Brain metastases in colorectal cancer: prognostic factors and survival analysis
Purpose Colorectal cancer (CRC) brain metastases (BM) are an uncommon and late event. We aim to investigate the impact of clinical factors, treatment modalities and RAS/BRAF status on the outcomes of CRC patients with BM. Patients We retrospectively analysed CRC patients who developed BM in our cent...
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| Published in: | International journal of colorectal disease Vol. 33; no. 11; pp. 1517 - 1523 |
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| Main Authors: | , , , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
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Berlin/Heidelberg
Springer Berlin Heidelberg
01-11-2018
Springer Springer Nature B.V |
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| Abstract | Purpose
Colorectal cancer (CRC) brain metastases (BM) are an uncommon and late event. We aim to investigate the impact of clinical factors, treatment modalities and RAS/BRAF status on the outcomes of CRC patients with BM.
Patients
We retrospectively analysed CRC patients who developed BM in our centre between January 1997 and June 2017. Clinical factors, treatment modalities, RAS/BRAF status and survival were evaluated.
Results
Twenty-eight patients were recorded; 82% had left-sided (LS) CRC and 71% had lung metastases. Median time to BM diagnosis was 36 months (m) and 93% of patients received local treatment of BM (43% whole brain radiotherapy, 50% surgery). Right-sided (RS) CRC showed shorter time to BM, not previously described (9.3 vs 46.6 m for RS and LS CRC, respectively; HR = 4.7,
p
= 0.006). Median overall survival (mOS) from BM treatment was 9.5 m, better in patients who underwent surgery than those treated with radiotherapy alone (12.1 vs 4.6 m, respectively; HR = 0.3,
p
= 0.019) and in those without progressive metastatic extracranial disease (7.2 vs 20.9 m, for progressive and non-progressive, respectively; HR = 0.3,
p
= 0.056). Patients with two or more metastatic extracranial locations showed worse prognosis (5.9 vs 16.3 m, for > 2 vs 0–1, respectively; HR = 3.7,
p
= 0.015). RAS/BRAF status did not showed prognostic value.
Conclusions
Time to BM diagnosis is shorter in RS CRC. The presence of two or more metastatic extracranial locations and progressive metastatic extracranial disease at the time of BM diagnosis could be bad prognosis factors for CRC BM patients. |
|---|---|
| AbstractList | PURPOSEColorectal cancer (CRC) brain metastases (BM) are an uncommon and late event. We aim to investigate the impact of clinical factors, treatment modalities and RAS/BRAF status on the outcomes of CRC patients with BM.PATIENTSWe retrospectively analysed CRC patients who developed BM in our centre between January 1997 and June 2017. Clinical factors, treatment modalities, RAS/BRAF status and survival were evaluated.RESULTSTwenty-eight patients were recorded; 82% had left-sided (LS) CRC and 71% had lung metastases. Median time to BM diagnosis was 36 months (m) and 93% of patients received local treatment of BM (43% whole brain radiotherapy, 50% surgery). Right-sided (RS) CRC showed shorter time to BM, not previously described (9.3 vs 46.6 m for RS and LS CRC, respectively; HR = 4.7, p = 0.006). Median overall survival (mOS) from BM treatment was 9.5 m, better in patients who underwent surgery than those treated with radiotherapy alone (12.1 vs 4.6 m, respectively; HR = 0.3, p = 0.019) and in those without progressive metastatic extracranial disease (7.2 vs 20.9 m, for progressive and non-progressive, respectively; HR = 0.3, p = 0.056). Patients with two or more metastatic extracranial locations showed worse prognosis (5.9 vs 16.3 m, for > 2 vs 0-1, respectively; HR = 3.7, p = 0.015). RAS/BRAF status did not showed prognostic value.CONCLUSIONSTime to BM diagnosis is shorter in RS CRC. The presence of two or more metastatic extracranial locations and progressive metastatic extracranial disease at the time of BM diagnosis could be bad prognosis factors for CRC BM patients. Purpose Colorectal cancer (CRC) brain metastases (BM) are an uncommon and late event. We aim to investigate the impact of clinical factors, treatment modalities and RAS/BRAF status on the outcomes of CRC patients with BM. Patients We retrospectively analysed CRC patients who developed BM in our centre between January 1997 and June 2017. Clinical factors, treatment modalities, RAS/BRAF status and survival were evaluated. Results Twenty-eight patients were recorded; 82% had left-sided (LS) CRC and 71% had lung metastases. Median time to BM diagnosis was 36 months (m) and 93% of patients received local treatment of BM (43% whole brain radiotherapy, 50% surgery). Right-sided (RS) CRC showed shorter time to BM, not previously described (9.3 vs 46.6 m for RS and LS CRC, respectively; HR = 4.7, p = 0.006). Median overall survival (mOS) from BM treatment was 9.5 m, better in patients who underwent surgery than those treated with radiotherapy alone (12.1 vs 4.6 m, respectively; HR = 0.3, p = 0.019) and in those without progressive metastatic extracranial disease (7.2 vs 20.9 m, for progressive and non-progressive, respectively; HR = 0.3, p = 0.056). Patients with two or more metastatic extracranial locations showed worse prognosis (5.9 vs 16.3 m, for > 2 vs 0–1, respectively; HR = 3.7, p = 0.015). RAS/BRAF status did not showed prognostic value. Conclusions Time to BM diagnosis is shorter in RS CRC. The presence of two or more metastatic extracranial locations and progressive metastatic extracranial disease at the time of BM diagnosis could be bad prognosis factors for CRC BM patients. Colorectal cancer (CRC) brain metastases (BM) are an uncommon and late event. We aim to investigate the impact of clinical factors, treatment modalities and RAS/BRAF status on the outcomes of CRC patients with BM. We retrospectively analysed CRC patients who developed BM in our centre between January 1997 and June 2017. Clinical factors, treatment modalities, RAS/BRAF status and survival were evaluated. Twenty-eight patients were recorded; 82% had left-sided (LS) CRC and 71% had lung metastases. Median time to BM diagnosis was 36 months (m) and 93% of patients received local treatment of BM (43% whole brain radiotherapy, 50% surgery). Right-sided (RS) CRC showed shorter time to BM, not previously described (9.3 vs 46.6 m for RS and LS CRC, respectively; HR = 4.7, p = 0.006). Median overall survival (mOS) from BM treatment was 9.5 m, better in patients who underwent surgery than those treated with radiotherapy alone (12.1 vs 4.6 m, respectively; HR = 0.3, p = 0.019) and in those without progressive metastatic extracranial disease (7.2 vs 20.9 m, for progressive and non-progressive, respectively; HR = 0.3, p = 0.056). Patients with two or more metastatic extracranial locations showed worse prognosis (5.9 vs 16.3 m, for > 2 vs 0-1, respectively; HR = 3.7, p = 0.015). RAS/BRAF status did not showed prognostic value. Time to BM diagnosis is shorter in RS CRC. The presence of two or more metastatic extracranial locations and progressive metastatic extracranial disease at the time of BM diagnosis could be bad prognosis factors for CRC BM patients. Colorectal cancer (CRC) brain metastases (BM) are an uncommon and late event. We aim to investigate the impact of clinical factors, treatment modalities and RAS/BRAF status on the outcomes of CRC patients with BM. We retrospectively analysed CRC patients who developed BM in our centre between January 1997 and June 2017. Clinical factors, treatment modalities, RAS/BRAF status and survival were evaluated. Twenty-eight patients were recorded; 82% had left-sided (LS) CRC and 71% had lung metastases. Median time to BM diagnosis was 36 months (m) and 93% of patients received local treatment of BM (43% whole brain radiotherapy, 50% surgery). Right-sided (RS) CRC showed shorter time to BM, not previously described (9.3 vs 46.6 m for RS and LS CRC, respectively; HR = 4.7, p = 0.006). Median overall survival (mOS) from BM treatment was 9.5 m, better in patients who underwent surgery than those treated with radiotherapy alone (12.1 vs 4.6 m, respectively; HR = 0.3, p = 0.019) and in