Imaging Characteristics and Clinical Outcomes in Gastric Cancer with Brain Metastasis: A Propensity Score-Matched Study.

Purpose: This study aimed to investigate the impact of brain metastasis (BM) on the clinical outcomes of gastric cancer (GC) and explored related imaging characteristics.

Methods: GC patients of tumor stage IV treated at Nanfang Hospital from October 2004 to September 2022 were included. The comparisons of non-BM and BM group were used by propensity score matching (PSM). The Kaplan-Meier method was used to compare the overall survival (OS) and cancer-specific survival (CSS). Cox regression was used for multivariate analyses.

Results: A total of 1,051 patients were included. After PSM, non-BM group (n = 28) and BM group (n = 28) were more balanced in baseline variables. The OS (p < 0.05) and CSS (p < 0.05) of the BM group were inferior to those of the non-BM group. Multivariate Cox regression analysis suggests that brain metastasis is associated with poor OS (HR = 1.959, 95% CI: 1.031-3.721, p = 0.040) and CSS (HR = 1.988, 95% CI: 1.037-3.812, p = 0.038). Brain metastases predominantly occur in the frontal lobe (68.0%), followed by the parietal lobe (52.0%), and cerebellum (36.0%), these metastases frequently present with associated edema (65.1%) and necrosis (33.7%).

Conclusion: The presence of brain metastasis is associated with poor OS and CSS. Brain metastases from GC commonly occur in the frontal lobe, parietal lobe, and cerebellum, with frequent imaging features of edema and necrosis.