Brief Article
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Oct 14, 2011; 17(38): 4314-4320
Published online Oct 14, 2011. doi: 10.3748/wjg.v17.i38.4314
Role of surgical intervention in managing gastrointestinal metastases from lung cancer
Po-Chu Lee, Chiao Lo, Ming-Tsan Lin, Jin-Tung Liang, Been-Ren Lin
Po-Chu Lee, Department of Trauma, National Taiwan University Hospital and College of Medicine, Taipei 10002, Taiwan, China
Chiao Lo, Ming-Tsan Lin, Division of General Surgery, Department of Surgery, National Taiwan University Hospital and College of Medicine, Taipei 10002, Taiwan, China
Jin-Tung Liang, Been-Ren Lin, Division of Colorectal Surgery, Department of Surgery, National Taiwan University Hospital and College of Medicine, Taipei 10002, Taiwan, China
Author contributions: Lee PC and Lo C performed the majority of the data collection and the initial analysis; Lin MT and Liang JT performed the literature review and wrote the draft of the manuscript; Lin BR coordinated the study, analyzed the data, and wrote the manuscript.
Correspondence to: Dr. Been-Ren Lin, Division of Colorectal Surgery, Department of Surgery, National Taiwan University Hospital and College of Medicine, No. 7, Chung-Shan South Road, Taipei 10002, Taiwan, China. beenrenlin@ntu.edu.tw
Telephone: +886-2-23123456 Fax: +886-2-23934358
Received: January 15, 2011
Revised: May 5, 2011
Accepted: May 12, 2011
Published online: October 14, 2011
Abstract

AIM: To investigate the clinicopathological characteristics of late-stage lung cancer patients with gastrointestinal (GI)-tract metastases, focusing on therapeutic options and outcomes.

METHODS: Our institution (the National Taiwan University Hospital) diagnosed 8159 patients with lung cancer between 1987 and 2008, of which 21 developed symptomatic GI metastases. This study reviewed all of the patients’ information, including survival data, pathological reports, and surgical notes.

RESULTS: The most common histological type of lung cancer was adenocarcinoma, and 0.26% of patients with lung cancer developed GI metastases. The median duration from lung cancer diagnosis to GI metastases was three months (range, 0-108 mo), and the average time from diagnosis of GI metastasis to death was 2.8 mo. Most patients with symptomatic gastric and/or duodenal metastases exhibited GI bleeding and were diagnosed by panendoscopy. In contrast, small bowel metastases typically presented as an acute abdomen and were not diagnosed until laparotomy. All patients with small bowel or colonic metastases underwent surgical intervention, and their perioperative mortality was 22%. Our data revealed a therapeutic effect in patients with solitary GI metastasis and a favorable palliative effect on survival when metastases were diagnosed preoperatively. In patients with multiple GI metastases, the presentation varied according to the locations of the metastases.

CONCLUSION: Surgical treatment is worthwhile in a select group of patients with bowel perforation or obstruction. Physicians should be more alert to symptoms or signs indicating GI metastases.

Keywords: Gastrointestinal metastasis; Lung cancer; Palliative effect; Prognosis; Surgical intervention