title: Prognostic factors and treatment effects in patients with curatively resected brain metastasis from colorectal cancer.
abstract: BACKGROUND
  Colorectal cancer infrequently causes brain metastasis, and the prognosis is poor.
  
  
  OBJECTIVE
  The aim of this study was to identify the prognostic factors associated with survival and outcome of treatment for patients with brain metastasis from colorectal cancer.
  
  
  METHODS
  This is a retrospective study from a prospectively collected database.
  
  
  METHODS
  The investigation took place in a high-volume multidisciplinary tertiary cancer center in Japan.
  
  
  METHODS
  From 1979 to 2010, 113 consecutive patients who were treated for brain metastasis from colorectal cancer were identified.
  
  
  METHODS
  The primary outcome measure was overall survival.
  
  
  RESULTS
  Sixty-three patients had neurosurgical resection (including curative resection for 46 patients) followed by whole brain radiotherapy, 9 had stereotactic radiosurgery, 30 had whole brain radiotherapy, and 11 had steroid and palliative care. As a whole, the overall median survival time from diagnosis of brain metastasis was 5.4 months (95% CI, 4.3-7.6 months), and the 1-year survival rate was 29% (95% CI, 22%-38%). In the group of patients who underwent curative neurosurgical resection, the overall median survival time was 15.2 months (95% CI, 9.2-17.8 months), and the 1-year survival rate was 57% (95% CI, 43%-71%). On multivariate analysis, 1 or 2 brain metastatic lesions, no extracranial metastatic lesions, and neurosurgical resection were independent favorable prognostic factors overall (p = 0.0057, 0.0197, and <0.0001), and 1 or 2 brain metastatic lesions, no extracranial metastatic lesion, and no emergence of secondary brain metastatic lesions were independent favorable prognostic factors in the group of patients who underwent curative neurosurgical resection (p = 0.0137, 0.0081, and 0.0010).
  
  
  CONCLUSIONS
  This study was limited by its single-institute, retrospective, nonrandomized design and selection bias.
  
  
  CONCLUSIONS
  Neurosurgical resection in select patients is a reasonable option for brain metastasis from colorectal cancer, although it is not associated with long-term (5-year) survival. (see Video, Supplemental Digital Content 1, http://links.lww.com/DCR/A121 ).
authors: 1Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Bunkyo-Ku, Tokyo, Japan 2Department of Neurosurgery, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Bunkyo-Ku, Tokyo, Japan 3Department of Radiotherapy, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Bunkyo-Ku, Tokyo, Japan 4Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan.
authors: Yozo
authors: Y
authors: Suzuki
authors: Tatsuro
authors: T
authors: Yamaguchi
authors: Hiroshi
authors: H
authors: Matsumoto
authors: Daisuke
authors: D
authors: Nakano
authors: Goro
authors: G
authors: Honda
authors: Nobusada
authors: N
authors: Shinoura
authors: Katsuyuki
authors: K
authors: Karasawa
authors: Keiichi
authors: K
authors: Takahashi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome