Abstract
BackgroundFor brain metastases from non-specific primary tumors, the most frequently used and validated clinical prognostic assessment tool is Karnofsky performance status (KPS). Given the lack of prognostic factors of brain metastases from colorectal cancer (CRC) other than KPS, this study aimed to identify new prognostic factors.MethodsThis retrospective cohort study was conducted at a tertiary care cancer center. Subjects were patients with brain metastases from CRC among all patients who received initial treatment for CRC at the National Cancer Center Hospital from 1997 to 2015 (n = 7147). Prognostic clinicopathological variables for overall survival (OS) were investigated.ResultsThere were 68 consecutive patients with brain metastases from CRC, corresponding to 1.0% of all patients with CRC during the study period. Median survival time was 6.8 months. One-year and 3-year OS rates were 28.0 and 10.1%, respectively. Among the six covariates tested (age, KPS, presence of extracranial metastases, control of primary lesion, number of brain metastases, and history of chemotherapy), multivariate analysis revealed KPS (score ≥ 70), number of brain metastases (1–3), and no history of chemotherapy to be independent factors associated with better prognosis.ConclusionsIn addition to KPS, the number of brain lesions and history of chemotherapy were independent prognostic factors for OS in patients with brain metastases from CRC. An awareness of these factors may help gastrointestinal surgeons make appropriate choices in the treatment of these patients.
Highlights
For brain metastases from non-specific primary tumors, the most frequently used and validated clinical prognostic assessment tool is Karnofsky performance status (KPS)
The present study aimed to investigate prognostic factors of brain metastases from colorectal cancer (CRC), including KPS as an essential covariate, in order to provide insight that could help in the development of appropriate treatment strategies for brain metastases
Of the above-mentioned six factors, multivariate Cox proportional hazards regression models revealed that KPS score ≥ 70 [hazard ratios (HR) of KPS score < 70, 1.88; p = 0.045], number of brain lesions ≤3 [HR of number of brain lesions > 3, 2.04; p = 0.033], and no history of systemic chemotherapy before the development of brain metastases [HR of past history of systemic chemotherapy, 2.39; p = 0.006] were independent factors associated with a better prognosis (Table 2)
Summary
For brain metastases from non-specific primary tumors, the most frequently used and validated clinical prognostic assessment tool is Karnofsky performance status (KPS). Given the lack of prognostic factors of brain metastases from colorectal cancer (CRC) other than KPS, this study aimed to identify new prognostic factors. Since survival following the treatment of brain metastases is highly variable and partly dependent on the clinical course of the primary tumor, investigating prognostic factors of brain metastases from CRC is important. While a number of reports have examined prognostic factors of brain metastases from CRC [14,15,16,17,18], these studies did not adopt KPS as a covariate, which as mentioned above is a significant prognostic factor in the DS-GPA model. The present study aimed to investigate prognostic factors of brain metastases from CRC, including KPS as an essential covariate, in order to provide insight that could help in the development of appropriate treatment strategies for brain metastases
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
