Quan Jichuan, Ma Chenxi, Sun Peng, Wang Song, Zhuang Meng, Liu Zheng, Jiang Zheng, Chen Haipeng, Yang Ming, Zhao Zhixun, Guan Xu, Wang Xishan
Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Colorectal Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
Scand J Gastroenterol. 2019 Nov;54(11):1370-1375. doi: 10.1080/00365521.2019.1686056. Epub 2019 Nov 5.
Brain metastasis (BM) from colorectal cancer (CRC) seriously affects the survival and quality of life of patients. However, this disease is not fully understood. It is not clear when follow-up monitoring should be conducted to achieve early diagnosis. Furthermore, the reported prognostic factors have varied among different studies. Our study aims to determine the clinicopathological, survival and prognostic factors, as well as the timing of BM occurrence. We retrospectively studied the patients with BM from CRC between January 2000 and July 2017. The clinicopathologic features were assessed, and the time from primary tumor surgery and extracranial metastases (lung, liver and bone) to the occurrence of BM was calculated, respectively. Survival time after BM was statistically analyzed. Multivariate Cox analysis was carried out to determine the independent factors that affected survival. 52 patients were analyzed. Most of the patients (86.5%) had combined extracranial metastases when BM was diagnosed, and lung was the commonest extracranial metastasis location. The median time interval from CRC surgery to the diagnosis of BM was 20.5 months, and the median time interval from lung, liver and bone metastases to BM was 7, 5 and 2 months, respectively. After diagnosis of BM, the median survival was 9 months. Extracranial metastases ( =.012) and Karnofsky performance status ( =.025) were independent prognostic factors based on multivariate analysis. BM from colorectal cancer often occur in the late stage, and has an extremely poor prognosis. Identifying the timing of brain metastasis can help to detect this disease early.
结直肠癌脑转移（BM）严重影响患者的生存和生活质量。然而，这种疾病尚未被完全了解。目前尚不清楚何时应进行随访监测以实现早期诊断。此外，不同研究报告的预后因素也各不相同。我们的研究旨在确定临床病理特征、生存情况和预后因素，以及BM发生的时间。我们回顾性研究了2000年1月至2017年7月期间发生结直肠癌脑转移的患者。评估了临床病理特征，并分别计算了从原发性肿瘤手术和颅外转移（肺、肝和骨）到BM发生的时间。对BM后的生存时间进行了统计分析。进行多变量Cox分析以确定影响生存的独立因素。共分析了52例患者。大多数患者（86.5%）在诊断BM时合并有颅外转移，肺是最常见的颅外转移部位。从结直肠癌手术到诊断BM的中位时间间隔为20.5个月，从肺、肝和骨转移到BM的中位时间间隔分别为7、5和2个月。诊断BM后，中位生存期为9个月。多变量分析显示，颅外转移（P = 0.012）和卡诺夫斯基功能状态（P = 0.025）是独立的预后因素。结直肠癌脑转移通常发生在晚期，预后极差。确定脑转移的时间有助于早期发现这种疾病。
