Colorectal metastases from gastric adenocarcinoma: A single-center retrospective study of diagnostic challenges, clinicopathologic features, and clinical outcomes

Abstract

Abstract

BACKGROUNDColorectal metastasis from gastric adenocarcinoma is a rare manifestation of advanced disease that frequently mimics primary colorectal adenocarcinoma, creating substantial diagnostic challenges and potentially leading to inappropriate management.Existing evidence is limited to isolated case reports and small institutional series, resulting in an incomplete understanding of its clinicopathologic characteristics, diagnostic approach, treatment patterns, and clinical outcomes.We hypothesized that comprehensive clinicopathologic evaluation of a retrospective cohort could improve recognition of this uncommon metastatic pattern and facilitate accurate diagnosis and appropriate clinical management. AIMTo characterize the clinicopathologic features, diagnostic challenges, treatment patterns, and clinical outcomes of colorectal metastases from gastric adenocarcinoma.metastases with a median disease-free interval of 32 months (range, 20-131 months).Poorly cohesive carcinoma, including signet-ring cell carcinoma, was the predominant histological subtype.Immunohistochemistry demonstrated frequent cytokeratin 7 positivity with variable cytokeratin 20 and caudal-type homeobox transcription factor 2 expression, emphasizing the importance of integrated clinicopathologic correlation rather than individual markers for determining tumor origin.Surgery was primarily performed for symptom relief or diagnostic confirmation, while systemic therapy remained the principal treatment.Median overall survival after colorectal metastasis diagnosis was 9 months. CONCLUSIONColorectal metastasis from gastric adenocarcinoma remains diagnostically challenging.Accurate clinicopathologic correlation facilitates appropriate management, although prognosis remains poor despite multidisciplinary treatment.