Brain metastases in gastrointestinal cancer patients: a ten-year retrospective study

Recent investigations across different populations have drawn attention to the delayed presentation of GI cancers as BMs. Accordingly, this study aimed to evaluate the incidence of BMs in GI cancers over the past decade at one of the primary national referral centers for such patients.

This descriptive, cross-sectional study was conducted in 2025 at Alzahra Hospital. The study population comprised all patients with GI cancers who visited the hospital between 2015 and 2025 and had complete medical records.

7469 patients diagnosed with GI cancers. 91 (1.21%) had small bowel cancer, and 18 (0.24%) had anal cancer, with no cases of BM reported in these groups. Among 1708 patients (22.86%) with gastric cancer, 12 (0.7%) developed BM. In the group with esophageal cancer (452 patients; 6.05%), 3 (0.7%) developed BM. Out of 1318 patients (17.64%) with pancreatic cancer, 5 (0.4%) had BM. Among 912 patients (12.21%) diagnosed with liver cancer, 3 (0.3%) were found to have BM. In the colorectal cancer group, which included 2970 patients (39.76%), 18 (0.6%) developed BM. Overall, brain metastases were identified in 41 patients (0.5%) out of 7469 GI cancer cases.

The number of patients with BMs secondary to primary GI cancers identified in this single-center study was lower than that reported in prior investigations. Nevertheless, patients in this cohort received a diagnosis of primary GI cancer at a younger age, and both the interval between initial cancer diagnosis and the development of BMs, as well as post-metastasis survival, were shorter.