Epidemiology and Outcomes of Patients With Brain Metastases From Colorectal Cancer—Who Are These Patients?

Bonadio, Renata Colombo; Freitas, Guilherme Fialho de; Batista, Daniel Negrini; Moreira, Otavio Augusto; Dias, Carla Andressa Rodrigues; Castria, Tiago Biachi De; Sabbaga, Jorge; Hoff, Paulo M.

doi:10.1016/j.clcc.2021.04.002

Cited by 6 publications

(5 citation statements)

References 21 publications

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“…As shown in Table 1 , a total of 17 retrospective cohort studies ( 4 , 8 , 11 – 13 , 15 , 25 – 35 ), involving 1,438 patients with CRC BM were included. Among the 17 studies, 11 ( 4 , 8 , 12 , 13 , 25 – 27 , 29 , 30 , 32 , 34 ) studies clearly pointed out the radiation modalities with either WBRT or RS, whereas the remaining 6 ( 11 , 15 , 28 , 31 , 33 , 35 ) did not.…”

Section: Resultsmentioning

confidence: 99%

“…A recent study ( 43 ) focusing on the relevance of extracranial metastatic patterns and the survival outcome of patients with CRC BM showed that patients with lung metastasis lived longer than those with liver metastasis, and concurrent liver and lung metastasis were associated with the worst survival outcome. However, only five studies ( 4 , 12 , 28 , 30 , 35 ) reported the survival outcome of patients with and without ECM, and the survival of patients with different metastatic patterns was not reported in the included studies.…”

Section: Discussionmentioning

confidence: 99%

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Survival Outcome of Surgical Resection vs. Radiotherapy in Brain Metastasis From Colorectal Cancer: A Meta-Analysis

et al. 2022

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BackgroundThe incidence of brain metastasis from colorectal cancer (CRC) increases along with the greater survival rate for CRC because of the advances in therapeutic modalities. Local treatment strategies for brain metastasis include surgical resection and radiotherapy. Nevertheless, given the incongruent literature, the optimal therapeutic approach remains to be investigated. This study aims to systematically compare the real-world survival outcome of surgical resection and radiotherapy in patients with brain metastasis from CRC.MethodsFollowing Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines (PROSPERO, ID: CRD42021240200), the Cochrane Library, Embase, and Medline were searched from the inception of the database to August 2021. Meta-analyses were conducted with results pooled using hazard ratios with corresponding 95% CIs to evaluate the overall survival (OS) following local treatment for brain metastasis from CRC. Summary effects were evaluated using a series of random-effect models.ResultsIn this review, 17 retrospective studies comprising 1,438 participants were included. In comparison with radiotherapy, the OS of patients who received brain metastasectomy was generally longer (HR, 0.53; 95% CI, 0.47–0.60). Extracerebral metastases (HR, 1.58; 95% CI, 1.34–1.86) and multiple brain metastases (HR, 1.38; 95% CI, 1.10–1.72) were associated with worse survival outcomes.ConclusionsFor patients with brain metastasis from CRC, the current real-world evidence demonstrated the survival benefit of aggressive neurosurgical management in suitable patients. Additionally, patients with extracerebral metastases and multiple brain metastases had worse survival outcomes.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=240200.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Survival Outcome of Surgical Resection vs. Radiotherapy in Brain Metastasis From Colorectal Cancer: A Meta-Analysis

et al. 2022

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“…Similar conclusions were also found. [ 28 ] In our study, we observed that patients with better physical status (KPS ≥ 70) can get better survival improvements than patients with poor physical status (KPS < 70) (10 months vs 4 months), both in univariate analysis and in multivariate analysis.…”

