Department of Neurosurgery, University Hospital Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany.
Division of Neuropathology, University Hospital Leipzig, Liebigstrasse 26, 04103, Leipzig, Germany.
BMC Cancer. 2022 Mar 28;22(1):336. doi: 10.1186/s12885-022-09435-1.
Brain metastasis (BM) of colorectal cancer is a disease with a poor prognosis of only a few months survival. However, it is difficult to estimate the individual prognosis of each patient due to the lack of definitive prognosis parameters. The number of metastases and the Karnofsky performance score are known predictors for survival. We investigated whether or not the neurological performance score and the tumor volumetrics are equally suitable predictors for survival.
All patients with histologically diagnosed BM linked to colorectal cancer between 2012 and March 2020 were reviewed. The Medical Research Council Neurological Performance Score was used to quantify neurological performance. Univariate analysis with Kaplan-Meier estimate and log-rank test was performed. Survival prediction and multivariate analysis were performed employing Cox proportional hazard regression.
Twenty-five patients were included in our analysis with an overall survival of 4.9 months after surgery of the BM. Survival decreased in the univariate analysis with increasing postoperative neurological performance score, low Karnofsky performance score, absence of radiation therapy and radiation therapy modality. The neurological performance score is a reliable scoring parameter for estimating the prognostic course analogous to the Karnofsky performance score. Neither preoperative nor post resection residual tumor volume had any impact on overall survival in our small cohort.
Our data suggest that the postoperative neurological performance is a valuable prognostic factor for colorectal cancer patients with BM. Tumor volumetrics show no correlation to survival. Further investigations with a larger number of cases are mandatory.
结直肠癌脑转移（BM）是一种预后极差的疾病，患者的生存时间仅为数月。然而，由于缺乏明确的预后参数，难以评估每个患者的个体预后。转移灶的数量和卡氏行为状态评分是已知的生存预测因子。我们研究了神经功能状态评分和肿瘤体积是否同样适用于生存预测。
回顾了 2012 年至 2020 年 3 月间所有经组织学诊断为结直肠癌脑转移的患者。采用医学研究委员会神经功能状态评分（Medical Research Council Neurological Performance Score）来量化神经功能状态。采用 Kaplan-Meier 估计和对数秩检验进行单因素分析。采用 Cox 比例风险回归进行生存预测和多因素分析。
本研究共纳入 25 例患者，BM 手术后的总体生存时间为 4.9 个月。单因素分析显示，术后神经功能状态评分增加、卡氏行为状态评分低、未行放疗和放疗方式不同均与生存率降低相关。神经功能状态评分是一种可靠的评分参数，可用于估计预后，与卡氏行为状态评分相似。我们的小样本队列中，术前和术后残留肿瘤体积均与总生存时间无相关性。
我们的数据表明，结直肠癌脑转移患者术后神经功能状态是一个有价值的预后因素。肿瘤体积与生存时间无相关性。需要进一步进行更大样本量的研究。
