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Brain metastases from colorectal carcinoma: The long term survivors
Author(s) -
Farnell Gerald F.,
Buckner Jan C.,
Cascino Terrence L.,
O'Connell Michael J.,
Schomberg Paula J.,
Suman Vera
Publication year - 1996
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19960815)78:4<711::aid-cncr3>3.0.co;2-h
Subject(s) - medicine , radiation therapy , colorectal cancer , concomitant , carcinoma , retrospective cohort study , surgery , cancer , oncology , radiology
BACKGROUND Brain metastases occur in 25% to 35% of all cancer patients, with colorectal carcinoma accounting for approximately 8% of these. Information about patients with brain metastases from colorectal carcinoma is limited, with the largest previous series reporting only 40 patients. To date there have been no reports describing the subgroup of patients with long term survival (>1 yr). METHODS A retrospective review of 150 patients seen at the Mayo Clinic between 1976 and 1993 with pathologic (56) and/or radiographic (94) confirmation of brain metastases from colorectal carcinoma is presented. RESULTS The majority of patients (82%) with brain metastases from colorectal carcinoma have concomitant extracerebral metastases, especially in the lungs. Only 16% of the patients survived > 1 year after diagnosis (4 > 4 yrs., 2 > 10 yrs). Of these, 92% had single cerebral metastases and 38% had no systemic metastases. In addition, young age and the absence of bony metastases or memory loss were associated with increased survival. Median survival for all of the patients receiving surgery and radiotherapy (39), surgery alone (11), radiotherapy alone (79) and supportive care (17) are 42, 45, 16, and 8 weeks, respectively. Thirty percent of the patients treated with radiotherapy showed regression of their tumors on follow‐up head scans; three had complete regression. CONCLUSIONS One‐year survivors of brain metastases from colorectal carcinoma were uncommon, accounting for 16% of the patients and most of these (92%) had solitary lesions. Nineteen of 24 long term survivors had surgical resection as part of their treatment. Given the similar results in patients treated with surgery plus radiotherapy and those treated with surgery alone, as well as the potential long term side effects of radiotherapy, withholding radiotherapy for those patients with the possibility of long term survival should be considered. Cancer 1996;78:711‐6.