Human Neurosciences Department Neurosurgery Division, Sapienza University Rome, Rome, Italy.
Neuroscience Department "Rita Levi Montalcini", Neurosurgery Unit, Università degli studi di Torino, Turin, Italy; Experimental Neurosurgery Unit, IRCCS "Neuromed", Pozzilli, Italy.
World Neurosurg. 2024 Sep;189:e1040-e1048. doi: 10.1016/j.wneu.2024.07.073. Epub 2024 Jul 14.
Brain metastases (BMs) from colorectal cancer (CRC) are a small percentage of metastatic patients and surgery is considered the best choice to improve survival. While most research has focused on the risk of CRC spreading to the brain, no studies have examined the characteristics of BMs in relation to surgery and outcome. In this study, we evaluate the clinical and radiologic features of BMs from CRC patients who underwent surgery and analyze their outcomes.
The study is a retrospective observational analysis that included a cohort of 31 patients affected by CRC surgically-treated for their related BMs. For all patients, clinical and surgical data (number, site, side, tumor and edema volume, and morphology) were recorded.
Analysis found that synchronous diagnosis and lesion morphology, particularly cystic versus solid, had the most significant impact on survival (6 vs. 22 months, P = 0.04). To compare BMs with cystic morphology to those with solid morphology, a multivariate analysis was conducted. No significant differences were observed between the 2 groups in terms of age, sex, clinical onset, or performance status. The analysis revealed no significant differences in localization with regard to site, tumor and edema volume, biology, or complications rate.
BMs derived from CRC have a significantly different prognosis depending on whether they present as a solid or cystic pattern. Although solid pattern is more common, cystic BMs in this tumor type are less frequent and are associated with a poorer prognosis, regardless of molecular expression, location, size, and adjuvant treatment.
结直肠癌（CRC）脑转移（BMs）在转移性患者中占比较小，手术被认为是改善生存的最佳选择。虽然大多数研究都集中在 CRC 扩散到大脑的风险上，但没有研究检查与手术和结果相关的 BMs 的特征。在这项研究中，我们评估了接受手术治疗的 CRC 患者的 BMs 的临床和影像学特征，并分析了他们的结局。
本研究是一项回顾性观察分析，包括 31 名接受手术治疗 CRC 相关 BMs 的患者队列。对所有患者，均记录了临床和手术数据（数量、部位、侧别、肿瘤和水肿体积及形态）。
分析发现，同步诊断和病变形态，特别是囊性与实性，对生存有最显著影响（6 个月与 22 个月，P=0.04）。为了比较具有囊性形态的 BMs 和具有实性形态的 BMs，进行了多变量分析。两组在年龄、性别、临床发病情况或表现状态方面无显著差异。分析显示，两组在部位、肿瘤和水肿体积、生物学和并发症发生率方面无显著差异。
CRC 来源的 BMs 的预后显著不同，取决于其是否呈实性或囊性模式。尽管实性模式更为常见，但这种肿瘤类型的囊性 BMs 较少见，且预后较差，无论分子表达、位置、大小和辅助治疗如何。
