Background: Brain metastases (BM) from gastric cancer (GC) are rare but associated with poor prognosis, significantly impacting patient survival and quality of life. The objective of this systematic review and meta-analysis is to consolidate existing research on BM from GC, evaluate the incidence and clinical outcomes, and explore the effectiveness of treatment options. Methods: A systematic search was conducted across the Medline, Web of Science, and Scopus databases, following PRISMA guidelines. Eighteen high-quality studies, as per the Newcastle–Ottawa Quality Assessment Scale, were included, encompassing 70,237 GC patients, of whom 621 developed BM. Data on progression-free survival (PFS), overall survival (OS), neurological symptoms, and HER2 status were analyzed using a random-effects model. Results: The incidence of BM in GC patients was found to be 2.29% (95% CI: 1.06–3.53%), with the range extending from 0.47% to 7.79% across studies. HER2-positive status was significantly associated with a higher likelihood of developing BM, with an odds ratio of 43.24 (95% CI: 2.05–913.39;p= 0.02), although this finding was based on limited data. The surgical resection of BM was linked to significantly improved survival outcomes, with a mean difference in OS of 12.39 months (95% CI: 2.03–22.75;p= 0.02) compared to non-surgical approaches. Conclusions: The surgical resection of brain metastases in GC patients significantly enhances overall survival, while HER2-positive patients may show a higher risk for developing BM. These findings underscore the importance of tailored therapeutic approaches for GC patients with BM.
背景：胃癌脑转移虽属罕见，但预后不良，显著影响患者生存期与生活质量。本系统综述与荟萃分析旨在整合现有胃癌脑转移相关研究，评估其发生率与临床结局，并探讨治疗方案的有效性。方法：遵循PRISMA指南，系统检索Medline、Web of Science及Scopus数据库。根据纽卡斯尔-渥太华质量评估量表纳入18项高质量研究，共涵盖70,237例胃癌患者，其中621例发生脑转移。采用随机效应模型分析无进展生存期、总生存期、神经系统症状及HER2状态等数据。结果：胃癌患者脑转移发生率为2.29%（95% CI：1.06–3.53%），各研究间发生率范围为0.47%至7.79%。HER2阳性状态与脑转移发生风险显著相关（比值比=43.24，95% CI：2.05–913.39；p=0.02），但该结论基于有限数据得出。脑转移手术切除与生存结局显著改善相关，相较于非手术治疗，总生存期平均延长12.39个月（95% CI：2.03–22.75；p=0.02）。结论：手术切除可显著延长胃癌脑转移患者总生存期，而HER2阳性患者可能具有更高的脑转移发生风险。这些发现强调了针对胃癌脑转移患者制定个体化治疗策略的重要性。
肿瘤(癌症)患者之家