Resection of brain metastases from colorectal carcinoma in 73 patients

Wroński, Marek; Arbit, Ehud

doi:10.1002/(sici)1097-0142(19990415)85:8<1677::aid-cncr6>3.0.co;2-c

Cited by 150 publications

(108 citation statements)

References 49 publications

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“…None of our patients received stereotactic radiotherapy and just half underwent surgical resection. Surgery combined with WBRT is proven to be the most effective treatment for isolated CRC brain metastasis in patients who are ideal surgical candidates [10][11][12]26 . Farnell 28 , for instance, published interesting work looking at the survival rates of 150 mCRC patients treated with different treatment modalities and determining the main characteristics in long-term survivors.…”

Section: Discussionmentioning

confidence: 99%

“…Many affected patients will suffer considerable loss of autonomy due to neurocognitive and functional deficits, as well as morbidity associated with steroids and anticonvulsants. Only a small number of patients who can have surgical resection with or without postoperative wholebrain radiotherapy (WBRT) are considered, with more encouraging outcomes [median overall survival (mOS) of approximately 8 months] [10][11][12] . Over the last few years, stereotactic radiosurgery has become another treatment modality with outcomes appearing to be comparable to those of surgical resection for patients with oligometastases that are small and present minimal mass effects.…”

Section: Introductionmentioning

confidence: 99%

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Brain metastasis in advanced colorectal cancer: Results from the South Australian metastatic colorectal cancer (SAmCRC) registry

et al. 2016

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Objective: Brain metastasis is considered rare in metastatic colorectal cancer (mCRC); thus, surveillance imaging does not routinely include the brain. The reported incidence of brain metastases ranges from 0.6% to 3.2%. Methods:The South Australian mCRC Registry (SAmCRC) was analyzed to assess the number of patients presenting with brain metastasis during their lifetime. Due to small numbers, a descriptive analysis is presented. Results:Only 59 patients of 4,100 on the registry at the time of analysis had developed brain metastasis (1.4%). The clinical characteristics of those with brain metastasis were as follows: the median age was 65.3 years and 51% were female. Where the VKi-ras2 Kirsten rat sarcoma viral oncogene homolog (KRAS) mutation status of the tumor was known, the majority harbored a KRAS mutation (55%); 31 (53%) underwent craniotomy and 55 (93%) underwent whole-brain radiotherapy. The median survival time from diagnosis of brain metastasis was 4.2 months (95% confidence interval 2.9-5.5). Patients who underwent craniotomy and radiotherapy had superior survival compared to those who underwent whole-brain radiotherapy (8.5 months vs. 2.2 months, respectively). Data from the SAmCRC (a population-based registry) confirm that brain metastases are rare and the median time to development is approximately 2 years. Conclusions: Brain metastasis is a rare outcome in advanced CRC. Patients within the registry tended to be female, young in age, and harbored with higher rates of KRAS mutations. Whether routine surveillance brain scanning should be considered remains controversial given the relative rarity of developing brain metastases in mCRC and ultimately, most patients with central nervous system involvement die from their extracranial disease.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Brain metastasis in advanced colorectal cancer: Results from the South Australian metastatic colorectal cancer (SAmCRC) registry

et al. 2016

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“…In the current series, infratentorial metastasis was not associated with a shorter median survival. Wronski et al [15][16][17][18][19] found that infratentorial location was an independent, negative predictive factor for survival in patients with brain metastases from melanoma, colon carcinoma, nonsmall cell lung carcinoma, and renal carcinoma but not in patients with breast carcinoma. The median survival in this series of untreated patients and treated patients was similar to the survival reported in other large series in which the median survival was between 3 months and 4 months.…”

Section: Discussionmentioning

confidence: 99%

Brain metastasis from prostate carcinoma

Tremont‐Lukats

Bobustuc

Lagos

et al. 2003

Cancer

202

113

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Here it goes again: A tandem catalytic process effects sequential Pd0‐catalyzed allylic alkylations through leaving group ionization and PdII‐catalyzed allylic alkylations by CH activation. By employing an oxidative trigger to convert the catalytic species from Pd0 into PdII, both transformations can be conducted in a single reaction vessel using the same precatalyst. This allows for the selective introduction of otherwise indistinguishable allyl groups.

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“…15,16 Unfortunately, patients with BM from CRC do not survive as long as patients with BM from other histologies. 6,17,18 This probably is secondary to the burden of systemic disease in patients with metastatic CRC to the brain; concomitant extracerebral metastases have been demonstrated in 77% to 97% of patients. 10,11,17,19 However, as improvements in the management of CRC have altered the natural history of this disease, the incidence of metastases at previously uncommon sites, such as the brain and bone, is increasing.…”

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confidence: 99%

Multidisciplinary management of colorectal brain metastases

Kruser

Chao

Elson

et al. 2008

Cancer

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BACKGROUND.The incidence of brain metastases (BM) from colorectal cancer (CRC) is increasing, and the management of this previously rare complication at a single institution is reported.METHODS.The records of all patients with BM from 1994 to 2005 were reviewed, and 49 patients (33 men, 16 women) with 102 BM from CRC were identified. Associations between patient and tumor characteristics, treatment modality, and survival were assessed.RESULTS.The median age at diagnosis of BM from CRC was 66 years. Forty patients (82%) had other systemic disease. The median survival after a diagnosis of BM from CRC was 5.1 months. Fifteen patients (31%) underwent surgery at some point, 14 patients (29%) underwent stereotactic radiosurgery (SRS), and 42 patients (86%) received whole‐brain radiotherapy during their management. Seven patients (14%) underwent upfront SRS. On multivariate analysis, a longer interval from diagnosis of CRC to diagnosis of BM was associated significantly with shorter survival (p = .01). Sex, Karnofsky performance status, tumor location, recursive partitioning analysis class, and initial treatment modality did not have an impact on survival.CONCLUSIONS.Because BM from CRC are a late‐stage phenomenon, the majority of patients in the current study had other systemic involvement, and survival after CNS involvement was poor. The results indicated that a high prevalence of systemic disease limits the proportion of patients who are strong candidates for upfront SRS, thereby limiting the impact that this modality has on outcomes in this population as a whole. Late development (>1 year after the primary tumor diagnosis) of CNS involvement may predict for poorer survival after therapy for patients with BM from CRC. Cancer 2008. © 2008 American Cancer Society.

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Resection of brain metastases from colorectal carcinoma in 73 patients

Cited by 150 publications

References 49 publications

Brain metastasis in advanced colorectal cancer: Results from the South Australian metastatic colorectal cancer (SAmCRC) registry

Brain metastasis in advanced colorectal cancer: Results from the South Australian metastatic colorectal cancer (SAmCRC) registry

Brain metastasis from prostate carcinoma

Multidisciplinary management of colorectal brain metastases

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