Tang Dong, Lv Jianjian, Liu Zhijing, Zhan Shuhui, Gao Yuqiang
Department of Gastroenterology, Qingdao Municipal Hospital, The Affiliated Municipal Hospital of Qingdao University, Qingdao, China.
Department of Oncology, Qingdao Municipal Hospital, The Affiliated Municipal Hospital of Qingdao University, Qingdao, China.
Front Oncol. 2022 Jul 8;12:922016. doi: 10.3389/fonc.2022.922016. eCollection 2022.
Gastric metastasis from lung cancer (GMLC) is a rare occurrence. The clinicopathological characteristics, outcomes, and prognostic factors remain largely elusive.
We conducted a systematic review on case reports and case series of GMLC by scanning MEDLINE, Embase, and ISI Web of Knowledge. Data involving the clinicopathological features, treatment, and outcomes were extracted and analyzed. Survival analysis was performed using Kaplan-Meier method. The Cox proportional hazards regression model was used to identify potential prognostic factors associated with survival. Furthermore, a case of metastatic gastric adenocarcinoma of pulmonary origin with epidermal growth factor receptor (EGFR) L858R+T790M mutation was also described and included.
Seventy-eight records involving 114 cases (including ours) were finally included. The median age on admission was 65 years with a male predominance of 79.8%. Lung adenocarcinoma (42.1%), located in the right upper lobe (30.3%), was the most frequent primary tumor. Bleeding (36.7%) and abdominal pain (35.8%) were the two most common symptoms. Endoscopically, gastric lesions were typically presented as elevated lesions with or without volcano-like ulceration, or ulcerative lesions, mostly involving the gastric corpus. The median overall survival time and survival time after diagnosis of metastatic cancer were 11 months [95% confidence interval (CI): 7-14] and 4.5 months (95% CI: 3-9), respectively. The survival analyses revealed that surgical interventions (including lung surgery and/or abdominal surgery) and systemic therapy (including chemotherapy, radiotherapy, and/or targeted therapy) seemed to be positive prognostic factors for both overall survival and survival after diagnosis of metastatic cancer.
Clinicians should be alerted to the occurrence of gastric metastasis in lung cancer patients. Comprehensive evaluation and appropriate treatment for specific patients may improve the survival rate of GMLC patients.
肺癌胃转移（GMLC）较为罕见。其临床病理特征、预后及预后因素仍大多不明。
通过检索MEDLINE、Embase和ISI Web of Knowledge，对GMLC的病例报告和病例系列进行系统综述。提取并分析涉及临床病理特征、治疗及预后的数据。采用Kaplan-Meier法进行生存分析。使用Cox比例风险回归模型确定与生存相关的潜在预后因素。此外，还描述并纳入了1例具有表皮生长因子受体（EGFR）L858R+T790M突变的肺源性转移性胃腺癌病例。
最终纳入78篇记录，涉及114例患者（包括我们的病例）。入院时的中位年龄为65岁，男性占79.8%。肺腺癌（42.1%）是最常见的原发肿瘤，其中位于右上叶的占30.3%。出血（36.7%）和腹痛（35.8%）是最常见的两种症状。在内镜下，胃部病变通常表现为隆起性病变，有或无火山口样溃疡，或溃疡性病变，大多累及胃体。转移性癌症诊断后的中位总生存时间和生存时间分别为11个月[95%置信区间（CI）：7 - 14]和4.5个月（95% CI：3 - 9）。生存分析显示，手术干预（包括肺部手术和/或腹部手术）和全身治疗（包括化疗、放疗和/或靶向治疗）似乎是总生存和转移性癌症诊断后生存的阳性预后因素。
临床医生应警惕肺癌患者发生胃转移。对特定患者进行综合评估和适当治疗可能提高GMLC患者的生存率。
