Patients with brain metastases derived from gastrointestinal cancer: clinical characteristics and prognostic factors

Li, Lin; Zhao, Chuanhua; Ge, Fei‐Jiao; Wang, Y.; Chen, Y.-L.; Liu, R.-R.; Jia, Ru; Liu, L.-J.; Liu, J.-Z.; Xu, Jianming

doi:10.1007/s12094-015-1341-8

Cited by 12 publications

(19 citation statements)

References 23 publications

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“…Our study showed that the survival time for patients without local treatment for brain metastases was 1.97 months, which was similar to that of reports in literature [10, 27]. Median survival time for the entire cohort was 10.25 months, which seemed to be longer than that reported previously (usually within 7 months) [8, 10, 18, 25, 27]. This may be a result of better patient awareness of symptoms and the application of screening programs leading to earlier diagnosis, effective systemic therapies, and aggressive local therapy.…”

Section: Discussionsupporting

confidence: 91%

“…The majority of patients (76.3%) developed BM more than 30 days after the primary tumor diagnosis. 194 patients (71.9%) had extracranial metastases, and similar observations were described by other authors [25–27]. Data further showed that only 26.3% patients had multiple cerebral lesions (more than 3), which was different from lung cancer [1].…”

Section: Discussionsupporting

confidence: 76%

“…The brain metastasis-free interval highly depends on the primary site [28, 29]. In our series, median brain metastasis-free interval was 16.66 months (rang 0–173.01), which was much longer than that of lung cancer (usually within 1 year) [27, 30]. Whilst brain metastases from digestive cancers are rare, the clinical outcome of patients who develop them is poor.…”

Section: Discussionmentioning

confidence: 92%

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The Choice of Local Treatment Modalities for Patients with Brain Metastases from Digestive Cancers

Dong

Wang

et al. 2019

Journal of Oncology

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Background Brain metastases (BMs) from digestive cancers are rare; therefore, no optimal treatment modality has been defined. Methods We retrospectively reviewed the clinical data of 68257 patients with digestive cancers. Propensity score matching (PSM) was used to balance patient backgrounds between groups. Survival differences between different treatment modalities were compared. Univariate and multivariate Cox proportional hazards models were performed to identify prognostic factors on overall survival (OS). Results 270 patients with BM entered the study. In the entire group, the median survival time after diagnosis of brain metastases was 10.25 months (95% CI: 8.41–12.09 months); local treatment could significantly prolong OS (respectively, P < 0.01; even after PSM, P < 0.01); combination treatment was more effective than single treatment modality (respectively, P < 0.01; even after PSM, P < 0.01). However, each combination modality was identically effective (P > 0.05). When patients were divided into three groups based on 1, 2-3, or more than 3 metastatic lesion(s), same results were identified between local treatment and without local treatment (1 lesion, P < 0.01; 2-3 lesions, P < 0.01; more than 3 lesions, P < 0.01, respectively) and combination and single treatment (P < 0.01, P=0.02, P=0.03, respectively). However, there was no difference between different combined treatments (P > 0.05). Multivariate analysis revealed that performance status (P < 0.01), presence of extracranial metastasis (P=0.04), number of BM (P < 0.01), and local treatment for BM (P < 0.01) were independent prognostic factors. Conclusions Regardless of the number of brain lesions, local treatment achieved higher overall survival times than no local treatment, and combination therapy could offer survival benefit to patients as compared with single therapy.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 92%

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The Choice of Local Treatment Modalities for Patients with Brain Metastases from Digestive Cancers

Dong

Wang

et al. 2019

Journal of Oncology

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“…The number of patients with brain metastases has gradually risen in recent years. Moreover, brain metastasis has been observed in advanced gastric cancer, with a poor prognosis (median survival of 2‐4 months) . However, this patient survived for 2 years while receiving apatinib.…”

Section: Discussionmentioning

confidence: 97%

Combination of apatinib and continuous nutritional support for a gastric cancer patient with brain metastasis prolongs survival

Yang

Pei

Mi³

2018

J Clin Pharm Ther

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“…However, the incidence of brain metastases in GI malignancies is low, ranging from 0.33% with pancreatic cancer to 4% in colorectal cancer and imaging for brain metastases is primarily guided by clinical suspicion and symptoms. [72][73][74] Although there is a lack of prospective or retrospective data evaluating CDT and PCDT specifically in GI malignancies, several factors are important to consider when evaluating a patient for CDT or PCDT. Patients with GI malignancies are at higher risk of bleeding with anticoagulation, 14 thus, careful consideration and patient selection is warranted to prevent significant bleeding complications that can occur with overnight infusion of thrombolytics.…”

Section: Catheter-directed Thrombolysismentioning

confidence: 99%

Epidemiology, Prevention, Diagnosis, and Management of Venous Thromboembolism in Gastrointestinal Cancers

Chapin

Sudheendra

Goity

et al. 2020

Digestive Disease Interventions

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Venous thromboembolism (VTE) is a leading cause of cardiovascular death and is associated with significant morbidity. Patients with cancer, and gastrointestinal (GI) malignancies in particular, are at increased risk of VTE, increased risk of bleeding with VTE treatment, and increased risk of recurrent VTE compared with the general population. VTE has been shown to be a leading cause of death among patients with cancer. This review will discuss special considerations in the prevention, diagnosis, and management of VTE in patients with GI malignancies. Given the increased risk of VTE observed in ambulatory patients with GI malignancies, multiple trials have examined and demonstrated the efficacy of prophylactic anticoagulation in high-risk patients with cancer undergoing chemotherapy, particularly in patients with gastric and pancreatic cancers. Patients with GI malignancies have also played a central role in discussions of the risks and benefits of the use of direct oral anticoagulants in patients with cancers, with first-line anticoagulation options expanding to include low-molecular-weight heparin, rivaroxaban, edoxaban, and apixaban. However, there continue to be concerns regarding an increased risk of bleeding with edoxaban and rivaroxaban in patients with GI malignancies. In addition to anticoagulation, individualized risk and benefit analysis should be undertaken for interventions including inferior vena cava (IVC) filter placement and catheter-directed thrombolysis in the setting of increased risk of bleeding and recurrent VTE for patients with GI malignancies. Several unique scenarios that may be seen with GI malignancies, including incidental VTE, splanchnic vein thrombosis, IVC thrombosis, and iliac vein compression, require individualized decision making.

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Patients with brain metastases derived from gastrointestinal cancer: clinical characteristics and prognostic factors

Abstract: RPA class, chemotherapy after brain metastases, and treatment regimens were independent prognostic factors for the survival of patients with brain metastases derived from gastrointestinal cancers.

Cited by 12 publications

References 23 publications

The Choice of Local Treatment Modalities for Patients with Brain Metastases from Digestive Cancers

The Choice of Local Treatment Modalities for Patients with Brain Metastases from Digestive Cancers

Combination of apatinib and continuous nutritional support for a gastric cancer patient with brain metastasis prolongs survival

Epidemiology, Prevention, Diagnosis, and Management of Venous Thromboembolism in Gastrointestinal Cancers

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