Prognostic Factors of Brain Metastases from Colorectal Cancer

Overview

Journal BMC Cancer

Publisher Biomed Central

Specialty Oncology

Date 2019 Aug 2

PMID 31366387

Citations 13

Authors

Jun Imaizumi

Dai Shida

Yoshitaka Narita

Yasuji Miyakita

Taro Tanabe

Atsuo Takashima

Narikazu Boku

Hiroshi Igaki

Jun Itami

Yukihide Kanemitsu

Affiliations

Soon will be listed here.

Abstract

Background: For brain metastases from non-specific primary tumors, the most frequently used and validated clinical prognostic assessment tool is Karnofsky performance status (KPS). Given the lack of prognostic factors of brain metastases from colorectal cancer (CRC) other than KPS, this study aimed to identify new prognostic factors.

Methods: This retrospective cohort study was conducted at a tertiary care cancer center. Subjects were patients with brain metastases from CRC among all patients who received initial treatment for CRC at the National Cancer Center Hospital from 1997 to 2015 (n = 7147). Prognostic clinicopathological variables for overall survival (OS) were investigated.

Results: There were 68 consecutive patients with brain metastases from CRC, corresponding to 1.0% of all patients with CRC during the study period. Median survival time was 6.8 months. One-year and 3-year OS rates were 28.0 and 10.1%, respectively. Among the six covariates tested (age, KPS, presence of extracranial metastases, control of primary lesion, number of brain metastases, and history of chemotherapy), multivariate analysis revealed KPS (score ≥ 70), number of brain metastases (1-3), and no history of chemotherapy to be independent factors associated with better prognosis.

Conclusions: In addition to KPS, the number of brain lesions and history of chemotherapy were independent prognostic factors for OS in patients with brain metastases from CRC. An awareness of these factors may help gastrointestinal surgeons make appropriate choices in the treatment of these patients.

Citing Articles

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References

Gaspar L, Scott C, Murray K, Curran W . Validation of the RTOG recursive partitioning analysis (RPA) classification for brain metastases. Int J Radiat Oncol Biol Phys. 2000; 47(4):1001-6. DOI: 10.1016/s0360-3016(00)00547-2. View

Schouten L, Rutten J, Huveneers H, Twijnstra A . Incidence of brain metastases in a cohort of patients with carcinoma of the breast, colon, kidney, and lung and melanoma. Cancer. 2002; 94(10):2698-705. DOI: 10.1002/cncr.10541. View

Barnholtz-Sloan J, Sloan A, Davis F, Vigneau F, Lai P, Sawaya R . Incidence proportions of brain metastases in patients diagnosed (1973 to 2001) in the Metropolitan Detroit Cancer Surveillance System. J Clin Oncol. 2004; 22(14):2865-72. DOI: 10.1200/JCO.2004.12.149. View

Bartelt S, Momm F, Weissenberger C, Lutterbach J . Patients with brain metastases from gastrointestinal tract cancer treated with whole brain radiation therapy: prognostic factors and survival. World J Gastroenterol. 2004; 10(22):3345-8. PMC: 4572310. DOI: 10.3748/wjg.v10.i22.3345. View

Aprile G, Zanon E, Tuniz F, Iaiza E, De Pauli F, Pella N . Neurosurgical management and postoperative whole-brain radiotherapy for colorectal cancer patients with symptomatic brain metastases. J Cancer Res Clin Oncol. 2008; 135(3):451-7. DOI: 10.1007/s00432-008-0468-1. View

Mongan J, Fadul C, Cole B, Zaki B, Suriawinata A, Ripple G . Brain metastases from colorectal cancer: risk factors, incidence, and the possible role of chemokines. Clin Colorectal Cancer. 2009; 8(2):100-5. DOI: 10.3816/CCC.2009.n.016. View

Sperduto P, Chao S, Sneed P, Luo X, Suh J, Roberge D . Diagnosis-specific prognostic factors, indexes, and treatment outcomes for patients with newly diagnosed brain metastases: a multi-institutional analysis of 4,259 patients. Int J Radiat Oncol Biol Phys. 2009; 77(3):655-61. DOI: 10.1016/j.ijrobp.2009.08.025. View

Jung M, Ahn J, Chang J, Suh C, Hong S, Roh J . Brain metastases from colorectal carcinoma: prognostic factors and outcome. J Neurooncol. 2010; 101(1):49-55. DOI: 10.1007/s11060-010-0214-9. View

Caballero J, Sneed P, Lamborn K, Ma L, Denduluri S, Nakamura J . Prognostic factors for survival in patients treated with stereotactic radiosurgery for recurrent brain metastases after prior whole brain radiotherapy. Int J Radiat Oncol Biol Phys. 2011; 83(1):303-9. DOI: 10.1016/j.ijrobp.2011.06.1987. View

10.

