Clinicopathological study of brain metastasis in gastric cancer patients

Brain metastasis from cancers of the gastrointestinal tract is uncommon; brain metastasis from gastric cancer is rare and its incidence is low. Brain metastasis of gastric cancer is often difficult to treat and is resectable in only a few cases. We have treated three patients who had a solitary brain metastasis after a gastrectomy. These three cases are reviewed along with eight other previously reported cases of brain metastasis to clarify the clinicopathological features and to suggest guidelines for patients with metastatic brain tumors. The clinicopathological features of 11 cases of brain metastasis were analyzed. For comparison purposes, the 11 cases were classified into three groups as follows: a resection group, a chemoradiotherapy group, and a nontreatment group. All the patients had advanced gastric cancer of stage III or more. The resection group had the most survivors, and survival rates decreased in the order of the resection group, the chemoradiotherapy group, and the nontreatment group. There was a statistically significant difference between the resection group and the nontreatment group (P = 0.0177). Aggressive multidisciplinary treatment, including a resection, for brain metastasis should improve the quality of life and prolong life expectancy.