Hammoud M A, McCutcheon I E, Elsouki R, Schoppa D, Patt Y Z
Department of Neurosurgery, University of Texas M. D. Anderson Cancer Center, Houston 77030, USA.
Ann Surg Oncol. 1996 Sep;3(5):453-63. doi: 10.1007/BF02305763.
Brain metastasis from colorectal cancer is rare. The present study reports the nature of this disease and analyzes factors correlated with survival in patients harboring such disease.
One hundred patients diagnosed between 1980 and 1994 with metastatic brain tumors secondary to colorectal adenocarcinoma were retrospectively reviewed. Of these patients, 36 underwent surgery, 57 underwent radiotherapy alone, and the remaining seven received steroids.
The most common primary sites were the sigmoid colon and rectum (65%). Brain metastases with concomitant liver and/or lung metastases were seen more frequently than brain metastases alone. The median interval between the diagnosis of primary cancer and the diagnosis of brain metastasis was 26 months (95% confidence interval = 22-30). The median survival time after the diagnosis of brain metastasis was 1 month for patients who received only steroids, 3 months for those who received radiotherapy (p = 0.1), and 9 months for those who underwent surgery (p < 0.0001). The extent of noncerebral systemic disease was not correlated with survival (p > 0.05), but early onset of brain metastasis was significantly associated with poor prognosis (p = 0.04).
Surgical removal of colorectal metastatic brain lesions results in significantly increased survival time, regardless of the status of the noncerebral systemic disease.
结直肠癌脑转移罕见。本研究报告了该疾病的性质，并分析了患有此类疾病患者的生存相关因素。
回顾性分析了1980年至1994年间诊断为结直肠腺癌继发脑转移瘤的100例患者。其中，36例接受了手术，57例仅接受了放疗，其余7例接受了类固醇治疗。
最常见的原发部位是乙状结肠和直肠（65%）。伴有肝和/或肺转移的脑转移比单纯脑转移更常见。原发性癌症诊断与脑转移诊断之间的中位间隔为26个月（95%置信区间=22 - 30）。脑转移诊断后，仅接受类固醇治疗的患者中位生存时间为1个月，接受放疗的患者为3个月（p = 0.1），接受手术的患者为9个月（p < 0.0001）。非脑系统性疾病的范围与生存无关（p > 0.05），但脑转移的早期发生与预后不良显著相关（p = 0.04）。
手术切除结直肠转移性脑病变可显著延长生存时间，无论非脑系统性疾病的状况如何。