Sperduto P, Kased N, Roberge D, Xu Z, Shanley R, Luo X . Summary report on the graded prognostic assessment: an accurate and facile diagnosis-specific tool to estimate survival for patients with brain metastases. J Clin Oncol. 2011; 30(4):419-25. PMC: 3269967. DOI: 10.1200/JCO.2011.38.0527. View

11.

Noura S, Ohue M, Shingai T, Fujiwara A, Imada S, Sueda T . Brain metastasis from colorectal cancer: prognostic factors and survival. J Surg Oncol. 2012; 106(2):144-8. DOI: 10.1002/jso.23055. View

12.

Nieder C, Andratschke N, Geinitz H, Grosu A . Diagnosis-specific graded prognostic assessment score is valid in patients with brain metastases treated in routine clinical practice in two European countries. Med Sci Monit. 2012; 18(7):CR450-5. PMC: 3560784. DOI: 10.12659/msm.883213. View

13.

Likhacheva A, Pinnix C, Parikh N, Allen P, Guha-Thakurta N, McAleer M . Validation of Recursive Partitioning Analysis and Diagnosis-Specific Graded Prognostic Assessment in patients treated initially with radiosurgery alone. J Neurosurg. 2012; 117 Suppl:38-44. PMC: 3910154. DOI: 10.3171/2012.3.GKS1289. View

14.

Suzuki Y, Yamaguchi T, Matsumoto H, Nakano D, Honda G, Shinoura N . Prognostic factors and treatment effects in patients with curatively resected brain metastasis from colorectal cancer. Dis Colon Rectum. 2013; 57(1):56-63. DOI: 10.1097/01.dcr.0000436998.30504.98. View

15.

Nieder C, Marienhagen K, Dalhaug A, Aandahl G, Haukland E, Pawinski A . Prognostic models predicting survival of patients with brain metastases: integration of lactate dehydrogenase, albumin and extracranial organ involvement. Clin Oncol (R Coll Radiol). 2014; 26(8):447-52. DOI: 10.1016/j.clon.2014.03.006. View

16.

Yamamoto M, Serizawa T, Shuto T, Akabane A, Higuchi Y, Kawagishi J . Stereotactic radiosurgery for patients with brain metastases - authors' reply. Lancet Oncol. 2014; 15(7):e248. DOI: 10.1016/S1470-2045(14)70221-9. View

17.

Michl M, Thurmaier J, Schubert-Fritschle G, Wiedemann M, Laubender R, Nussler N . Brain Metastasis in Colorectal Cancer Patients: Survival and Analysis of Prognostic Factors. Clin Colorectal Cancer. 2015; 14(4):281-90. DOI: 10.1016/j.clcc.2015.05.009. View

18.

Diener-West M, Dobbins T, Phillips T, Nelson D . Identification of an optimal subgroup for treatment evaluation of patients with brain metastases using RTOG study 7916. Int J Radiat Oncol Biol Phys. 1989; 16(3):669-73. DOI: 10.1016/0360-3016(89)90483-5. View

19.

Nozawa H, Ishihara S, Kawai K, Sasaki K, Murono K, Otani K . Brain Metastasis from Colorectal Cancer: Predictors and Treatment Outcomes. Oncology. 2017; 93(5):309-314. DOI: 10.1159/000478661. View

20.

Brown P, Ahluwalia M, Khan O, Asher A, Wefel J, Gondi V . Whole-Brain Radiotherapy for Brain Metastases: Evolution or Revolution?. J Clin Oncol. 2017; 36(5):483-491. PMC: 6075843. DOI: 10.1200/JCO.2017.75.9589. View