Section: Discussionmentioning

confidence: 67%

Brain metastasis from colorectal cancer: Treatment, survival, and prognosis

Wang

Zhu

et al. 2022

Medicine

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To investigate the clinical characteristics, survival, prognostic factors, and treatment of brain metastasis (BM) from colorectal cancer (CRC). Twenty-one patients with BM from CRC were retrospectively reviewed. Predictive factors for BM and prognostic factors after the diagnosis of BM were examined by univariate and multivariate COX analysis. The time from the development of extracranial metastases, including lung, bone, and liver, to the occurrence of BM was recorded separately. The median overall survival time was 7 months. In univariate prognostic analysis, median survival with multimodal therapy was better than that with unimodal therapy (10 months vs 3 months, P = .000). In addition, median survival with Karnofsky performance status (KPS) < 70, 1 BM lesion, primary tumor stage of II-III, extracranial lesions < 2, and no extracranial metastasis were much better than the other groups (P < .05 of all). Although there was not a significant difference in median survival between patients receiving combination treatment with bevacizumab and those who did not, treatment with bevacizumab was associated with better survival (10 months vs 5 months, P = .436). The time intervals from bone, liver, and lung metastases to BM were 3, 6.5, and 11 months, respectively. Based on multivariate Cox analysis, KPS and treatment modalities were independent prognosis factors (P = .039 and P = .000, respectively). CRC patients with a high KPS and multimodal treatment have improved survival.Abbreviations: BM = brain metastasis, CI = confidence interval, CRC = colorectal cancer, KPS = Karnofskyperformance status, KRAS = Kirsten rat sarcoma viral oncogene homolog, OS = overall survival, RAS = rat sarcoma viral oncogene homolog, WBRT = whole-brain radiotherapy.

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“…Moreover, the primary tumors of patients with brain metastases were predominantly left‐sided, particularly in the rectum 30 . Other studies also demonstrated that brain metastases occurred more commonly in patients with primary left‐sided tumors 31 . Quan et al.…”

Section: Discussionmentioning

confidence: 98%

“…30 Other studies also demonstrated that brain metastases occurred more commonly in patients with primary left-sided tumors. 31…”

Section: Discussionmentioning

confidence: 99%

Construction and validation of machine learning models for predicting distant metastases in newly diagnosed colorectal cancer patients: A large‐scale and real‐world cohort study

Wei,

Yu,

Wang

et al. 2024

Cancer Medicine

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BackgroundMore accurate prediction of distant metastases (DM) in patients with colorectal cancer (CRC) would optimize individualized treatment and follow‐up strategies. Multiple prediction models based on machine learning have been developed to assess the likelihood of developing DM.MethodsClinicopathological features of patients with CRC were obtained from the National Cancer Center (NCC, China) and the Surveillance, Epidemiology, and End Results (SEER) database. The algorithms used to create the prediction models included random forest (RF), logistic regression, extreme gradient boosting, deep neural networks, and the K‐Nearest Neighbor machine. The prediction models' performances were evaluated using receiver operating characteristic (ROC) curves.ResultsIn total, 200,958 patients, 3241 from NCC and 197,717 CRC from SEER were identified, of whom 21,736 (10.8%) developed DM. The machine‐learning‐based prediction models for DM were constructed with 12 features remaining after iterative filtering. The RF model performed the best, with areas under the ROC curve of 0.843, 0.793, and 0.806, respectively, on the training, test, and external validation sets. For the risk stratification analysis, the patients were separated into high‐, middle‐, and low‐risk groups according to their risk scores. Patients in the high‐risk group had the highest incidence of DM and the worst prognosis. Surgery, chemotherapy, and radiotherapy could significantly improve the prognosis of the high‐risk and middle‐risk groups, whereas the low‐risk group only benefited from surgery and chemotherapy.ConclusionThe RF‐based model accurately predicted the likelihood of DM and identified patients with CRC in the high‐risk group, providing guidance for personalized clinical decision‐making.

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Epidemiology and Outcomes of Patients With Brain Metastases From Colorectal Cancer—Who Are These Patients?

Cited by 6 publications

References 21 publications

Survival Outcome of Surgical Resection vs. Radiotherapy in Brain Metastasis From Colorectal Cancer: A Meta-Analysis

Survival Outcome of Surgical Resection vs. Radiotherapy in Brain Metastasis From Colorectal Cancer: A Meta-Analysis

Brain metastasis from colorectal cancer: Treatment, survival, and prognosis

Construction and validation of machine learning models for predicting distant metastases in newly diagnosed colorectal cancer patients: A large‐scale and real‐world cohort study

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