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deteriorating clinical condition. Because there is evidence that an improvement in survival in this setting can be obtained with surgery followed by radiation therapy3 (as also underlined by Damiens et al.), we are considering including brain imaging in the restaging of all our long-surviving metastatic colorectal cancer patients. In doing so, we aim to detect brain metastases as soon as possible, so as to be able to treat those metastases with a bimodality approach when possible, and to offer our patients longer and better survival. As Damiens et al. describe in their paper, treating patients later, only when the brain metastases become clinically evident, leads to dismal survival, despite any treatment.

Comment on “Clinical Features and Course of Brain Metastases in Colorectal Cancer: An Experience from a Single Institution”