Diffuse bone metastasis with hematologic disorders from gastric cancer: Clinicopathological features and prognosis

Bone metastases diffusely invading the bone marrow from gastric cancer ofte n manifest a rapid clinical course and the prognosis is very poor due to he matologic disorders such as DIC (disseminated intravascular coagulation) an d/or MAHA (microangiopathic hemolytic anemia). The objective of this study was to clarify the clinicopathological features and prognosis of patients w ith gastric cancer in whom diffuse bone metastasis associated with hematolo gic disorders were evident. Thirty-eight patients with bone metastasis from a primary gastric cancer were thus selected and placed into 2 groups consi sting of 15 with diffuse bone metastasis with DIC and/or MAMA, and 23 patie nts who had bone metastasis without hematological disorders. We compared th e clinicopathological features and prognosis between the two groups. The cl inicopathological features in patients with diffuse bone metastasis accompa nied by hematologic disorders were significantly related to undifferentiate d adenocarcinoma, a relatively younger age, elevated levels of serum ALP-BI and LDH, and a lower frequency of extraosseous metastasis. The median surv ival time after manifestation was 2 and 11 months for the patients with or without hematologic disorders, respectively. The prognosis was significantl y worse in cases of DIC with the median survival being only one month. Sinc e: prognosis of diffuse bone metastasis from gastric cancer is significantl y poor, close attention should be directed to the specific clinicopathologi c features related to diffuse bone metastasis plus hematologic disorders. R egarding high risk patients, a regular follow-up of the serum chemistry lev els and a bone scan will aid in the early detection of the disease.