Bone metastasis of gastric cancer: Clinical evaluation on bone scintigram / 대한내과학회지

ABSTRACT

BACKGROUND: It has been known that bone metastasis rarely occurs in gastric cancer, compared with lung and breast cancers. But its incidence is variable according to authors and has not been reported in Korea. We investigated the incidence and related clinical parameters of bone metastasis. METHODS: We studied a total of 226 gastric cancer patients who were diagnosed by endoscopic biopsy at Our Lady of Mercy Hospital and UiJongBu St. Mary's Hospital from 1993 to 2000. We performed abdominal CT and bone scan at the time of cancer diagnosis in all patients. The data of parameters including gross findings on gastrofibroscopy, histology, laboratory findings were obtained for analysis. RESULTS: 226 patients (male 158 patients, female 68 patients) were included and their mean age was 58.9+/-13.0 years. The rate of early gastric cancer was 24.8% and 75.2% for advanced cancer. The incidence of bone metastasis based on bone scintigram was 11.9% (27/226 subjects) and the main involvement sites were spine (81.5%), rib (74.1%), skull (29.6%), pelvis (14.8%). The incidence was higher in advanced stage or corpus location or elevated CEA level. Other parameters including age, sex, pathology, endoscopic gross morphology, levels of Ca, alkaline phosphatase were not significant in relation to bone metastasis. Bone metastasis was more related to lung metastasis than liver metastasis. CONCLUSION: In our study, bone metastasis is not rare in gastric cancer. Therefore, the evaluation of it should be performed selectively according to the staging, tumor location and tumor marker level.