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

doi:10.4251/wjgo.124919

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Publication Name

World Journal of Gastrointestinal Oncology

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1948-5204

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Retrospective Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Oncol. Dec 15, 2026; 18(12): 124919
Published online Dec 15, 2026. doi: 10.4251/wjgo.124919

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

Ying-Jung Chen, Po-Jung Chen, Yen-Cheng Chen, Chi-Han Yang, Tsung-Kun Chang, Wei-Chih Su, Ching-Wen Huang, Hsiang-Lin Tsai, Jaw-Yuan Wang

Ying-Jung Chen, Po-Jung Chen, Yen-Cheng Chen, Chi-Han Yang, Tsung-Kun Chang, Wei-Chih Su, Ching-Wen Huang, Hsiang-Lin Tsai, Jaw-Yuan Wang, Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan

Author contributions: Chen YJ and Wang JY contributed to conception and design; Wang JY contributed to administrative support; Wang JY, Huang CW, and Tsai HL contributed to provision of study materials or patients; Chen PJ, Yang CH, and Chang TK contributed to collection and assembly of %; Chen YJ, Su WC, and Tsai HL contributed to data analysis and interpretation; Chen YJ contributed to manuscript writing. All authors have read and approved the final manuscript.

AI contribution statement: AI tools, specifically ChatGPT, OpenAI, were used solely for language polishing and formatting assistance. No AI tool was used to generate research data, interpret results, or formulate conclusions. All AI-assisted content was critically reviewed and revised by the authors, who take full responsibility for the accuracy, originality, and integrity of the manuscript.

Supported by Mentor-Guided Research Project of Chung-Ho Memorial Hospital, Kaohsiung Medical University, No. KMUH114-4M34, No. KMUH114-4R37, No. KMUH114-4M35, No. KMUH114-4R38, No. KMUH113-3R31, No. KMUH113-3R32, No. KMUH113-3R33, No. KMUH113-3M58, and No. KMUH113-3M59.

Institutional review board statement: The study was approved by the Institutional Review Board of Kaohsiung Medical University Hospital, approval No. KMUHIRB-E(I)-20260040.

Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Data sharing statement: No additional data are available.

Corresponding author: Jaw-Yuan Wang, MD, PhD, Professor, Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No. 100 Tzyou 1^st Road, Kaohsiung 80708, Taiwan. cy614112@ms14.hinet.net

Received: June 26, 2026
Revised: July 24, 2026
Accepted: August 17, 2026
Published online: December 15, 2026
Processing time: 136 Days and 21.7 Hours

Core Tip

Core Tip: Colorectal metastasis from gastric cancer is an exceptionally rare entity that frequently mimics primary colorectal carcinoma, creating substantial diagnostic challenges. In this retrospective study of six patients, we characterized the clinicopathologic features, immunohistochemical profiles, treatment strategies, and survival outcomes of this uncommon metastatic pattern. Our findings demonstrate considerable heterogeneity in cytokeratin 7, cytokeratin 20, and caudal-type homeobox 2 expression, emphasizing that immunohistochemistry should always be interpreted together with morphologic features and clinical history. Despite multimodal treatment, prognosis remained poor, although very late metastasis can occur more than 10 years after initial gastric cancer diagnosis.