Department of Medicine, Rawalpindi Medical University, Rawalpindi, Pakistan.
Department of Community Medicine, Rawalpindi Medical University, Rawalpindi, Pakistan.
Sci Rep. 2023 Oct 31;13(1):18664. doi: 10.1038/s41598-023-46109-9.
Brain metastasis in gastric cancer (GC) patients is a rare phenomenon that is associated with adverse clinical outcomes and poor survival rates. We conducted a retrospective cohort study to investigate the incidence, risk factors and prognostic factors of brain metastasis in GC patients. Data on sociodemographic and tumor characteristics of GC patients from 2010 to 2019 was extracted from the Surveillance, Epidemiology and End-Results (SEER) database. Descriptive statistics, multivariable logistic and Cox regression were applied on SPSS. Kaplan-Meier-Survival curves and ROC curves were constructed. A total of 59,231 GC patients, aged 66.65 ± 13.410 years were included. Brain metastasis was reported in 368 (0.62%) patients. On logistic regression, the risk of brain metastasis was significantly greater in males, patients aged < 60 years and patients having concurrent bone and lung metastasis. High grade and high N stage were significant risk factors for development of brain metastasis. Patients who had undergone surgery for the primary tumor were at reduced risk for brain metastasis (adjusted odds ratio 0.210, 95% CI 0.131-0.337). The median OS was 3 months in patients with brain metastasis and 17 months in patients without brain metastasis (p < 0.05). On Cox regression, Grade IV tumors and primary antral tumors were significant predictable parameters for poor prognosis. Overall Survival (OS) and Cancer-Specific Survival (CSS) were prolonged in patients who had undergone surgery. Brain metastasis in gastric cancer is associated with significantly worse survival. Employing large-scale screening for high-risk patients holds a promising impact to improve survival rates, but it must be accurately balanced with a comprehensive understanding of clinicopathological aspects for accurate diagnosis and treatment.
胃癌（GC）患者的脑转移是一种罕见的现象，与不良的临床结局和生存率低有关。我们进行了一项回顾性队列研究，以调查 GC 患者脑转移的发生率、危险因素和预后因素。从监测、流行病学和最终结果（SEER）数据库中提取了 2010 年至 2019 年 GC 患者的社会人口统计学和肿瘤特征数据。SPSS 上应用描述性统计、多变量逻辑和 Cox 回归。绘制 Kaplan-Meier 生存曲线和 ROC 曲线。共纳入 59231 例年龄为 66.65±13.410 岁的 GC 患者。报告了 368 例（0.62%）脑转移患者。在逻辑回归中，男性、年龄<60 岁和同时发生骨和肺转移的患者发生脑转移的风险显著增加。高级别和高 N 期是脑转移发展的显著危险因素。接受原发性肿瘤手术的患者发生脑转移的风险降低（调整后的优势比 0.210，95%CI 0.131-0.337）。脑转移患者的中位 OS 为 3 个月，无脑转移患者的中位 OS 为 17 个月（p<0.05）。在 Cox 回归中，IV 级肿瘤和胃窦部原发性肿瘤是预后不良的显著预测参数。接受手术的患者总生存（OS）和癌症特异性生存（CSS）延长。胃癌脑转移与生存率显著降低相关。对高危患者进行大规模筛查有望提高生存率，但必须与对临床病理方面的全面了解相平衡，以进行准确的诊断和治疗。
