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Posted by on Mar 23, 2015 in Colorectal cancer | 1 comment

In a nutshell

This study analyzed the characteristics and survival of patients with colorectal cancer that had spread to the brain. 

Some background

In a relatively low number of cases cancer can metastasize (spread) to the brain. Most patients with brain metastases will suffer from symptoms including memory problems, language problems or problems thinking clearly.

Previous reports suggest that only 1% to 3% of patients with colorectal cancer will have brain metastases. However, recent improvements in the treatment of colorectal cancer have prolonged patient survival, which has increased the occurrence of brain metastases. As a result of this it is important to examine what the prognosis is for colorectal cancer patients with symptomatic brain metastases.

Methods & findings

This study reviewed 1364 colorectal cancer patient records. 25 of patients (0.02%) developed brain metastases and were assessed further. Imaging technology was used to determine the size or number of brain metastases. The extent of patients’ brain-related symptoms and overall survival time were also investigated.

On average, brain metastases were diagnosed 25.3 months after the first surgery for colorectal cancer. They were diagnosed following symptoms including headaches, abnormal movement, nausea, problems speaking or facial paralysis. There was an average of 2 brain metastases per patient, with an average size of 22 mm. 92% of patients also had cancer in other organs including the lung (100%), liver (74%) or lymph nodes (39%).

The average patient survival time after diagnosis of the brain metastasis was 2.8 months. The average survival time was 4.8 months for patients who had brain surgery (13 patients) and 1.5 months for patients who had whole-brain radiotherapy or best care (12 patients).

Two factors were linked to longer patient survival time: having only 1 brain metastasis and receiving additional chemotherapy. Patients who received additional chemotherapy had an average survival time of 7.4 months, compared to an average survival time of 1.5 months for patients who did not receive additional chemotherapy.

The bottom line

The authors concluded that brain metastases are rare in patients with colorectal cancer, but that prognosis is poor. They suggest that continued chemotherapy may improve patient survival.

The fine print

This study was retrospective (based on medical records) and only included a very small number of patients which may limit the value of the results.

Published By :

Clinical Colorectal Cancer

Date :

Dec 01, 2014

Original Title :

Prognostic factors for patients with advanced colorectal cancer and symptomatic brain metastases.

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