Survival of patients following neurosurgical treatment of colorectal adenocarcinoma metastasis in the Northern Sydney-Central Coast area.

Cerebral metastases from gastrointestinal primaries constitute about 3-5% of surgically resected brain secondaries. There has been a paucity of regional and worldwide data concerning the survival and clinical course of patients undergoing neurosurgical treatment of cerebral metastases from colorectal origin. The clinical course and survival of 32 patients undergoing neurosurgical intervention for colorectal carcinoma metastases between 1999 and 2007 was examined. The 21 male and 11 female patients examined had a median age of 61.8 years at diagnosis of colorectal cancer; median interval between colorectal cancer diagnosis and cerebral metastatic disease was 27.6 months; and 88% of patients underwent microsurgical resection. Median survival from neurosurgical intervention was 7.5 months. Perioperative mortality was 3%. Age, gender and infratentorial location of lesions had no significant impact on survival. Patients undergoing whole brain radiotherapy (WBRT) had a significantly longer survival than those not undertaking this treatment (median survival 10.6 vs. 5.2 months, p = 0.018). A randomised, controlled trial of the utility of WBRT following surgical resection in this tumour subtype seems appropriate.