关键词: 胃癌, 预后, 肝转移, 骨转移, SEER

Abstract: ObjectiveTo investigate the relationship between the site of distant metastases and the prognosis of patients with gastric adenocarcinoma. 
MethodsCases of gastric adenocarcinoma with distant metastasis diagnosed from January 2010 to December 2014 in the US SEER database were chosen. The survival curves were drawn by KaplanMeier method， and the independent prognostic factors of overall survival and cancer specific survival were analyzed by Cox proportional hazards regression model. 
ResultsA total of 6532 cases were enrolled in this study, including 784 cases of bone metastases, 126 cases of brain metastases, 2692 cases of liver metastases, 958 cases of lung metastases and 2321 cases of distant lymph node metastases. In patients with single organ metastases， overall survival and cancer specific survival of patients with bone metastases were poorer than those with liver metastases； overall survival and cancer specific survival of patients with distant lymph node metastases were better than those with bone metastases， liver metastases， lung metastases and brain metastases. Cox multivariate analysis showed that in patients with distant metastasis of gastric adenocarcinoma， the overall survival and cancer specific survival were poor in men， elderly， unmarried， poorly differentiated， without primary surgery or multiple organ metastasis. 
ConclusionDifferent metastatic sites have different effects on the prognosis of patients with gastric cancer. In patients with single organ metastasis of gastric adenocarcinoma， patients with bone metastases have poorer prognosis than those with liver metastases or distant lymph node metastases. For patients with gastric adenocarcinoma with distant metastasis， male， venerable age， unmarried， low differentiation， non primary surgery or multiple organ metastasis were the risk factors for prognosis.

Key words: Gastric cancer, Prognosis, Liver metastasis, Bone metastasis, SEER