Colorectal cancer and brain metastases: An aggressive disease with a different response to treatment

Chahine, Georges; Ibrahim, Tony; Felefly, Tony; El-Ahmadie, Abir; Freiha, Pamela; El-Khoury, Lionel; Khalifé-Saleh, Nadine; Saleh, Khalil

doi:10.1177/0300891618765541

Cited by 12 publications

(14 citation statements)

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“…Overall, 541,244 CRC cases were included, involving 1547 patients diagnosed with BM [ 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ]. The overall average incidence of BM in CRC patients was 2.10% (95%CI 0.98–3.22) ranging from 0.1% up to 11.5% [ 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ]. Fifty-seven percent of patients were male and 43% were female ( Figure 2 and Table 2 ).…”

Section: Resultsmentioning

confidence: 99%

“…The smallest study population reported on five patients, while the largest study included 475 patients with BM. The analyzed studies are shown in Figure 6 and Table 7 [ 9 , 10 , 11 , 12 , 14 , 15 , 18 , 20 , 23 , 24 , 25 , 26 , 27 , 29 , 34 , 45 , 46 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 ].…”

Section: Resultsmentioning

confidence: 99%

“… Incidence of BM (%) in all patients suffering from colorectal cancer (CRC) [ 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ]. The overall average incidence of BM in CRC patients was 2.10% (95% confidence interval (CI) 0.98–3.22).…”

Section: Figurementioning

confidence: 99%

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Brain Metastases from Colorectal Cancer: A Systematic Review of the Literature and Meta-Analysis to Establish a Guideline for Daily Treatment

Müller

Köhler

Hendricks

et al. 2021

Cancers

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Colorectal cancer (CRC) is the third most common malignancy worldwide. Most patients with metastatic CRC develop liver or lung metastases, while a minority suffer from brain metastases. There is little information available regarding the presentation, treatment, and overall survival of brain metastases (BM) from CRC. This systematic review and meta-analysis includes data collected from three major databases (PubMed, Cochrane, and Embase) based on the key words “brain”, “metastas*”, “tumor”, “colorectal”, “cancer”, and “malignancy”. In total, 1318 articles were identified in the search and 86 studies matched the inclusion criteria. The incidence of BM varied between 0.1% and 11.5%. Most patients developed metastases at other sites prior to developing BM. Lung metastases and KRAS mutations were described as risk factors for additional BM. Patients with BM suffered from various symptoms, but up to 96.8% of BM patients were asymptomatic at the time of BM diagnosis. Median survival time ranged from 2 to 9.6 months, and overall survival (OS) increased up to 41.1 months in patients on a multimodal therapy regimen. Several factors including age, blood levels of carcinoembryonic antigen (CEA), multiple metastases sites, number of brain lesions, and presence of the KRAS mutation were predictors of OS. For BM diagnosis, MRI was considered to be state of the art. Treatment consisted of a combination of surgery, radiation, or systemic treatment.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Brain Metastases from Colorectal Cancer: A Systematic Review of the Literature and Meta-Analysis to Establish a Guideline for Daily Treatment

Müller

Köhler

Hendricks

et al. 2021

Cancers

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“…Advanced stage melanoma patients had a similar 50% risk [7]. In contrast, brain metastases developed in only about 2% of cases with renal cell carcinoma and colorectal cancer [8,9]. Nowadays, in order to achieve durable control of brain disease, minimize the early and late adverse effects of therapy and maintain quality of life, surgery and radiotherapy are the treatment of choice.…”

Section: Introductionmentioning

confidence: 99%

Stereotactic radiotherapy for brain oligometastases

Lupattelli

Tini

Nardone³

et al. 2022

Rep Pract Oncol Radiother.

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“…The outcome of patients with CRC has greatly improved with the advancement of multimodality treatment. However, the prognosis remains poor for patients at late stages (clinical stages III and IV) since these patients present tumor metastasis and poor response to treatment ( 2 , 3 ). Unfortunately, many patients with CRC are diagnosed at the advanced stage.…”

Section: Introductionmentioning

confidence: 99%

Clinical Significance and Prognostic Value of the Maximum Standardized Uptake Value of 18F-Flurodeoxyglucose Positron Emission Tomography–Computed Tomography in Colorectal Cancer

et al. 2021

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BackgroundThe role of 18F-flurodeoxyglucose (18F-FDG) positron emission tomography–computed tomography (PET/CT) in colorectal cancer (CRC) remains unclear. This study aimed to explore the association of the maximum standardized uptake value (SUVmax), a parameter of 18F-FDG PET/CT, with KRAS mutation, the Ki-67 index, and survival in patients with CRC.MethodsData of 66 patients with CRC who underwent 18F-FDG PET/CT was retrospectively collected in our center. The clinical significance of the SUVmax in CRC and the association of the SUVmax with KRAS mutation and the Ki-67 index were determined. A meta-analysis was conducted by a systematic search of PubMed, Web of Science, and CNKI databases, and the data from published articles were combined with that of our study. The association of the SUVmax with KRAS mutation and the Ki-67 index was determined using the odds ratio to estimate the pooled results. The hazard ratio was used to quantitatively evaluate the prognosis of the SUVmax in CRC.ResultsBy analyzing the data of 66 patients with CRC, the SUVmax was found not to be related to the tumor-node-metastasis stage, clinical stage, sex, and KRAS mutation but was related to the tumor location and nerve invasion. The SUVmax had no significant correlation with the tumor biomarkers and the Ki-67 index. Data of 17 studies indicated that the SUVmax was significantly increased in the mutated type compared with the wild type of KRAS in CRC; four studies showed that there was no remarkable difference between patients with a high and low Ki-67 index score regarding the SUVmax. Twelve studies revealed that the SUVmax had no significant association with overall survival and disease-free survival in CRC patients.ConclusionsBased on the combined data, this study demonstrated that the SUVmax of 18F-FDG PET/CT was different between colon and rectal cancers and associated with KRAS mutation but not the Ki-67 index; there was no significant association between the SUVmax and survival of patients with CRC.

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Colorectal cancer and brain metastases: An aggressive disease with a different response to treatment

Abstract: CRC with BM is an aggressive disease resistant to standard treatment and is associated with poor outcomes. Adding antiangiogenic therapy might be of value for those patients. Patients with BM developing early in the disease course might respond better to treatment.

Cited by 12 publications

References 50 publications

Brain Metastases from Colorectal Cancer: A Systematic Review of the Literature and Meta-Analysis to Establish a Guideline for Daily Treatment

Brain Metastases from Colorectal Cancer: A Systematic Review of the Literature and Meta-Analysis to Establish a Guideline for Daily Treatment

Stereotactic radiotherapy for brain oligometastases

Clinical Significance and Prognostic Value of the Maximum Standardized Uptake Value of 18F-Flurodeoxyglucose Positron Emission Tomography–Computed Tomography in Colorectal Cancer

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