those without progressive metastatic extracranial disease (7.2 vs 20.9 m, for progressive and non-progressive, respectively; HR = 0.3, p = 0.056). Patients with two or more metastatic extracranial locations showed worse prognosis (5.9 vs 16.3 m, for > 2 vs 0-1, respectively; HR = 3.7, p = 0.015). RAS/BRAF status did not showed prognostic value. Time to BM diagnosis is shorter in RS CRC. The presence of two or more metastatic extracranial locations and progressive metastatic extracranial disease at the time of BM diagnosis could be bad prognosis factors for CRC BM patients. PurposeColorectal cancer (CRC) brain metastases (BM) are an uncommon and late event. We aim to investigate the impact of clinical factors, treatment modalities and RAS/BRAF status on the outcomes of CRC patients with BM.PatientsWe retrospectively analysed CRC patients who developed BM in our centre between January 1997 and June 2017. Clinical factors, treatment modalities, RAS/BRAF status and survival were evaluated.ResultsTwenty-eight patients were recorded; 82% had left-sided (LS) CRC and 71% had lung metastases. Median time to BM diagnosis was 36 months (m) and 93% of patients received local treatment of BM (43% whole brain radiotherapy, 50% surgery). Right-sided (RS) CRC showed shorter time to BM, not previously described (9.3 vs 46.6 m for RS and LS CRC, respectively; HR = 4.7, p = 0.006). Median overall survival (mOS) from BM treatment was 9.5 m, better in patients who underwent surgery than those treated with radiotherapy alone (12.1 vs 4.6 m, respectively; HR = 0.3, p = 0.019) and in those without progressive metastatic extracranial disease (7.2 vs 20.9 m, for progressive and non-progressive, respectively; HR = 0.3, p = 0.056). Patients with two or more metastatic extracranial locations showed worse prognosis (5.9 vs 16.3 m, for > 2 vs 0–1, respectively; HR = 3.7, p = 0.015). RAS/BRAF status did not showed prognostic value.ConclusionsTime to BM diagnosis is shorter in RS CRC. The presence of two or more metastatic extracranial locations and progressive metastatic extracranial disease at the time of BM diagnosis could be bad prognosis factors for CRC BM patients. Purpose Colorectal cancer (CRC) brain metastases (BM) are an uncommon and late event. We aim to investigate the impact of clinical factors, treatment modalities and RAS/BRAF status on the outcomes of CRC patients with BM. Patients We retrospectively analysed CRC patients who developed BM in our centre between January 1997 and June 2017. Clinical factors, treatment modalities, RAS/BRAF status and survival were evaluated. Results Twenty-eight patients were recorded; 82% had left-sided (LS) CRC and 71% had lung metastases. Median time to BM diagnosis was 36 months (m) and 93% of patients received local treatment of BM (43% whole brain radiotherapy, 50% surgery). Right-sided (RS) CRC showed shorter time to BM, not previously described (9.3 vs 46.6 m for RS and LS CRC, respectively; HR = 4.7, p = 0.006). Median overall survival (mOS) from BM treatment was 9.5 m, better in patients who underwent surgery than those treated with radiotherapy alone (12.1 vs 4.6 m, respectively; HR = 0.3, p = 0.019) and in those without progressive metastatic extracranial disease (7.2 vs 20.9 m, for progressive and non-progressive, respectively; HR = 0.3, p = 0.056). Patients with two or more metastatic extracranial locations showed worse prognosis (5.9 vs 16.3 m, for > 2 vs 0-1, respectively; HR = 3.7, p = 0.015). RAS/BRAF status did not showed prognostic value. Conclusions Time to BM diagnosis is shorter in RS CRC. The presence of two or more metastatic extracranial locations and progressive metastatic extracranial disease at the time of BM diagnosis could be bad prognosis factors for CRC BM patients. |
| Audience | Academic |
| Author | Andres Granyo, Marta Virgili Manrique, Anna Cristina Barnadas Molins, Agusti Martin-Richard, Marta Del Carpio Huerta, Luis Paez Lopez-Bravo, David Espinosa Mariscal, Iñigo Gomila Pons, Paula Sebio Garcia, Ana Szafranska, Justyna Barba Joaquin, Andres Tobeña Puyal, Maria |
