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D'Angelo et al. J Cancer Metastasis Treat 2019;5:30 I http://dx.doi.org/10.20517/2394-4722.2018.86 Page 3 of 18

Survival 28 months 2 year

Palliation Radiotherapy, brachytherapy, stenting or dilatation Endoscopic hemostatic procedures, stents Endoluminal stent, endoscopic or endovascular therapy for bleeding

Surgery Only for complications, obstruction or bleeding Only for emergency situation, bypass for obstruction Obstruction, bleeding obstruction, mass effect Emergency, bypass for obstruction Obstruction, bleeding Bypass for obstruction Intestinal obstruction, bleeding, perforation

Therapy Chemotherapy or endocrine therapy Systemic therapy, hormonal therapy Systemic therapy Systemic therapy, radiotherapy, endoscopy Systemic therapy, hormonal therapy Systemic therapy Systemic therapy Systemic therapy Individualized, systemic therapy Medical therapy

Gastric metastasis receptor Positive CK7, GCDFP-15, CEA, ER, PgR. Negative CK20 Positive CK, GCDFP-15, CEA, ER, PgR. Negative CK20 Positive ER, PgR, CK7, CK18. Negative HER2, CK20 ER, PgR, E-cadherin,

Gastric histology Signet ring morphology Signet ring morphology Signet ring Signet ring Signet ring

Gastric biopsy Negative in 30% Negative in 50%

Breast histology Lobular 83% Lobular Lobular Lobular Lobular Lobular 83% Lobular Lobular

Thickened visceral wall, other metastasis has low sensitivity

CT ER: estrogen receptor; PgR: progesterone receptor; HER: human epithelial receptor; CK: cytokeratin; GCDFP-15: gross cystic disease fluid protein 15; CEA: carcinoembryonic antigen

Endoscopy Linitis plastica, negative in 50% Linitis plastica, normal mucosa in 30% Diffuse infiltration Linitis plastica Normal in 50% 3 patterns: localized, PET diffuse, external compression* Sub-mucosal type lesion, solitary lesions* Linitis plastica Linitis plastica, normal mucosa in 50% Discrete nodules, linitis plastica Linitis plastica (lobular type); discrete nodules (ductal type)

Non specific: dysphagia, dyspepsia, anorexia, abdominal pain, early satiety, nausea, vomiting, bleeding Non specific: nausea, vomiting, epigastric pain, anorexia, dyspepsia, bloating Inexpressive Nausea, vomiting, epigastric pain, anorexia, weight loss, dysphagia, melena, hematemesis, iron deficiency anemia, guaiac positive stools Epigastric pain, melena, anemia, nausea, vomiting Epigastric pain, dysphagia, vomiting, gastrointestin

Symptoms
Table 1. Summary of reviews from 2000 to 2018 DFS Incidence Study Many 0.3%-18% Pectasides et al. [7] , years 2009 Few 7.4%-18% Ayantude et al. [8] , months 2007 to several years 4-5 years 2%-18% Villa Guzman et al. [9] , 2017 6%-18% Reiman et al. [10] , 2001 7 years 8%-35% Critchley et al. [11] , 2011 50-78 Namikawa et al. [13] , months 2013 75.6 Weigt et al. [12] , 2015 months 2%-18% Barranco et al. [14] , 2017 Many