Yang Lin, He Wenzhuo, Xie Qiankun, Liu Shousheng, Kong Pengfei, Jiang Chang, Zhang Bei, Xia Liangping
Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China,
State Key Laboratory of Oncology in Southern China, Guangzhou, China,
Cancer Manag Res. 2018 Nov 15;10:5649-5658. doi: 10.2147/CMAR.S180173. eCollection 2018.
Population-based incidence evaluations and prognosis assessments of brain metastasis (BM) at diagnosis of colorectal cancer (CRC) are lacking. Our study sought to determine the incidence of BM in CRC patients, median survival of patients with BM, and the risk factors of BM in CRC.
Patients diagnosed with CRC were identified using the Surveillance, Epidemiology, and End Results database. Multivariable logistic and Cox regression analyses were performed to identify predictors of the presence of BM at CRC diagnosis and the factors associated with poor survival. Kaplan-Meier analysis was used to estimate the survival difference between subgroups.
We identified 170,793 adult patients diagnosed with CRC between 2010 and 2013. From these patients, we identified 401 patients with BM at the time of CRC diagnosis, which represents 0.23% of the entire patient CRC cohort and 1.3% of the patients with metastatic disease to any site. Median survival of patients with BM was 7.0 months, and the survival could increase to 15.59 months if there was no metastasis to other organs. We found that extracranial metastases number, tumor site, and pathology type were associated with BM at CRC diagnosis.
The findings of this study indicate the incidence and prognosis for patients with BM at the time of CRC diagnosis. Our findings lend support for positive treatment for BM without metastasis to other organs.
目前缺乏基于人群的结直肠癌(CRC)诊断时脑转移(BM)的发病率评估和预后评估。我们的研究旨在确定CRC患者中BM的发病率、BM患者的中位生存期以及CRC中BM的危险因素。
使用监测、流行病学和最终结果数据库识别诊断为CRC的患者。进行多变量逻辑回归和Cox回归分析,以确定CRC诊断时BM存在的预测因素以及与生存不良相关的因素。采用Kaplan-Meier分析来估计亚组之间的生存差异。
我们识别出2010年至2013年间诊断为CRC的170,793名成年患者。在这些患者中,我们识别出401名在CRC诊断时患有BM的患者,占整个CRC患者队列的0.23%,占任何部位有转移疾病患者的1.3%。BM患者的中位生存期为7.0个月,如果没有其他器官转移,生存期可延长至15.59个月。我们发现颅外转移数量、肿瘤部位和病理类型与CRC诊断时的BM相关。
本研究结果表明了CRC诊断时BM患者的发病率和预后。我们的研究结果支持对无其他器官转移的BM进行积极治疗。