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Page 4 of 18 D'Angelo et al. J Cancer Metastasis Treat 2019;5:30 I http://dx.doi.org/10.20517/2394-4722.2018.86

Table 2. Characteristics of patients
Variables Number of patients n (%)
Age, years
≥ 55 34 59
< 55 24 41
Symptoms
Yes 45 90
No 5 10
Presentation
Synchronous 10 17
Metachronous 54 83
Endoscopy
Linitis plastica 21 37
Ulcers 16 29
Polyp/Nodule 4 7
Other 15 27
Other metastasis
Yes 56 81
No 13 19
Therapy
CHT ± OT 41 69
Surgery + CHT 10 17
Surgery 7 12
RT 1 2
Overall survival
Median 24
CHT 23
Surgery + CHT 91
Surgery 45
CHT: chemotherapy; OT: hormonal therapy; RT: radiotherapy

Table 3. Characteristics of primary breast cancer
Variables Number of patients n (%)
Histology
Lobular 42 64
Ductal 16 24
Other 8 12
ER status (breast)
Positive 34 92
Negative 3 8
PgR status (breast)
Positive 29 80
Negative 7 20
HER2 status (breast)
Positive 7 25
Negative 21 75
ER: estrogen receptor; PgR: progesterone receptor; HER: human epithelial receptor

Symptoms
Ten articles reported the most common presentation symptoms related to gastric metastasis: they are often
non specific, with epigastric pain as the most frequently reported, followed by nausea, vomiting, dyspepsia
and dysphagia. Other reported symptoms are anorexia, early satiety, weight loss, and bleeding that may
manifest as hematemesis, melena or iron deficiency anemia. One article used the term “inexpressive” to
describe these symptoms.

Endoscopy
All the studies reported the main endoscopic findings, and the majority of them agreed that the most
common presentation is linitis plastica. Because linitis plastica is caused by the infiltration of tumor cells
in submucosa, the overlying mucosa is normal, thus resulting in negative exam results in 50% of cases,
as reported in two studies, or 30%, as reported by Ayantude. Two articles discussed different patterns of