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Brain metastases from colorectal cancer
T D Alden1, J W Gianino, T J Saclarides
1Department of General Surgery, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois, USA.
Diseases of the Colon and Rectum
|May 1, 1996
Summary
Brain metastases from colorectal cancer have a dismal prognosis, with survival rarely exceeding 2.8 months. Craniotomy offers minimal benefit, making it rarely indicated for these patients.
Area of Science:
- Oncology
- Neurology
- Surgical Oncology
Background:
- Colorectal cancer frequently metastasizes to the brain.
- Understanding the prognosis and treatment of brain metastases is crucial for patient care.
Purpose of the Study:
- To determine the time to diagnosis, presentation, survival, and treatment impact for brain metastases from colorectal cancer.
- To analyze prognostic factors including metastatic patterns and treatment modalities.
Main Methods:
- Retrospective review of 19 patients with metastatic colorectal cancer to the brain between 1980 and 1994.
- Data collection on patient characteristics, primary tumor details, and metastatic disease extent and location.
- Statistical analysis using STATISTICA for Windows.
Main Results:
- Mean age was 66 years; 58% had disseminated disease at diagnosis.
- Lesions were solitary in 63%, unilateral in 89%, and cerebral in 53%.
- Median survival was 2.8 months (0% 1-year survival); craniotomy (4.1 months) showed longer survival than radiation (2.8 months), but other factors had no impact.
Conclusions:
- Brain metastases from colorectal cancer are rarely the sole site of metastasis.
- Survival is poor regardless of treatment, thus craniotomy is seldom indicated.
- Exceptions for craniotomy include patients with minimal impairment, long disease-free interval, solitary metastasis, and no extracranial disease.