[Clinicopathological study of gastric cancer with bone metastasis]

Fifty-eight patients with bone metastasis from gastric cancer, of whom 33 patients were resected cases and 25 were autopsies, were investigated. The incidence of bone metastasis of gastric cancer was 13.4% (33/246) among autopsies and was higher than that (1.5%, 33/2242) among resected cases. We attempted to clarify the factors related to bone metastasis by clinicopathological study. Bone metastasis had a tendency to occur in invasive cancer such as Borrmann types three or four. Histological examination revealed that 86% (50/58) of bone metastasis was poorly differentiated adenocarcinoma and that the stroma was scirrhous type in almost all cases. We measured serum alkaline phosphatase in patients with bone metastasis of recurrent gastric cancer, and found that the levels were relatively related to the condition of bone metastasis. However, the prognosis of patients with bone metastasis was not good and the mean survival time was about 5 months after the appearance of symptoms. In our department, we employ total body hyperthermia in such cases. This method has proved relatively effective for bone metastasis, as reflected by bone scintigram and changes in serum alkaline phosphatase values. As there is no reliable method of treatment for bone metastasis of gastric cancer, the present approach may be worth trying.