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The clinical and pathological features of 133 colorectal cancer patients with brain metastasis: a multicenter retrospective analysis of the Gastrointestinal Tumors Working Committee of the Turkish Oncology Group (TOG)

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Abstract

Brain metastasis in colorectal cancer is highly rare. In the present study, we aimed to determine the frequency of brain metastasis in colorectal cancer patients and to establish prognostic characteristics of colorectal cancer patients with brain metastasis. In this cross-sectional study, the medical files of colorectal cancer patients with brain metastases who were definitely diagnosed by histopathologically were retrospectively reviewed. Brain metastasis was detected in 2.7 % (n = 133) of 4,864 colorectal cancer patients. The majority of cases were male (53 %), older than 65 years (59 %), with rectum cancer (56 %), a poorly differentiated tumor (70 %); had adenocarcinoma histology (97 %), and metachronous metastasis (86 %); received chemotherapy at least once for metastatic disease before brain metastasis developed (72 %), had progression with lung metastasis before (51 %), and 26 % (n = 31) of patients with extracranial disease at time the diagnosis of brain metastasis had both lung and bone metastases. The mean follow-up duration was 51 months (range 5–92), and the mean survival was 25.8 months (95 % CI 20.4–29.3). Overall survival rates were 81 % in the first year, 42.3 % in the third year, and 15.7 % in the fifth year. In multiple variable analysis, the most important independent risk factor for overall survival was determined as the presence of lung metastasis (HR 1.43, 95 % CI 1.27–4.14; P = 0.012). Brain metastasis develops late in the period of colorectal cancer and prognosis in these patients is poor. However, early screening of brain metastases in patients with lung metastasis may improve survival outcomes with new treatment modalities.

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References

  1. Farnell GF, Buckner JC, Cascino TL, O’Connell MJ, Schomberg PJ, et al. Brain metastasis from colorectal carcinoma. The long term survivors. Cancer. 1996;78:711–6.

    Article  PubMed  CAS  Google Scholar 

  2. Fabi A, Felici A, Metro G, Mirri A, Bria E, et al. Brain metastases from solid tumors: disease outcome according to type of treatment and therapeutic resources of the treating center. J Exp Clin Cancer Res. 2011;30:10–6.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Go PH, Klaassen Z, Meadows MC, Chamberlain RS. Gastrointestinal cancer and brain metastasis: a rare and ominous sign. Cancer. 2011;117:3630–40.

    Article  PubMed  Google Scholar 

  4. Damiens K, Ayoub JPM, Lemieux B, Aubin F, Saliba W, et al. Clinical features and course of brain metastases in colorectal cancers: an experience from a single institution. Curr Oncol. 2012;19:254–9.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  5. Zang YW, Gu XD, Xiang JB, Chen ZY. Brain metastases from colorectal cancer: microenvironment and molecular mechanisms. Int J Mol Sci. 2012;13:15784–800.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  6. Magni E, Santoro L, Ravenda PS, Leonardi MC, Bonomo G, et al. Brain metastases from colorectal cancer: main clinical factors conditioning outcome. Int J Colorectal Dis. 2014;29:201–8.

    Article  PubMed  Google Scholar 

  7. Bartelt S, Momm F, Weissenberger C, Lutterbach J. Patients with brain metastases from gastrointestinal tract cancer treated with whole brain radiation therapy: prognostic factors and survival. World J Gastroenterol. 2004;10:3345–8.

    PubMed  Google Scholar 

  8. Giglio P, Gilbert MR. Neurologic complications of cancer and its treatment. Curr Oncol Rep. 2010;12:50–9.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Siegel R, Naishadham D, Jemal A. Cancer Statistics 2013. CA Cancer J Clin. 2013;63:11–30.

    Article  PubMed  Google Scholar 

  10. Gaspar L, Scott C, Rotman M, Asbell S, Phillips T, et al. Recursive partitioning analysis (RPA) of prognostic factors in three Radiation Therapy Oncology Group (RTOG) brain metastases trials. Int J Rad Oncol Biol Phys. 1997;37:745–51.

    Article  CAS  Google Scholar 

  11. Jung M, Ahn JB, Chang JH, Suh CO, Hong S, et al. Brain metastases from colorectal carcinoma: prognostic factors and outcome. J Neurooncol. 2011;101:49–55.

