BACKGROUND: The aim of our study is to evaluate the outcome of patients affected by brain metastases from colorectal cancer and to correlate the outcome with prognostic factors. METHODS: Patients were retrospectively evaluated. Survival distributions were estimated by using the Kaplan-Meier method. The log-rank test was used to assess the impact on survival of individual factors. RESULTS: Among 41 patients (25M and 16F; median age 58), 58.5 % had rectal cancer and 39 % synchronous metastatic disease; 95 % had extracranial metastases, most common site was lung (87.8 %). Seven patients had synchronous brain metastases. Median overall survival after diagnosis of brain metastases was 5 months [95 % confidence interval 3-12 months]. Median survival from brain metastases diagnosis was 4.2 months in patients treated with radiotherapy (29.3 %), 11.9 months in those with radio- and chemotherapy (21.9 %) and 21.4 months in those with surgery with/without radiotherapy or chemotherapy (29.3 %) (P < 0.0001). On multivariate analysis, no independent prognostic factors were found for disease-free interval from diagnosis to brain metastases and overall survival; amount of chemotherapy before brain metastases have no statistically significant relation to brain-metastases-free-interval even if patients who received more than one line of chemotherapy have a longer median brain-metastases-free-interval than those who received less than one. KRAS was found mutated in 17/28 patients without statistically significant correlation to outcome due to the small sample size. CONCLUSIONS: Prognosis of brain-metastases-patients is poor. An interesting tool is to evaluate the correlation of KRAS status and brain metastases with aim to tailor treatment and follow-up.
BACKGROUND: The aim of our study is to evaluate the outcome of patients affected by brain metastases from colorectal cancer and to correlate the outcome with prognostic factors. METHODS:Patients were retrospectively evaluated. Survival distributions were estimated by using the Kaplan-Meier method. The log-rank test was used to assess the impact on survival of individual factors. RESULTS: Among 41 patients (25M and 16F; median age 58), 58.5 % had rectal cancer and 39 % synchronous metastatic disease; 95 % had extracranial metastases, most common site was lung (87.8 %). Seven patients had synchronous brain metastases. Median overall survival after diagnosis of brain metastases was 5 months [95 % confidence interval 3-12 months]. Median survival from brain metastases diagnosis was 4.2 months in patients treated with radiotherapy (29.3 %), 11.9 months in those with radio- and chemotherapy (21.9 %) and 21.4 months in those with surgery with/without radiotherapy or chemotherapy (29.3 %) (P < 0.0001). On multivariate analysis, no independent prognostic factors were found for disease-free interval from diagnosis to brain metastases and overall survival; amount of chemotherapy before brain metastases have no statistically significant relation to brain-metastases-free-interval even if patients who received more than one line of chemotherapy have a longer median brain-metastases-free-interval than those who received less than one. KRAS was found mutated in 17/28 patients without statistically significant correlation to outcome due to the small sample size. CONCLUSIONS: Prognosis of brain-metastases-patients is poor. An interesting tool is to evaluate the correlation of KRAS status and brain metastases with aim to tailor treatment and follow-up.
Authors: Jeanne Tie; Lara Lipton; Jayesh Desai; Peter Gibbs; Robert N Jorissen; Michael Christie; Katharine J Drummond; Benjamin N J Thomson; Valery Usatoff; Peter M Evans; Adrian W Pick; Simon Knight; Peter W G Carne; Roger Berry; Adrian Polglase; Paul McMurrick; Qi Zhao; Dana Busam; Robert L Strausberg; Enric Domingo; Ian P M Tomlinson; Rachel Midgley; David Kerr; Oliver M Sieber Journal: Clin Cancer Res Date: 2011-01-14 Impact factor: 12.531
Authors: Ji Yeon Baek; Myoung Hee Kang; Yong Sang Hong; Tae Won Kim; Dae Yong Kim; Jae Hwan Oh; Seung Hoon Lee; Jin Hong Park; Jong Hoon Kim; Sun Young Kim Journal: J Neurooncol Date: 2011-02-19 Impact factor: 4.130
Authors: Tim J Kruser; Samuel T Chao; Paul Elson; Gene H Barnett; Michael A Vogelbaum; Lilyana Angelov; Robert J Weil; Robert Pelley; John H Suh Journal: Cancer Date: 2008-07-01 Impact factor: 6.860
Authors: John P Mongan; Camilo E Fadul; Bernard F Cole; Bassem I Zaki; Arief A Suriawinata; Gregory H Ripple; Tor D Tosteson; J Marc Pipas Journal: Clin Colorectal Cancer Date: 2009-03 Impact factor: 4.481
Authors: S Stremitzer; A S Berghoff; N B Volz; W Zhang; D Yang; S Stintzing; Y Ning; Y Sunakawa; S Yamauchi; A Sebio; S Matsusaka; S Okazaki; D Hanna; A Parekh; A Mendez; M D Berger; R El-Khoueiry; P Birner; M Preusser; H-J Lenz Journal: Pharmacogenomics J Date: 2015-12-22 Impact factor: 3.550
Authors: Luis Del Carpio Huerta; Anna Cristina Virgili Manrique; Justyna Szafranska; Marta Martin-Richard; David Paez Lopez-Bravo; Ana Sebio Garcia; Iñigo Espinosa Mariscal; Paula Gomila Pons; Marta Andres Granyo; Andres Barba Joaquin; Agusti Barnadas Molins; Maria Tobeña Puyal Journal: Int J Colorectal Dis Date: 2018-06-25 Impact factor: 2.571
Authors: Johannes Lemke; Jan Scheele; Thomas Kapapa; Silvia von Karstedt; Christian Rainer Wirtz; Doris Henne-Bruns; Marko Kornmann Journal: Int J Mol Sci Date: 2014-09-22 Impact factor: 5.923