Patients with brain metastasis from colorectal cancer

Background: This study aimed to retrospectively evaluate the treatment strategies and possible prognostic factors in patients with brain metastases (BMs) from colorectal cancers (CRC). Methods We retrospectively reviewed 40 patients with BMs from CRC who were treated at our center between July 2011 and May 2022. Clinicopathological characteristics and clinical outcomes were analyzed. Results The median follow-up time was 3 (range, 0.5–28) months. The median survival time after diagnosis of BMs was 4 months. The 1-year survival rate was 9.5%. In the univariate analysis, the absence of extracranial metastases was significantly associated with better overall survival (OS) but not intracranial progression-free survival (iPFS), while Eastern Cooperative Oncology Group performance status, recursive partitioning analysis (RPA) classification and local treatment of BMs were significantly associated with iPFS and OS. Multivariate analysis showed that only local treatment of BMs influenced the iPFS and OS. In addition, the OS was better in patients with intracranial benefit. The median time interval between the diagnosis of the primary tumor and BMs was 28 (range, 2–107) months. Among these BMs, 16.2% of the BM occurred within the first year after diagnosis of the primary tumor, 43.2% in the first 2 years, and 67.6% in the first 3 years. Conclusions local treatment of BMs was an independent prognostic factor for patients with BMs from CRC. Earlier detection followed by an aggressive local therapeutic approach for BMs had a great influence on treatment outcomes as well as the long-term prognosis and quality of life.