建议进一步进行前瞻性试验来验证我们的假设，并最终实施常规筛查程序以检测无症状的脑转移。
