title: Prognostic factors and multidisciplinary treatment modalities for brain metastases from colorectal cancer: analysis of 93 patients.
abstract: BACKGROUND
  The purpose of this study was to review patient characteristics and evaluate the potential factors affecting prognosis in cases of brain metastasis (BM) from colorectal cancer (CRC).
  
  
  METHODS
  We retrospectively reviewed 93 cases of BM from CRC in our hospital. Patient demographics, neurologic symptoms, and location and number of BMs were recorded. Factors analyzed included: age; sex; Karnofsky performance score; number of BMs; presence of extracranial metastases; dimensions; location of tumors; treatment modalities.
  
  
  RESULTS
  The overall 1- and 2-year survival rates were 27.7 and 9.9%. On multivariate analysis, the number of BMs, extracranial metastases and the initial treatment modalities were found to be independent prognostic factors for overall survival. Patients treated with surgical resection followed by WBRT or SRS had an improved prognosis relative to those treated with surgery alone (P=0.02 and P=0.02, respectively). No significance difference in survival rate was found between patients treated with SRS alone or SRS plus WBRT (P=0.11).
  
  
  CONCLUSIONS
  Surgical resection of BMs from CRC in selected patients may help prolong survival. Additional radiotherapy following surgery is valuable in improving prognosis. Extracranial metastasis, multiple BM lesions and initial non operation can be considered as independent factors associated with poor prognosis.
authors.affiliation: Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, 200040, China. 061105315@fudan.edu.cn.
authors.forename: Xiao-Dong
authors.initials: XD
authors.lastname: Gu
authors.affiliation: Department of General Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, 200011, China. yantaocai@hotmail.com.
authors.forename: Yan-Tao
authors.initials: YT
authors.lastname: Cai
authors.affiliation: Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, 200040, China. hankunh@sohu.com.
authors.forename: Yi-Ming
authors.initials: YM
authors.lastname: Zhou
authors.affiliation: Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, 200040, China. gxdgxd737@sohu.com.
authors.forename: Zhen-Yang
authors.initials: ZY
authors.lastname: Li
authors.affiliation: Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, 200040, China. 68875417@qq.com.
authors.forename: Jian-Bin
authors.initials: JB
authors.lastname: Xiang
authors.affiliation: Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, 200040, China. zongyouc@sohu.com.
authors.forename: Zong-You
authors.initials: ZY
authors.lastname: Chen
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000401:mortality / Q000473:pathology / Q000556:secondary* / Q000628:therapy; D015179:Colorectal Neoplasms / Q000473:pathology*; D003131:Combined Modality Therapy / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors