Leptomeningeal carcinomatosis and brain metastases in gastroesophageal carcinoma: a real-world analysis of clinical and pathologic characteristics and outcomes

• DOI: 10.1007/s11060-024-04576-8
• Publication Date: 2024-02-19T15:02:56Z
• Authors: Thais Baccili Cur...; Zeynep Baskurt; Lucy X. Ma; Carly C. Barron; Abdul Farooq; Marie Phillipe Sa...; Xin Wang; Yvonne Bach; Hiroko Ayoama; Raymond W. Jang; Eric Chen; Patrick Veit-Haibach; Ben Wang; Sangeetha Kalimuthu; James Cotton; Rebecca Wong; Aruz Mesci; Elena Elimova
• Keywords: 03 medical and health sciences; 0302 clinical medicine; Research

Abstract Background Brain metastasis (BrM) and Leptomeningeal Carcinomatosis (LMC) are uncommon complications in gastroesophageal carcinoma (GEC) patients. These patients have a poor prognosis challenging to treat. We described the clinicopathologic features outcomes largest cohort of Central Nervous System (CNS) GEC Methods single-center retrospective study treated from 2007 2021. Clinicopathologic characteristics treatment modalities were reviewed. Survival was calculated date CNS diagnosis until death/last follow-up using Kaplan-Meier method. A multivariable Cox proportional hazards regression model used. Results Of 3283 patients, 100 (3.04%) diagnosed with BrM 20 LMC (0.61%). Patients known human epidermal growth factor receptor 2 (HER2) status ( N = 48), 60% HER2 positive (defined as IHC 3 + or 2+/FISH+). Among most signet-ring subtype (85%), only 15% (2/13) positive. Median survival 0.7; 3.8; 7.7 months best supportive care, radiation, surgery, respectively p < 0.001). In LMC, median 0.7 month who had care (7/19) 2.8 for those whole brain radiation therapy 0.015). Multivariate analysis showed worse ECOG ≥ 0.002), number 4 0.001) metastatic sites 0.009). Conclusion expression enriched BrM, while it is LMC. surgery followed by an improved OS WBRT benefited