Objective  Influence of clinicopathological characteristics and different therapy patterns on the overall survival of patientswith gastric cancer with bone metastasis was investigated.

  Methods  A total of 146 gastric cancer patients with bone metastasis wereenrolled from December 1996 to December 2014.Data of clinicopathological characteristics, treatment methods, and overall survivalwere collected.Univariate and multivariate analyses were performed using log-rank tests and Cox's proportional hazard model, respectively.

  Results  A total of 51(34.9%)patients had synchronous metastasis, while 95(65.1%)had metachronous metastasis.Moreover, 35(24.0%)patients only had bone metastasis, while 111(76.0%)patients were complicated with other organ metastases, such as liver(30.0%), peritoneal(24.0%), lung(15.1%), and bone marrow(7.5%).After diagnosis of bone metastasis, bisphosphonates, bone radiotherapy and bone surgery were applied in 99(67.8%), 34(23.3%), and 5(3.4%)patients, respectively.Additionally, 96(65.6%)patientsreceived palliative chemotherapy.The median overall survival was 5.8 months(95% CI: 4.284-7.316).Multivariate analysis revealedthat KPS < 80(P=0.030), bone marrow metastasis(P < 0.001), elevated serum CA199(P < 0.001), and without palliative chemotherapy(P < 0.001) were independent poor prognostic factors.

  Conclusion  The outcome of gastric cancer with bone metastasis is very poor, especially in patients with bone marrow metastasis, worse KPS, and elevated CA199.Palliative chemotherapy may be beneficial for the survival of these patients.