Prognostic Factors for Patients With Advanced Colorectal Cancer and Symptomatic Brain Metastases

Tokoro, Tadao; Okuno, Kiyotaka; Hida, Jin-chi; Yoshifuji, Takehito; Daito, Koji; Sugiura, Fumiaki

doi:10.1016/j.clcc.2014.09.008

Cited by 21 publications

(40 citation statements)

References 30 publications

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“…The most common site of metastases from CRC is the liver; 15-25% of the patients develop liver metastasis synchronously, while another 30-50% of the patients develop liver metastases later [4,5] . In contrast, the incidence of brain metastasis (BM) in CRC is very low (1.2-3.2%) [6][7][8][9][10] and typically occurs at a later stage of disease progression. The incidence of CRC metastasis to previously uncommon sites including the brain is increasing [7,11] , with improved survival for patients with unresectable/metastatic CRC due to expanded treatment options being implicated in this change [7] .…”

Section: Introductionmentioning

confidence: 96%

Brain Metastasis from Colorectal Cancer: Predictors and Treatment Outcomes

Nozawa

Ishihara²,

Kawai³

et al. 2017

Oncology

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Objective: Difficulties are associated with the management of brain metastasis (BM), which portends a poor prognosis in the treatment of colorectal cancer (CRC). The aim of the present study was to identify risk factors for BM in CRC and evaluate the outcomes of various treatment modalities. Methods: We retrospectively reviewed data on a total of 2,238 patients with primary CRC who underwent surgical resection at our hospital between 1999 and 2014. Predictive factors for BM and prognostic factors after the diagnosis of BM were examined by univariate and multivariate analyses using Cox proportional hazards models. Results: Three patients (0.1%) had BM at the initial diagnosis, and 23 patients (1.2%) developed metachronous BM during the median follow-up period of 44.6 months. Lung and bone metastases were identified as independent predictive factors for BM. Median survival after the diagnosis of BM was 7.4 months. Stereotactic radiosurgery, administered to 41% of the patients with BM, was associated with a better postdiagnostic survival. Conclusion: CRC patients with metastasis to the lung or bone were at a higher risk of BM. Because the survival is still limited, it is crucial to determine the treatment strategy in consideration of the characteristics of each therapy and quality of life in CRC patients with BM.

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Section: Introductionmentioning

confidence: 96%

Brain Metastasis from Colorectal Cancer: Predictors and Treatment Outcomes

Nozawa

Ishihara²,

Kawai³

et al. 2017

Oncology

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show abstract

“…Overall rates were only 28% and 15% for stages III and IV, respectively, due to missing data. Associated liver and lung metastases were reported in 39% (from 12% to 80%) and 63% (from 27% to 92%) of patients, respectively. There was a regular relationship between the presence of lung metastases and the subsequent development of BMs .…”

Section: Resultsmentioning

confidence: 99%

“…Neurosurgery for BMs resection was offered to patients in good general conditions, with one to three symptomatic and surgically accessible lesions, limited extracranial disease and a life expectancy exceeding 3 months. Surgical treatment alone was reported between 4% and 64% of patients. The overall rate of surgery alone was 12% (Table ).…”

Section: Resultsmentioning

confidence: 99%

“…For this reason, very few data were available on chemotherapy for CRC BMs to drive any conclusion on what may be the optimal management. In only two retrospective series of CRC BMs, adjuvant chemotherapy after local control was identified as prognostic factor: median overall survival varied between 1.5 and 3.1 months without chemotherapy and from 7.4 to 12.4 months with chemotherapy . Moreover, gemcitabine had been described as a radiosensitizer on a twice‐weekly schedule for multiple BMs …”

Section: Resultsmentioning

confidence: 99%

“…The most frequent favourable clinical prognostic factors were high Karnofsky score (≥70), low recursive partitioning analysis classes (I or II), the lack of extracranial disease and low number of BMs (<2) …”

Section: Resultsmentioning

confidence: 99%

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