CLINICAL AND ENDOSCOPIC ASPECTS OF METASTASES TO THE GASTROINTESTINAL TRACT

Aims:

Characterize the endoscopic aspects of metastases to the gastrointestinal tract and analyze the survival rate of this patients.

Methods:

A retrospective, single center, observational study, between January 2009 to December 2017. All patients with metastatic lesions to the GI tract with histological confirmation were included. Hematologic cancers, Kaposi sarcoma and tumors with direct invasion were excluded.

Results:

In this period, 54,478 endoscopic exams were performed and 95 patients had diagnosis of GI metastasis (GIMs). There were 49 men and 46 women, with a mean age of 58.9 years. The principle indication for endoscopy were abdominal pain (31.6%) and the most common primary malignancy was melanoma (25.3%), followed by lung (15.8%) and breast cancer (14.7%). The incidence of GIMs in patients with melanoma was 2.2%, in lung cancer was 0.4% and in breast cancer was 0.15. The most common site of metastasis in the GI tract was the stomach (63.2%) and the most common endoscopic presentation was a solitary, ulcerated lesion in the gastric body. The overall mean and median survival rates were respectively 13.3 months (CI 95% 8.2 – 18.3), and 4.7 months (CI 95% – 3.7 – 5.6). The mean and the median survival rates for patients that received palliative treatment (68 patients) were higher compared with the patients that just received supportive care (27 patients). Mean survival rate: 14.62 versus 7.98 months; median 5.47 versus 1.46 months The comparison of the Kaplan-Meier survival curves between these two groups is different with chi-square test of 6.85 and Log Rank p value = 0.009.

Conclusions:

Melanoma, breast and lung cancer were the most common metastasis to the GIT. The stomach was the main site of the metastatic lesions. The patients that received palliative treatment before the diagnosis of the GI metastasis had a longer survival rate than patients that received only supportive care.