UNASSIGNED: We conducted a systematic review on case reports and case series of GMLC by scanning MEDLINE, Embase, and ISI Web of Knowledge. Data involving the clinicopathological features, treatment, and outcomes were extracted and analyzed. Survival analysis was performed using Kaplan-Meier method. The Cox proportional hazards regression model was used to identify potential prognostic factors associated with survival. Furthermore, a case of metastatic gastric adenocarcinoma of pulmonary origin with epidermal growth factor receptor (EGFR) L858R+T790M mutation was also described and included.
UNASSIGNED: Seventy-eight records involving 114 cases (including ours) were finally included. The median age on admission was 65 years with a male predominance of 79.8%. Lung adenocarcinoma (42.1%), located in the right upper lobe (30.3%), was the most frequent primary tumor. Bleeding (36.7%) and abdominal pain (35.8%) were the two most common symptoms. Endoscopically, gastric lesions were typically presented as elevated lesions with or without volcano-like ulceration, or ulcerative lesions, mostly involving the gastric corpus. The median overall survival time and survival time after diagnosis of metastatic cancer were 11 months [95% confidence interval (CI): 7-14] and 4.5 months (95% CI: 3-9), respectively. The survival analyses revealed that surgical interventions (including lung surgery and/or abdominal surgery) and systemic therapy (including chemotherapy, radiotherapy, and/or targeted therapy) seemed to be positive prognostic factors for both overall survival and survival after diagnosis of metastatic cancer.
UNASSIGNED: Clinicians should be alerted to the occurrence of gastric metastasis in lung cancer patients. Comprehensive evaluation and appropriate treatment for specific patients may improve the survival rate of GMLC patients.
■我们通过扫描MEDLINE对GMLC的病例报告和病例系列进行了系统回顾,Embase,和ISIWebofKnowledge。涉及临床病理特征的数据,治疗,并对结果进行提取和分析。使用Kaplan-Meier方法进行生存分析。Cox比例风险回归模型用于确定与生存相关的潜在预后因素。此外,我们还描述并纳入了1例具有表皮生长因子受体(EGFR)L858R+T790M突变的肺起源的转移性胃腺癌.
■最终包括了涉及114个案例(包括我们的案例)的78个记录。入院年龄中位数为65岁,男性占79.8%。肺腺癌(42.1%),位于右上叶(30.3%),是最常见的原发性肿瘤。出血(36.7%)和腹痛(35.8%)是最常见的两种症状。内窥镜检查,胃病变通常表现为有或没有火山样溃疡的隆起病变,或者溃疡性病变,主要累及胃体。中位总生存期和诊断为转移癌的生存时间分别为11个月[95%可信区间(CI):7-14]和4.5个月(95%CI:3-9)。分别。生存分析显示,手术干预(包括肺部手术和/或腹部手术)和全身治疗(包括化疗,放射治疗,和/或靶向治疗)似乎是总生存率和诊断转移性癌症后生存率的积极预后因素。
■临床医生应警惕肺癌患者胃转移的发生。综合评估并针对特定患者进行适当治疗可提高GMLC患者的生存率。