Breast cancer: Presentation and intervention in women with gastrointestinal metastasis and carcinomatosis
Breast cancer: Presentation and intervention in women with gastrointestinal metastasis and carcinomatosis
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DOI：
10.1245/aso.2005.03.030
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发表时间：
2005-11-01
影响因子：
3.7
通讯作者：
Donohue, JH
中科院分区：
文献类型：
--
作者：
McLemore, EC;Pockaj, BA;Donohue, JH
背景：乳腺癌转移到胃肠道或腹膜是罕见的。我们回顾了乳腺癌转移到胃肠道，腹膜，或both.Methods：我们进行了回顾性分析的所有患者（1985-2000年）的乳腺癌转移到胃肠道或腹膜的病理诊断的乳腺癌的自然病史。患者被分为三组：胃肠道转移，癌病，或两者兼而有之。结果：73例患者中，23例（32%）仅胃肠道转移，32例（44%）仅癌病，和IS（25%）有两个。首次诊断乳腺癌的中位年龄为55岁。初步诊断和转移性表现之间的平均间隔为7年。胃肠道转移部位包括食管（8%）、胃（28%）、小肠（19%）和结肠和直肠（45%）。浸润性小叶癌占34（64%）的53胃肠道转移。诊断后的中位总生存期为28个月。47例患者（64%）的姑息性手术干预不影响总生存率。选择胃肠道转移患者行姑息性手术（44 vs. 9个月）可能会获得一些生存获益。诊断时的高龄和胃转移对生存率有负面影响，而全身化疗或他莫昔芬治疗对生存率有积极影响。结论：浸润性小叶癌患者更常发生胃肠道转移。手术干预并没有显著延长总生存期，但可以考虑在一组选定的患者。
Background: Breast cancer metastatic to the gastrointestinal tract or peritoneum is rare. We reviewed the natural history of ductal and lobular carcinoma in women with breast cancer metastatic to the gastrointestinal tract, peritoneum, or both.Methods: We performed a retrospective review of all patients (1985-2000) with a pathologic diagnosis of breast cancer metastatic to the gastrointestinal tract or peritoneum. Patients were categorized into three groups: those with gastrointestinal metastasis, carcinomatosis, or both.Results: Of 73 patients, 23 (32%) had gastrointestinal metastasis only, 32 (44%) had carcinomatosis only, and IS (25%) had both. The median age at initial breast cancer diagnosis was 55 years. The mean interval between the primary diagnosis and metastatic presentation was 7 years. Sites of gastrointestinal metastases included the esophagus (8%), stomach (28%), small intestine (19%), and colon and rectum (45%). Infiltrating lobular carcinoma represented 34 (64%) of the 53 gastrointestinal metastases. The median overall survival after diagnosis was 28 months. Palliative surgical intervention in 47 patients (64%) did not affect overall survival. Some survival benefit may have accrued to select patients with gastrointestinal metastasis who underwent surgical palliation (44 vs. 9 months). Advanced age at diagnosis and gastric metastases had a negative effect on survival, whereas treatment with systemic chemotherapy or tamoxifen had a positive effect on survival.Conclusions: Gastrointestinal metastasis occurred more often in patients with invasive lobular carcinoma. Surgical intervention did not significantly extend overall survival but may be considered in a select group of patients.