International Journal of Colorectal Disease

, Volume 20, Issue 1, pp 57–61

Brain metastasis from colorectal cancer

  • Hisashi Onodera
  • Satoshi Nagayama
  • Tsuyoshi Tachibana
  • Akihisa Fujimoto
  • Masayuki Imamura
Original Article



The mechanism of brain metastasis is not well understood, but the affinity between cancer cells and neural tissues may be involved in the process. The aim of our study is to elucidate the involvement of neural cell adhesion molecule (NCAM) and therapeutic parameters in patients with brain metastasis from colorectal cancer.


We retrospectively identified 17 patients with brain metastasis from colorectal cancer. Data were collected with regard to patients’ characteristics, location, and stage of primary tumor, and extent and location of metastatic disease. NCAM histochemical staining was undertaken using a paraffin block, and compared with 56 Dukes C patients and 13 Dukes D patients.


Neural cell adhesion molecule expression was significantly higher in the primary tumors of the brain metastasis patients than in the lesions of the Dukes C and Dukes D control groups (p=0.0004). Patients whose tumor was managed by radiosurgery survived longer than patients who had had whole brain radiation or those who had been left untreated.


The fact that NCAM expression was high in the primary tumors of brain metastasis patients suggests that the affinity of cancer cells to a particular organ is important for circulation-mediated metastasis. Controlling local tumors using radiosurgery is certainly going to play an important role in extending survival and improving the patient’s quality of life (QOL).


NCAM expression Brain metastasis Colorectal cancer Radiosurgery QOL 


  1. 1.
    Schouten LJ, Rutten J, Huveneers HA, Twijnstra A (2002) Incidence of brain metastases in a cohort of patients with carcinoma of the breast, colon, kidney, and lung and melanoma. Cancer 94:2698–2705CrossRefPubMedGoogle Scholar
  2. 2.
    Takahashi JA, Llena JF, Hirano A (1996) Pathology of cerebral metastases. Neurosurg Clin N Am 7:345–367PubMedGoogle Scholar
  3. 3.
    Yamazoe Y, Maetani S, Nishikawa T, Onodera H, Tobe T, Imamura M (1994) The prognostic role of the DNA ploidy pattern in colorectal cancer analysis using paraffin-embedded tissue by an improved method. Jpn J Surg 24:30–36Google Scholar
  4. 4.
    Edelman GM (1983) Cell adhesion molecule. Science 219:450–457PubMedGoogle Scholar
  5. 5.
    Farinola MA, Weir EG, Ali SZ (2003) CD56 expression of neuroendocrine neoplasms on immunophenotyping by flow cytometry. Cancer 99:240–246CrossRefPubMedGoogle Scholar
  6. 6.
    Daniel L, Bouvier C, Chetaille B, Gouvernet J, Luccioni A, Rossi D, Lechevallier E, Muracciole X, Coulange C, Figarella-Branger D (2003) Neural cell adhesion molecule expression in renal cell carcinomas: relation to metastatic behavior. Hum Pathol 34:528–532CrossRefPubMedGoogle Scholar
  7. 7.
    Bartsch U (2003) Neural CAMS and their role in the development and organization of myelin sheaths. Front Biosci 8:477–490Google Scholar
  8. 8.
    Sytnyk V, Leshchyns’ka I, Delling M, Dityateva G, Dityatev A, Schachner M (2002) Neural cell adhesion molecule promotes accumulation of TGN organelles at sites of neuron-to-neuron contacts. J Cell Biol 159:649–661CrossRefPubMedGoogle Scholar
  9. 9.
    Linneman D, Raz A, Bock E (1989) Differential expression of cell adhesion molecules in variants of K 735 melanoma cells differing in metastatic capacity. Int J Cancer 43:709–712PubMedGoogle Scholar
  10. 10.
    Cascino TL, Leavengood JM, Kemeny N, Posner JB (1983) Brain metastases from colorectal cancer. J Neurooncol 1:203–209PubMedGoogle Scholar
  11. 11.
    Hammoud MA, McCutcheon IE, Elsouki R, Schoppa D, Patt YZ (1996) Colorectal carcinoma and brain metastasis: distribution, treatment, and survival. Ann Surg Oncol 3:453–463PubMedGoogle Scholar
  12. 12.
    Zorrilla M, Alonso V, Herrero A, Corral M, Puertolas T, Trufero JM, Artal A, Anton A (2001) Brain metastases from colorectal carcinoma. Tumori 87:332–334PubMedGoogle Scholar
  13. 13.
    Ko FC, Liu JM, Chen WS, Chiang JK, Lin TC, Lin JK (1999) Risk and patterns of brain metastases in colorectal cancer: 27-year experience. Dis Colon Rectum 42:1467–1471PubMedGoogle Scholar
  14. 14.
    Farnell GF, Bucker JC, Cascino TL, O’Connell MJ, Schomberg PJ, Suman V (1996) Brain metastases from colorectal carcinoma—the long term survivors. Cancer 78:711–716CrossRefPubMedGoogle Scholar
  15. 15.
    Wronski M, Arbit E (1999) Resection of brain metastases from colorectal carcinoma in 73 patients. Cancer 85:1677–1685CrossRefPubMedGoogle Scholar
  16. 16.
    Alden TD, Gianino JW, Saclarides TJ (1996) Brain metastases from colorectal cancer. Dis Colon Rectum 39:541–545PubMedGoogle Scholar
  17. 17.
    Petrovich Z, Yu C, Giannotta SL, O’Day S, Apuzzo ML (2002) Survival and pattern of failure in brain metastasis treated with stereotactic gamma knife radiosurgery. J Neurosurg 97 [Suppl 5]:499–506PubMedGoogle Scholar
  18. 18.
    Thornton AF, Harsh GR IV (1996) Recommendation for treatment of brain metastases. Neurosurg Clin N Am 7:559–564PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Hisashi Onodera
    • 1
  • Satoshi Nagayama
    • 1
  • Tsuyoshi Tachibana
    • 1
  • Akihisa Fujimoto
    • 1
  • Masayuki Imamura
    • 1
  1. 1.Department of Surgery and Surgical Basic Science, Graduate School of MedicineKyoto UniversityKyotoJapan

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