Published online Oct 21, 2020. doi: 10.3748/wjg.v26.i39.6037
Peer-review started: May 28, 2020
First decision: June 18, 2020
Revised: August 28, 2020
Accepted: September 5, 2020
Article in press: September 5, 2020
Published online: October 21, 2020
Detailed information on metastatic patterns in of patients with esophageal and gastric cancer is limited. Early recognition of metastases is important to avoid futile locoregional treatments. Furthermore, knowledge on metastatic patterns is necessary for further development of personalized treatment modalities.
To gain insight into the metastatic pattern of gastroesophageal cancer.
A nationwide retrospective autopsy study of 3876 patients with adenocarcinoma (AC) or squamous cell carcinoma (SCC) of the esophagus or stomach between 1990 and 2017 was performed. Only patient with metastases were included for analysis. The metastatic pattern was analyzed according to the primary tumor location and histological subtype.
Metastatic disease was found in 268 esophageal and 331 gastric cancer patients. In esophageal cancer, the most common metastatic locations were liver (56%), distant lymph nodes (53%) and lung (50%). Esophageal AC showed more frequently metastases to the peritoneum and bone compared with esophageal SCC. In gastric cancer, the most common metastatic locations were distant lymph nodes (56%), liver (53%) and peritoneum (51%). Intestinal-type AC of the stomach showed metastases to the liver more frequently, whereas metastases to the bone, female reproductive organs and colorectum were observed more frequently in diffuse-type gastric AC.
This study showed differences in metastatic patterns of patients with esophageal and gastric cancer according to the primary tumor location and histological subtype.
Core tip: In this nationwide retrospective autopsy study, the metastatic pattern of 599 patients with metastases of primary adenocarcinoma or squamous cell carcinoma of the esophagus or stomach were evaluated. Differences in metastatic patterns of these patients were found according both to the primary tumor location as well as the histological subtype. This study provides robust data regarding metastatic patterns in esophageal and gastric cancer patients. Knowledge of metastatic patterns is helpful during preoperative staging, follow-up and in future research.