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Brain metastases from colorectal carcinoma: prognostic factors and outcome

 Minkyu Jung  ;  Joong Bae Ahn  ;  Jong Hee Chang  ;  Chang Ok Suh  ;  Soojung Hong  ;  Jae Kyung Roh  ;  Sang Joon Shin  ;  Sun Young Rha 
 JOURNAL OF NEURO-ONCOLOGY, Vol.101(1) : 49-55, 2011 
Journal Title
Issue Date
Adenocarcinoma/mortality ; Adenocarcinoma/pathology* ; Adenocarcinoma/therapy ; Adult ; Aged ; Aged, 80 and over ; Brain Neoplasms/mortality ; Brain Neoplasms/secondary* ; Brain Neoplasms/therapy ; Colorectal Neoplasms/mortality ; Colorectal Neoplasms/pathology* ; Colorectal Neoplasms/therapy ; Cranial Irradiation ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Prognosis ; Radiosurgery ; Retrospective Studies ; Treatment Outcome
Brain neopla ;  Neoplasm metastasis ;  Colorectal neoplasms  ; Prognosis 
Brain metastases from colorectal carcinoma (CRC) are rare. The objectives of this study are to assess the natural history, outcome, and possible prognostic factors in CRC patients with brain metastases. Between 1995 and 2008, 8,732 patients with CRC were treated at Yonsei University Health System. Brain metastases were found in 1.4% of these patients. Retrospective review and statistical analysis of these 126 patients were performed. Median time from diagnosis of metastatic CRC (mCRC) to brain metastases was 9.0 months (range 0-85 months), and 14 patients (11.1%) had brain involvement as their initial presentation. Among the 126 patients, 91.3% had other systemic metastases; the most common extracranial metastatic site was lung (72.2%). Median follow-up duration was 6.1 months (range 0.1-90.3 months), and median survival after diagnosis of brain metastases was 5.4 months [95% confidence interval (CI) 3.9-6.9 months]. Median survival time after diagnosis of brain metastases was 1.5 months for patients who received only steroids (15.9%), 4.0 months for those who received whole-brain radiation therapy (37.5%), 9.5 months for those who received gamma-knife surgery (GKS) (32.5%), and 11.5 months for those who underwent surgery (20%) (P < 0.001). On multivariate analysis, recursive partitioning analysis (RPA) class and amount of chemotherapy before brain metastasis were independent prognostic factors for survival. Overall prognosis of patients with brain metastases from CRC is poor. Nevertheless, patients with low RPA class, or those with previous less chemotherapy showed good prognosis, indicating that proper treatment may result in improved survival time.
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1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Roh, Jae Kyung(노재경)
Rha, Sun Young(라선영) ORCID logo https://orcid.org/0000-0002-2512-4531
Suh, Chang Ok(서창옥)
Shin, Sang Joon(신상준) ORCID logo https://orcid.org/0000-0001-5350-7241
Ahn, Joong Bae(안중배) ORCID logo https://orcid.org/0000-0001-6787-1503
Chang, Jong Hee(장종희)
Jung, Min Kyu(정민규) ORCID logo https://orcid.org/0000-0001-8281-3387
Hong, Soo Jung(홍수정)
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