| Author_xml | – sequence: 1 givenname: Luis orcidid: 0000-0001-9017-2460 surname: Del Carpio Huerta fullname: Del Carpio Huerta, Luis email: Lcarpio@santpau.cat organization: Medical Oncology Department, Santa Creu i Sant Pau Hospital – sequence: 2 givenname: Anna Cristina surname: Virgili Manrique fullname: Virgili Manrique, Anna Cristina organization: Medical Oncology Department, Santa Creu i Sant Pau Hospital – sequence: 3 givenname: Justyna surname: Szafranska fullname: Szafranska, Justyna organization: Pathology Department, Santa Creu i Sant Pau Hospital – sequence: 4 givenname: Marta surname: Martin-Richard fullname: Martin-Richard, Marta organization: Medical Oncology Department, Santa Creu i Sant Pau Hospital – sequence: 5 givenname: David surname: Paez Lopez-Bravo fullname: Paez Lopez-Bravo, David organization: Medical Oncology Department, Santa Creu i Sant Pau Hospital – sequence: 6 givenname: Ana surname: Sebio Garcia fullname: Sebio Garcia, Ana organization: Medical Oncology Department, Santa Creu i Sant Pau Hospital – sequence: 7 givenname: Iñigo surname: Espinosa Mariscal fullname: Espinosa Mariscal, Iñigo organization: Pathology Department, Santa Creu i Sant Pau Hospital – sequence: 8 givenname: Paula surname: Gomila Pons fullname: Gomila Pons, Paula organization: Medical Oncology Department, Santa Creu i Sant Pau Hospital – sequence: 9 givenname: Marta surname: Andres Granyo fullname: Andres Granyo, Marta organization: Medical Oncology Department, Santa Creu i Sant Pau Hospital – sequence: 10 givenname: Andres surname: Barba Joaquin fullname: Barba Joaquin, Andres organization: Medical Oncology Department, Santa Creu i Sant Pau Hospital – sequence: 11 givenname: Agusti surname: Barnadas Molins fullname: Barnadas Molins, Agusti organization: Medical Oncology Department, Santa Creu i Sant Pau Hospital – sequence: 12 givenname: Maria surname: Tobeña Puyal fullname: Tobeña Puyal, Maria email: Mtobena@santpau.cat organization: Medical Oncology Department, Santa Creu i Sant Pau Hospital |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/29943356$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_3862_jcoloproctology_75_44 crossref_primary_10_5582_bst_2019_01044 crossref_primary_10_1007_s00384_019_03306_1 crossref_primary_10_1016_j_semcancer_2019_10_010 crossref_primary_10_2147_CMAR_S320179 crossref_primary_10_3390_diagnostics12071586 crossref_primary_10_1186_s40792_022_01407_8 crossref_primary_10_1259_bjr_20200951 crossref_primary_10_3389_fmed_2022_768896 crossref_primary_10_3390_cancers13040900 |
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| ContentType | Journal Article |
| Copyright | Springer-Verlag GmbH Germany, part of Springer Nature 2018 COPYRIGHT 2018 Springer International Journal of Colorectal Disease is a copyright of Springer, (2018). All Rights Reserved. |
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| Keywords | Brain metastases Colorectal cancer location Whole brain radiotherapy Surgery Colorectal cancer |
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| PublicationTitle | International journal of colorectal disease |
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Colorectal cancer (CRC) brain metastases (BM) are an uncommon and late event. We aim to investigate the impact of clinical factors, treatment... Colorectal cancer (CRC) brain metastases (BM) are an uncommon and late event. We aim to investigate the impact of clinical factors, treatment modalities and... Purpose Colorectal cancer (CRC) brain metastases (BM) are an uncommon and late event. We aim to investigate the impact of clinical factors, treatment... PurposeColorectal cancer (CRC) brain metastases (BM) are an uncommon and late event. We aim to investigate the impact of clinical factors, treatment modalities... PURPOSEColorectal cancer (CRC) brain metastases (BM) are an uncommon and late event. We aim to investigate the impact of clinical factors, treatment modalities... |
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| Title | Brain metastases in colorectal cancer: prognostic factors and survival analysis |
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