Patients with colorectal cancer and brain metastasis: The relevance of extracranial metastatic patterns predicting time intervals to first occurrence of intracranial metastasis and survival

Thurmaier, Johannes; Heinemann, Volker; Engel, Jutta; Schubert‐Fritschle, Gabriele; Wiedemann, Max; Nüssler, Natascha C.; Ruppert, Reinhard; Kleeff, Jörg; Schepp, Wolfgang; Löhe, Florian; Karthaus, Meinolf; Neumann, Jens; Kumbrink, Jörg; Taverna, Francesco; Stahler, Arndt ; Heinrich, Kathrin; Westphalen, Christoph Benedikt; Holch, Julian W.; Kirchner, Thomas und Michl, Marlies (28. Oktober 2020): Patients with colorectal cancer and brain metastasis: The relevance of extracranial metastatic patterns predicting time intervals to first occurrence of intracranial metastasis and survival. In: International Journal of Cancer, Bd. 148, Nr. 8: S. 1919-1927

Abstract

To investigate the predictive impact of extracranial metastatic patterns on course of disease and survival in patients with colorectal cancer (CRC) and brain metastasis (BM). A total of 228 patients (134 male [59%], 94 female [41%]) with histologically proven CRC and BM were classified into different groups according to extracranial metastatic patterns. Time intervals to metastatic events and survival times from initial CRC diagnosis, extracranial and intracranial metastasis were analyzed. Extracranial organs mostly affected were liver (102 of 228 [44.7%]) and lung (96 of 228 [42.1%]). Liver and lung metastasis were detected in 31 patients (13.6%). Calculated over the entire course of disease, patients with lung metastasis showed longer OS than patients with liver metastasis or patients without lung metastasis (43.9 vs. 34.6 [p=0.002] vs. 35.0 months [p=0.002]). From the date of initial CRC diagnosis, lung metastasis occurred later in CRC history than liver metastasis (24.3 vs. 7.5 months). Once lung metastasis was diagnosed BM occurred faster than in patients with liver metastasis (15.8 vs. 26.0 months; Δ 10.2 months). Accordingly, OS from the diagnosis of liver metastasis was longer than from lung metastasis (27.1 vs. 19.6 months [p=0.08]). Once BM was present patients with lung metastasis lived longer than patients with liver metastasis (3.8 vs. 1.1 months [p=0.028]). Shortest survival times in all survival categories analyzed revealed patients with concurrent liver and lung metastasis. Patients with CRC and BM form a heterogenous cohort where EM to liver or lung predict survival.

• Dokumententyp: Zeitschriftenartikel
• Publikationsform: Publisher's Version
• Keywords: Brain metastasis; extracranial metastatic patterns; metastatic colorectal cancer
• Fakultät: Medizin > Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• Sprache: Englisch

Literaturliste

1.Nieder C, Spanne O, Mehta MP, Grosu AL, Geinitz H. Presenta- tion, patterns of care, and survival in patients with brain metasta- ses: what has changed in the last 20 years? Cancer. 2011;117: 2505-2512. 2. Tabouret E, Chinot O, Metellus P, Tallet A, Viens P, Gonçalves A. Recent trends in epidemiology of brain metastases: an overview. Anti- cancer Res. 2012;32:4655-4662. 3. Sundermeyer ML, Meropol NJ, Rogatko A, Wang H, Cohen SJ. Chang- ing patterns of bone and brain metastases in patients with colorectal cancer. Clin Colorectal Cancer. 2005;5:108-113. 4. Michl M, Thurmaier J, Schubert-Fritschle G, et al. Brain metastasis in colorectal cancer patients: survival and analysis of prognostic factors. Clin Colorectal Cancer. 2015;14:281-290. 5. Sperduto PW, Kased N, Roberge D, et al. Summary report on the graded prognostic assessment: an accurate and facile diagnosis- specific tool to estimate survival for patients with brain metastases. J Clin Oncol. 2012;30:419-425. 6. Kye BH, Kim HJ, Kan g WK , Cho HM, Hong Y K, Oh S T. Brain metastases f rom colo rectal cancer: the role of surgical resectioninselectedpatients.Colorectal Dis. 2012;14:e378-e385. 7. Kalkanis SN, Kondziolka D, Gaspar LE, et al. The role of surgical resection in the management of newly diagnosed brain metastases: a systematic review and evidence-based clinical practice guideline. J Neurooncol. 2010;96:33-43. 8. Linskey ME, Andrews DW, Asher AL, et al. The role of stereotactic radiosurgery in the management of patients with newly diagnosed brain metastases: a systematic review and evidence-based clinical practice guideline. J Neurooncol. 2010;96:45-68. 9. Damiens K, Ayoub JPM, Lemieux B, et al. Clinical features and course of brain metastases in colorectal cancer: an experience from a single institution. Curr Oncol. 2012;19:254-258. 10. Nieder C, Pawinski A, Balteskard L. Colorectal cancer metastatic to the brain: time trends in presentation and outcome. Oncology. 2009; 76:369-374. 11. Zoratto F, Loupakis F, Cremolini C, et al. Long-survivors with lung metastases and kras mutations have an increased risk to develop brain metastases from colorectal cancer. Ann Oncol. 2013;24: iv11-iv24. 12. Qiu M, Hu J, Yang D, Cosgrove DP, Xu R. Pattern of distant metasta- ses in colorectal cancer: a SEER based study. Oncotarget. 2015;6: 38658-38666. 13. Yaeger R, Cowell E, Chou JF, et al. RAS mutations affect pattern of metastatic spread and increase propensity for brain metastasis in colorectal cancer. Cancer. 2015;121:1195-1203. 14. Michl M, Heinemann V, Jung A, Engel J, Kirchner T, Neumann J. Expression of cancer stem cell markers in metastatic colorectal cancer correlates with liver metastasis, but not with metastasis to the central nervous system. Pathol Res Pract. 2015;211:601-609. 15. Farnell GF, Buckner JC, Cascino TL, O'Connell MJ, Schomberg PJ, Suman V. Brain metastases from colorectal carcinoma. The long term survivors. Cancer. 1996;78:711-716. 16. Tan WS, Ho KS, Eu KW. Brain metastases in colorectal cancers. World J Surg. 2009;33:817-821. 17. Imaizumi J, Shida D, Narita Y, et al. Prognostic factors of brain metas- tases from colorectal cancer. BMC Cancer. 2019;19:755. 18. Chyu n Y, Hayward E, Lokich J. Metastasis to the central nervous system from colorectal cancer. Med P ediatr Oncol. 1980;8: 305-308. 19. Kohne CH, Cunningham D, Di Costanzo F, et al. Clinical determinants of survival in patients with 5-fluorouracil-based treatment for meta- static colorectal cancer: results of a multivariate analysis of 3825 patients. Ann Oncol. 2002;13:308-317. 20. Ko FC, Liu JM, Chen WS, Chiang JK, Lin TC, Lin JK. Risk and patterns of brain metastases in colorectal cancer: 27-year experience. Dis Colon Rectum. 1999;42:1467-1471. 21. Jung M, Ahn JB, Chang JH, et al. Brain metastases from colorectal carcinoma: prognostic factors and outcome. J Neurooncol. 2011;101: 49-55.