Randrian Violaine, Portales Fabienne, Bouché Olivier, Thezenas Simon, Chibaudel Benoist, Mabro May, Terrebonne Eric, Garnier-Tixidre Claire, Louvet Christophe, André Thierry, Aparicio Thomas, Dubreuil Olivier, Bouché Gregoire, Ychou Marc, Tougeron David
Department of Hepatology and Gastro-enterology, CHU de Poitiers, Poitiers, France.
PRODICET, UR24144, Université de Poitiers, Poitiers, France.
J Neurooncol. 2025 Mar;172(1):229-238. doi: 10.1007/s11060-024-04905-x. Epub 2025 Jan 2.
Availability data are scarce and primarily retrospective in patients with brain metastasis (BM) from gastrointestinal (GI) cancers. The objective of this cohort was to determine prognostic factors for survival outcomes in patients with BM from GI cancers.
METACER is a national multicentric prospective cohort study which included patients with BM diagnosis during a histologically proven digestive cancer follow-up between 2010 and 2014. The primary endpoint was overall survival (OS). The secondary endpoints were Progression-Free survival (PFS), prognostic factors, and BM-free survival as time from disease diagnosis to BM diagnosis.
METACER included 130 patients, with colorectal cancer (CRC) (N = 105) and eso-gastric (N = 25) cancer (EGC). The median OS was 6.6 months: 7.1 months (95%CI: 4.7-9.7) in CRC patients and 5.2 months, (95%CI: 1.9-7.6) in EG patients (p = 0.827). In multivariate analysis, cerebral BM location (versus cerebellar), BM surgery, performance status (0-1 versus 2), and a unique BM were significantly associated with prolonged OS. BM-free survival were 30.8 months (95%CI:25.2-36.9) in CRC patients and 7.8 months (95%CI:3.8-13.6) in EGC patients (p < 0.001). In synchronous metastatic disease, BM-free survival were 18.6 months (95%CI:13.1-25.2) in CRC patients and 3.7 months (95%CI:0.03-7.8) in EGC patients (p < 0.001).
BM in GI cancers are of poor prognosis. BM surgery should be considered in case of unique brain lesion. In metastatic settings, EGC patients have shorter BM-free survival than CRC patients.
关于胃肠道（GI）癌脑转移（BM）患者的可获得数据稀缺且主要为回顾性研究。本队列研究的目的是确定GI癌脑转移患者生存结局的预后因素。
METACER是一项全国多中心前瞻性队列研究，纳入了2010年至2014年间在经组织学证实的消化道癌随访期间诊断为BM的患者。主要终点为总生存期（OS）。次要终点为无进展生存期（PFS）、预后因素以及从疾病诊断到BM诊断的无BM生存期。
METACER纳入了130例患者，其中结直肠癌（CRC）患者105例，食管胃癌（EGC）患者25例。中位总生存期为6.6个月：CRC患者为7.1个月（95%CI：4.7 - 9.7），EG患者为5.2个月（95%CI：1.9 - 7.6）（p = 0.827）。多因素分析显示，脑BM位置（相对于小脑）、BM手术、体能状态（0 - 1对比2）以及单一BM与总生存期延长显著相关。CRC患者的无BM生存期为30.8个月（95%CI：25.2 - 36.9），EGC患者为7.8个月（95%CI：3.8 - 13.6）（p < 0.001）。在同时性转移疾病中，CRC患者的无BM生存期为18.6个月（95%CI：13.1 - 25.2），EGC患者为3.7个月（95%CI：0.03 - 7.8）（p < 0.001）。
GI癌脑转移预后较差。对于单一脑病灶患者应考虑进行BM手术。在转移情况下，EGC患者的无BM生存期短于CRC患者。
