Clinical Features And Prognostic Analysis Of Patients With Pulmonary Metastatic Gastric Cancer

Objective: Digestive system tumor is a common malignant tumor in China.Although the incidence of gastric cancer in the world has decreased,the incidence and mortality of gastric cancer Patients in China are still high.Pulmonary metastasis is one of the main causes of Poor Prognosis in Patients with gastric cancer.This PaPer aims to exPlore the clinical characteristics and Prognosis survival analysis of Patients with gastric cancer with lung metastasis,imProve the understanding of gastric cancer with lung metastasis,and Provide reference for the diagnosis and treatment of Patients with gastric cancer with lung metastasis.Methods: To collect 2005-01-01 to 2005-01-01 days in the first affiliated hosPital of xinjiang medical university make a diagnosis and give treatment of the clinical data of 118 cases of gastric cancer Patients with Pulmonary metastasis and follow-uP data,including Patient gender,age,tumor location,tumor histologic grading,Primary tumors underwent surgery,do you have any merger extraPulmonary metastases,lungs tyPe,number of metastases,Presence of mediastinal lymPh node enlargement,Presence of merger Pleural effusion,Pulmonary metastases time and Presence of chemotheraPy,etc.Among them,93 cases were males and 25 cases were females.The ratio of male to female was 4:1.The age ranged from 25 to 81 years old,and the median age was 62 years old.There were 74 cases with no more than 65 years old and 44 cases with >age.According to the 7th edition of the American federation of cancer research(AJCC)gastric cancer TNM staging,there were 8 cases of tumor infiltration in stage T1,7 cases in stage T2,17 cases in stage T3,and 86 cases in stage T4.There were 9 cases of N0,13 cases of N1,52 cases of N2 and 44 cases of N3 in lymPh node metastasis.There were 51 cases of medium and high differentiation,and 67 cases of low and undifferentiation.Therewere 89 cases of simultaneous lung metastasis and 29 cases of heterotoPic metastasis.There were 37 cases with unilateral lung metastasis and 81 cases with bilateral lung metastasis.There were 46 Patients with Primary resection and 72 Patients without surgery.There were 84 Patients with extraPulmonary metastasis and 34 Patients with lung metastasis.Fifty-seven Patients were not treated with systemic chemotheraPy and 61 were treated with systemic chemotheraPy.The data were analyzed retrosPectively to analyze the clinical characteristics of Patients with lung metastasis of gastric cancer and the related factors affecting the Prognosis and survival of Patients.Results: Among the 118 Patients,the median survival time was 8.0 months,and the 1-,2-,and 3-year survival rates were28.0%,12.7%,and 3.4%,resPectively.Univariate analysis showed tumor histological grade,T stage,synchronous lung metastasis,Primary lesion without undergoing surgery,bilateral lung metastases,concomitant extraPulmonary metastasis and chemotheraPy to be associated with the Prognosis of Patients with Pulmonary metastatic gastric cancer,all with the P<0.05.Multivariate analysis showed tumor histological grade(HR=1.267,95%CI: 1.044-1.537;P=0.016),concomitant extraPulmonary metastasis(HR=1.855,95% CI:1.203-2.861;P=0.005)and bilateral lung metastases(HR=1.701,95% CI: 1.097-2.636;P=0.018)to be indePendent risk factors,and chemotheraPy(HR=0.402,95% CI:0.258-0.625;P<0.001))to be an indePendent Protective factor,for the Prognosis of Patients with Pulmonary metastatic gastric cancer.Conclusion: The Prognosis is Poor in Patients with Pulmonary metastatic gastric cancer,Particularly in those with extraPulmonary metastasis,bilateral lung metastases and/or Poorly differentiated/undifferentiated disease;chemotheraPy is exPected to extend the survival of Patients with Pulmonary metastatic gastric cancer.Active treatment is therefore clinically desirable in an effort to imProve the Prognosis of these Patients.