    Article  PubMed  Google Scholar 

  12. Patanaphan V, Salazar OM. Colorectal cancer: metastatic patterns and prognosis. South Med J. 1993;86:38–41.

    Article  PubMed  CAS  Google Scholar 

  13. Noura S, Ohue M, Shingai T, Fujiwara A, Imada S, et al. Brain metastasis from colorectal cancer: prognostic factors and survival. J Surg Oncol. 2012;106:144–8.

    Article  PubMed  Google Scholar 

  14. Mongan JP, Fadul CE, Cole BF, Zaki BI, Suriawinata AA, et al. Brain metastases from colorectal cancer: risk factors, incidence, and the possible role of chemokines. Clin Colorectal Cancer. 2009;8:100–5.

    Article  CAS  PubMed Central  Google Scholar 

  15. Matsunaga S, Shuto T, Kawahara N, Suenaga J, Inomori S, et al. Gamma knife surgery for brain metastases from colorectal cancer. J Neurosurg. 2011;114:782–9.

    Article  PubMed  Google Scholar 

  16. Mege D, Ouaissi M, Fuks D, Metellus P, Peltier J, et al. Patients with brain metastases from colorectal cancer are not condemned. Anticancer Res. 2013;33:5645–8.

    PubMed  Google Scholar 

  17. Nieder C, Nestle U, Motaref B, Walter K, Niewald M, et al. Prognostic factors in brain metastases: should patients be selected for aggressive treatment according to recursive partitioning analysis (RPA) classes? Int J Radiar Oncol Biol Phys. 2000;46:297–302.

    Article  CAS  Google Scholar 

  18. Weltman E, Salvajoli JV, Brandt RA, de Morais Hanriot R, Prisco FE, et al. Radiosurgery for brain metastases: a score index for predicting prognosis. Int J Radiat Oncol Biol Phys. 2000;46:1155–61.

    Article  PubMed  CAS  Google Scholar 

  19. Auchter RM, Lamond JP, Alexander E, Buatti JM, Chappell R, et al. A multiinstitutional outcome and prognostic factor analysis of radiosurgery for resectable single brain metastasis. Int J Radiat Oncol Biol Phys. 1996;35:27–35.

    Article  PubMed  CAS  Google Scholar 

  20. Hammoud MA, McCutcheon IE, Elsouki R, Scoppa D, Patt YZ. Colorectal carcinoma and brain metastases: distribution, treatment and survival. Ann Surg Oncol. 1996;3:453–63.

    Article  PubMed  CAS  Google Scholar 

  21. Jiang XB, Yang QY, Sai K, Zhang XH, Chen ZP, et al. Brain metastases from colorectal carcinoma: a description of 60 cases in a single Chinese cancer center. Tumur Biol. 2011;32:1249–56.

    Article  CAS  Google Scholar 

  22. Wang JY, Tang R, Chiang JM. Value of carcinoembryonic antigen in the management of colorectal cancer. Dis Colon Rectum. 1994;37:272–7.

    Article  PubMed  CAS  Google Scholar 

  23. Bakalakos EA, Burak WE Jr, Young DC, Martin EW Jr. Is carcino-embryonic antigen useful in the follow-up management of patients with colorectal liver metastases? Am J Surg. 1999;177:2–6.

    Article  PubMed  CAS  Google Scholar 

  24. Takagawa R, Fuji S, Ohta M, Nagano Y, Kunisaki C, et al. Preoperative serum carcinoembryonic antigen level as a predictive factor of recurrence after curative resection of colorectal cancer. Ann Surg Oncol. 2008;15:3433–9.

    Article  PubMed  Google Scholar 

  25. Ramam N, Monteiro A, Bernardo JE, Eugenio L, Antunes MJ. Lung metastases from colorectal cancer. Surgical resection and prognostic factors. Eur J Cardiothorac Surg. 2009;35:444–9.

    Article  Google Scholar 

Download references

Conflict of interest

We certify that all of our affiliations without financial involvement, within the past 5 years and foreseeable future and, any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript are completely disclosed (e.g., employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, and royalties).

