title: Brain metastases from colorectal cancer: the role of surgical resection in selected patients.
abstract: OBJECTIVE
  Brain metastasis is infrequent in colorectal cancer patients, and the prognosis is poor. In this retrospective study survival and prognostic factors were determined in patients with brain metastasis from colorectal cancer.
  
  
  METHODS
  Between 1997 and 2006, 39 patients with brain metastasis from colorectal cancer who survived more than 1 month were identified. Data were collected with regard to patient characteristics, location and stage of the primary tumour, extent and location of metastatic disease, and treatment modalities used.
  
  
  RESULTS
  Most (79.5%) patients had pulmonary metastases before brain metastasis, and the brain was the site of solitary metastasis in only one patient. The most frequent symptom was weakness [18 (43.6%) patients]. Overall median survival was 5.0 months and the 1- and 2-year survival rates were 21.8 and 9.1%, respectively. Univariate analysis revealed uncontrolled extracranial metastases (P = 0.019), multiple brain lesions (P = 0.026), bilateral brain metastases (P = 0.032) and serum carcinoembryonic antigen levels greater than 5 ng/ml (P = 0.008) to be poor prognostic factors. The median survival after the diagnosis of brain metastasis was significantly longer in patients who underwent surgical resection (15.2 ± 8.0 months) than in those treated by other modalities (P = 0.001). Treatment modality was the only independent prognostic factor for overall survival in patients with brain metastases from colorectal cancers (P = 0.015).
  
  
  CONCLUSIONS
  Aggressive surgical resection in selected patients with brain metastases from colorectal cancer may prolong survival, even in the presence of extracranial metastatic lesions.
authors.affiliation: Department of Surgery, St Vincent's Hospital, Suwon, Korea.
authors.forename: B-H
authors.initials: BH
authors.lastname: Kye
authors.forename: H J
authors.initials: HJ
authors.lastname: Kim
authors.forename: W K
authors.initials: WK
authors.lastname: Kang
authors.forename: H-M
authors.initials: HM
authors.lastname: Cho
authors.forename: Y-K
authors.initials: YK
authors.lastname: Hong
authors.forename: S T
authors.initials: ST
authors.lastname: Oh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001932:Brain Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery*; D002272:Carcinoembryonic Antigen / Q000097:blood; D003110:Colonic Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012004:Rectal Neoplasms / Q000473:pathology*; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D002272:Carcinoembryonic Antigen