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. 2020 Oct 21;26(39):6037-6046.
doi: 10.3748/wjg.v26.i39.6037.

Metastatic pattern in esophageal and gastric cancer: Influenced by site and histology

Moniek Hp Verstegen  1 , Mitchell Harker  2 , Carlijn van de Water  3 , Jolanda van Dieren  4 , Niek Hugen  1 , Iris D Nagtegaal  3 , Camiel Rosman  1 , Rachel S van der Post  3
Affiliations

Metastatic pattern in esophageal and gastric cancer: Influenced by site and histology

Moniek Hp Verstegen et al. World J Gastroenterol. .

Abstract

Background: 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.

Aim: To gain insight into the metastatic pattern of gastroesophageal cancer.

Methods: 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.

Results: 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.

Conclusion: This study showed differences in metastatic patterns of patients with esophageal and gastric cancer according to the primary tumor location and histological subtype.

Keywords: Adenocarcinoma; Carcinoma; Esophageal cancer; Gastric cancer; Gastroesophageal junction; Histology; Metastases; Squamous cell.

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Conflict of interest statement

Conflict-of-interest statement: None to declare.

Figures

Figure 1
Figure 1
Metastatic sites of patients with esophageal cancer. Other metastases of esophageal cancer (all types) with proportion ≥ 2%: pancreas (6%), brain (4%), mediastinum (3%), skin/subcutis (3%), thyroid gland (3%), spleen (3%), gallbladder (2%). AC: Adenocarcinoma; SSC: Squamous cell carcinoma.
Figure 2
Figure 2
Metastatic pattern of esophageal and gastric cancer by histological subtype. AC: Adenocarcinoma; SSC: Squamous cell carcinoma.
Figure 3
Figure 3
Metastatic sites of patients with gastric cancer. Other metastases of gastric cancer (all types) with proportion ≥ 2%: heart (7%), kidney (6%), pancreas (5%), thyroid gland (4%), brain (3%), large intestine (3%), small intestine (2%), mediastinum (2%), skin/subcutis (2%), urine bladder (2%). AC: Adenocarcinoma.
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