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Authors and Affiliations

  1. Department of Medical Oncology, Faculty of Medicine, Medical School of Sitki Kocman University, Mugla, 48000, Turkey

    Ozgur Tanriverdi

  2. Department of Radiation Oncology, Istanbul Medical School, Istanbul University, Istanbul, Turkey

    Esra Kaytan-Saglam

  3. Department of Radiation Oncology, Faculty of Medicine, Gazi University, Ankara, Turkey

    Sukran Ulger & Diclehan Kilic

  4. Clinic of Medical Oncology, Ataturk Training and Research Hospital, Katip Celebi University, Izmir, Turkey

    Ibrahim Vedat Bayoglu & Yuksel Kucukzeybek

  5. Clinic of Medical Oncology, Dr. Abdurrahman Yurtarslan Oncology Training and Research Hospital, Ankara, Turkey

    Ibrahim Turker & Berna Oksuzoglu

  6. Department of Medical Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey

    Turkan Ozturk-Topcu

  7. Medical Oncology Clinic, Kent Hospital, Izmir, Turkey

    Suna Cokmert

  8. Department of Medical Oncology, Faculty of Medicine, Marmara University, Istanbul, Turkey

    Serdar Turhal

  9. Department of Medical Oncology, Faculty of Medicine, Adnan Menderes University, Aydın, Turkey

    Esin Oktay & Nezih Meydan

  10. Department of Medical Oncology, Faculty of Medicine, Ege University, Izmir, Turkey

    Bulent Karabulut

  11. Department of Radiation Oncology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey

    Vildan Kaya

  12. Clinic of Medical Oncology, Tepecik Training and Research Hospital, Izmir, Turkey

    Tulay Akman

  13. Department of Radiation Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey

    Kamuran Ibis & Mert Saynak

  14. Department of Radiation Oncology, Medical Park Hospital, Izmir University, Izmir, Turkey

    Cenk Ahmet Sen

  15. Department of Medical Oncology, Training and Research Hospital, Sakarya University, Sakarya, Turkey

    Ozlem Uysal-Sonmez

  16. Department of Medical Oncology, Faculty of Medicine, Bilim University, Istanbul, Turkey

    Kezban Nur Pilancı, Gokhan Demir & Sezer Saglam

  17. Medical Oncology Clinic, Training and Research Hospital, Sanliurfa, Turkey

    Muharrem Kocar

  18. Department of Medical Oncology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey

    Serkan Menekse & Gamze Goksel

  19. Department of Medical Oncology, Faculty of Medicine, Pamukkale University, Denizli, Turkey

    Burcu Yapar-Taskoylu & Arzu Yaren

  20. Department of Medical Oncology, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey

    Ummugul Uyeturk

  21. Medical Oncology Clinic, State Hospital, Balıkesir, Turkey

    Nilufer Avci

  22. Radiation Oncology Clinic, Ataturk State Hospital, Aydın, Turkey

    Bengu Denizli & Esra Ilis-Temiz

Authors
  1. Ozgur Tanriverdi
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  2. Esra Kaytan-Saglam
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  3. Sukran Ulger
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  4. Ibrahim Vedat Bayoglu
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  5. Ibrahim Turker
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  6. Turkan Ozturk-Topcu
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  7. Suna Cokmert
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  8. Serdar Turhal
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  9. Esin Oktay
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  10. Bulent Karabulut
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  11. Diclehan Kilic
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  12. Yuksel Kucukzeybek
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  13. Berna Oksuzoglu
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  14. Nezih Meydan
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  15. Vildan Kaya
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  16. Tulay Akman
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  17. Kamuran Ibis
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  18. Mert Saynak
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  19. Cenk Ahmet Sen
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  20. Ozlem Uysal-Sonmez
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  21. Kezban Nur Pilancı
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  22. Gokhan Demir
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  23. Sezer Saglam
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  24. Muharrem Kocar
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  25. Serkan Menekse
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  26. Gamze Goksel
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  27. Burcu Yapar-Taskoylu
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  28. Arzu Yaren
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  29. Ummugul Uyeturk
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  30. Nilufer Avci
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  31. Bengu Denizli
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  32. Esra Ilis-Temiz
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Corresponding author

Correspondence to Ozgur Tanriverdi.

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Tanriverdi, O., Kaytan-Saglam, E., Ulger, S. et al. The clinical and pathological features of 133 colorectal cancer patients with brain metastasis: a multicenter retrospective analysis of the Gastrointestinal Tumors Working Committee of the Turkish Oncology Group (TOG). Med Oncol 31, 152 (2014). https://doi.org/10.1007/s12032-014-0152-z

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  • DOI: https://doi.org/10.1007/s12032-014-0152-z

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