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Novel graded prognostic assessment for colorectal cancer patients with brain metastases

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Abstract

Purpose

It is important to take into account potential prognostic factors to select patients with brain metastasis from colorectal cancer (CRC) who will benefit from active neurosurgical treatment. Therefore, we experimentally investigated our single institutional data to develop a novel CRC-specific graded prognostic assessment (GPA) and to help clinicians determine the optimal management.

Methods and materials

We retrospectively reviewed the records of 107 patients with brain metastases from CRC who received any kind of treatment in our hospital and had sufficient clinical information.

Results

The median overall survival was 5.2 months, and the 1- and 2-year overall survival rates were 23.7 and 6.6%, respectively. Multivariate analysis revealed that the number of brain metastases ≥ 6, presence of neurologic symptoms, and elevated serum carcinoembryonic antigen (≥ 30 ng/ml) were the independent prognostic factors for poor overall survival, while performance status was not. Based on this, we developed the CRC-specific GPA index and stratified patients into three categories. The median overall survival for patients with GPA scores of 0–0.5, 1.0–1.5, and 2.0–2.5 was 2.3, 4.3, and 12.7 months, respectively (p < 0.001). Surgery or stereotactic radiosurgery ± whole-brain radiotherapy showed a better survival than palliative whole-brain radiotherapy alone in patients with high GPA scores.

Conclusions

We developed a novel CRC-specific GPA index, which could help physicians to stratify patients with brain metastases. Further efforts are needed to validate and improve this index.

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Author notes

  1. Byoung Hyuck Kim and Hae Jin Park have equally contributed to this work.

Authors and Affiliations

  1. Department of Radiation Oncology, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea

    Byoung Hyuck Kim & Eui Kyu Chie

  2. Department of Radiation Oncology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea

    Byoung Hyuck Kim

  3. Department of Radiation Oncology, Hanyang University College of Medicine, Seoul, Republic of Korea

    Hae Jin Park

  4. Department of Radiation Oncology, Ewha Womans University College of Medicine, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul, 07985, Republic of Korea

    Kyubo Kim

  5. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea

    Sae-Won Han & Tae-You Kim

  6. Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea

    Seung-Yong Jeong & Kyu Joo Park

Authors
  1. Byoung Hyuck Kim
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  2. Hae Jin Park
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Corresponding authors

Correspondence to Kyubo Kim or Eui Kyu Chie.

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Kim, B.H., Park, H.J., Kim, K. et al. Novel graded prognostic assessment for colorectal cancer patients with brain metastases. Int J Clin Oncol 23, 1112–1120 (2018). https://doi.org/10.1007/s10147-018-1329-9

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  • DOI: https://doi.org/10.1007/s10147-018-1329-9

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