title: Central nervous system metastasis secondary to colorectal cancer: a retrospective cohort study of 20 cases.
abstract: BACKGROUND
  Involvement of the central nervous system (CNS) secondary to colorectal cancer is infrequent and associated with a poor prognosis. Its treatment is extrapolated from metastases of other origins as the information available on this scenario is limited. The goal of this study is to assess the clinical characteristics of a series of patients and determine the results in terms of progression-free survival (PFS) and global survival.
  
  
  METHODS
  The records of patients with CNS metastasis of colorectal origin who were treated in this facility between the years 2001 and 2016 were reviewed retrospectively.
  
  
  RESULTS
  20 patients with CNS lesions of this origin were identified. Of these, 45% were male and 55% were female (average age 65.5 years). The histology corresponded to tubular adenocarcinoma in 95% of cases. Around 85% of the patients showed a neurological deficit, and their recursive partitioning analysis (RPA) classifications were 1 in 20%, 2 in 55%, and 3 in 25% of the cases studied. The treatments provided were: holocerebral radiotherapy (45%), stereotactic radiosurgery (25%), surgery followed by holocerebral radiotherapy (25%), and exclusively palliative care (5%). The PFS was 2.6 months from treatment of the CNS lesion, while the median survival was 3.8 months. The survival times for patients receiving different treatments were as follows: surgery plus holocerebral radiotherapy 16.2 months, stereotactic radiotherapy 12 months, and holocerebral radiotherapy 2.4 months (p = 0.003).
  
  
  CONCLUSIONS
  The prognosis for patients with metastasis of colorectal origin is poor. The patients treated with surgery or stereotactic radiotherapy can have a greater survival.
authors.affiliation: Departamento de Hematología-Oncología, Oncología Médica, Facultad de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 319, Santiago, Chile 8330032.
authors.forename: Sebastián
authors.initials: S
authors.lastname: Mondaca
authors.affiliation: Departamento de Hematología-Oncología, Oncología Médica, Facultad de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 319, Santiago, Chile 8330032.
authors.forename: Valentina
authors.initials: V
authors.lastname: Hornig
authors.affiliation: Departamento de Hematología-Oncología, Radioterapia, Facultad de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 319, Santiago, Chile 8330032; Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada; Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada.
authors.forename: Pablo
authors.initials: P
authors.lastname: Munoz-Schuffenegger
authors.affiliation: Departamento de Hematología-Oncología, Oncología Médica, Facultad de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 319, Santiago, Chile 8330032.
authors.forename: Francisco
authors.initials: F
authors.lastname: Acevedo
authors.affiliation: Departamento de Hematología-Oncología, Oncología Médica, Facultad de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 319, Santiago, Chile 8330032.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Garrido
authors.affiliation: Departamento de Hematología-Oncología, Oncología Médica, Facultad de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 319, Santiago, Chile 8330032.
authors.forename: Bruno
authors.initials: B
authors.lastname: Nervi
keywords: Colorectal neoplasia; cerebral metastasis; neurosurgery; radiosurgery