Brain metastases in colorectal cancers

Area of Science:

• Oncology
• Neurosurgery
• Gastroenterology

Background:

• Colorectal cancer is common in Singapore, but brain metastases are rare (1-4%).
• This study reviews the incidence, presentation, and prognosis of brain metastases from colorectal cancer at a single institution.

Purpose of the Study:

• To determine the incidence of brain metastases in colorectal cancer patients.
• To analyze the clinical presentation and survival outcomes of patients with brain metastases from colorectal cancer.

Main Methods:

• Retrospective review of a prospectively collected database of 4378 colorectal cancer patients operated on between 1995 and 2003.
• Identification and analysis of patients who developed brain metastases.

Main Results:

• The incidence of brain metastases was 0.62% (27 patients).
• Most patients (71%) had rectal or sigmoid tumors, and 92.6% developed metachronous brain metastases.
• Median survival after diagnosis of brain metastases was only 2.4 months, with most patients symptomatic and receiving non-surgical treatment.

Conclusions:

• Late diagnosis likely contributes to poor survival in colorectal cancer brain metastases.
• Screening with brain scans is recommended for patients with lung/liver metastases, particularly those with left-sided colorectal cancer, to enable earlier diagnosis and potentially improve outcomes.