COLORECTAL-CARCINOMA AND BRAIN METASTASIS - DISTRIBUTION, TREATMENT, AND SURVIVAL

Background: Brain metastasis from colorectal cancer is rare. The prese nt study reports the nature of this disease and analyzes factors corre lated with survival in patients harboring such disease. Patients and M ethods: One hundred patients diagnosed between 1980 and 1994 with meta static brain tumors secondary to colorectal adenocarcinoma were retros pectively reviewed. Of these patients, 36 underwent surgery, 57 underw ent radiotherapy alone, and the remaining seven received steroids. Res ults: The most common primary sites were the sigmoid colon and rectum (65%). Brain metastases with concomitant liver and/or lung metastases were seen more frequently than brain metastases alone. The median inte rval between the diagnosis of primary cancer and the diagnosis of brai n metastasis was 26 months (95% confidence interval = 22-30). The medi an survival time after the diagnosis of brain metastasis was 1 month f or patients who received only steroids, 3 months for those who receive d radiotherapy (p = 0.1), and 9 months for those who underwent surgery (p < 0.0001). The extent of noncerebral systemic disease was not corr elated with survival (p > 0.05), but early onset of brain metastasis w as significantly associated with poor prognosis (p = 0.04). Conclusion : Surgical removal of colorectal metastatic brain lesions results in s ignificantly increased survival time, regardless of the status of the noncerebral systemic disease.