Brain metastasis in advanced colorectal cancer: results from the South Australian metastatic colorectal cancer (SAmCRC) registry
<b>Objective: </b> Brain metastasis is considered rare in metastatic colorectal cancer (mCRC); thus, surveillance imaging does not routinely include the brain. The reported incidence of brain metastases ranges from 0.6% to 3.2%. <b>Methods: </b> The South Australian mCRC Regi...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
China Anti-Cancer Association
2017-08-01
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| Series: | Cancer Biology & Medicine |
| Subjects: | |
| Online Access: | http://www.cancerbiomed.org/index.php/cocr/article/view/1072 |
| _version_ | 1818028009020456960 |
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| author | Gonzalo Tapia Rico Timothy J. Price Christos Karapetis Cynthia Piantadosi Rob Padbury Amitesh Roy Guy Maddern James Moore Scott Carruthers David Roder Amanda R. Townsend |
| author_facet | Gonzalo Tapia Rico Timothy J. Price Christos Karapetis Cynthia Piantadosi Rob Padbury Amitesh Roy Guy Maddern James Moore Scott Carruthers David Roder Amanda R. Townsend |
| author_sort | Gonzalo Tapia Rico |
| collection | DOAJ |
| description | <b>Objective: </b> Brain metastasis is considered rare in metastatic colorectal cancer (mCRC); thus, surveillance imaging does not routinely include the brain. The reported incidence of brain metastases ranges from 0.6% to 3.2%. <b>Methods: </b> The South Australian mCRC Registry (SAmCRC) was analyzed to assess the number of patients presenting with brain metastasis during their lifetime. Due to small numbers, a descriptive analysis is presented. <b>Results: </b> Only 59 patients of 4,100 on the registry at the time of analysis had developed brain metastasis (1.4%). The clinical characteristics of those with brain metastasis were as follows: the median age was 65.3 years and 51% were female. Where the V-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog (<i>KRAS</i>) mutation status of the tumor was known, the majority harbored a <i>KRAS</i> mutation (55%); 31 (53%) underwent craniotomy and 55 (93%) underwent whole-brain radiotherapy. The median survival time from diagnosis of brain metastasis was 4.2 months (95% confidence interval 2.9–5.5). Patients who underwent craniotomy and radiotherapy had superior survival compared to those who underwent whole-brain radiotherapy (8.5 months <i>vs</i>. 2.2 months, respectively). Data from the SAmCRC (a population-based registry) confirm that brain metastases are rare and the median time to development is approximately 2 years. <b>Conclusions: </b> Brain metastasis is a rare outcome in advanced CRC. Patients within the registry tended to be female, young in age, and harbored with higher rates of <i>KRAS</i> mutations. Whether routine surveillance brain scanning should be considered remains controversial given the relative rarity of developing brain metastases in mCRC and ultimately, most patients with central nervous system involvement die from their extracranial disease. |
| first_indexed | 2024-12-10T04:56:58Z |
| format | Article |
| id | doaj.art-57df834ed4dd4a78a18ceec8278aa3bf |
| institution | Directory Open Access Journal |
| issn | 2095-3941 2095-3941 |
| language | English |
| last_indexed | 2024-12-10T04:56:58Z |
| publishDate | 2017-08-01 |
| publisher | China Anti-Cancer Association |
| record_format | Article |
| series | Cancer Biology & Medicine |
| spelling | doaj.art-57df834ed4dd4a78a18ceec8278aa3bf2022-12-22T02:01:29ZengChina Anti-Cancer AssociationCancer Biology & Medicine2095-39412095-39412017-08-0114437137610.20892/j.issn.2095-3941.2017.00682017000068Brain metastasis in advanced colorectal cancer: results from the South Australian metastatic colorectal cancer (SAmCRC) registryGonzalo Tapia Rico0Timothy J. Price1Christos Karapetis2Cynthia Piantadosi3Rob Padbury4Amitesh Roy5Guy Maddern6James Moore7Scott Carruthers8David Roder9Amanda R. Townsend10Department of Medical Oncology, The Queen Elizabeth Hospital and University of Adelaide, Adelaide SA 5011, Australia;Department of Medical Oncology, The Queen Elizabeth Hospital and University of Adelaide, Adelaide SA 5011, Australia;Department of Medical Oncology, Flinders Medical Center and Flinders University, Adelaide SA 5042, Australia;Department of Surgery, Flinders Medical Center, Bedford Park SA 5042, Australia;Department of Surgery, Flinders Medical Center, Bedford Park SA 5042, Australia;Department of Medical Oncology, Flinders Medical Center and Flinders University, Adelaide SA 5042, Australia;Department of Surgery, The Queen Elizabeth Hospital, Adelaide SA 5011, Australia;Department of Surgery, Royal Adelaide Hospital, Adelaide SA 5000, Australia;Department of Radiation Oncology, Royal Adelaide Hospital, Adelaide SA 5000, Australia;Department of Epidemiology, University of South Australia, Adelaide SA 5005, AustraliaDepartment of Medical Oncology, The Queen Elizabeth Hospital and University of Adelaide, Adelaide SA 5011, Australia;<b>Objective: </b> Brain metastasis is considered rare in metastatic colorectal cancer (mCRC); thus, surveillance imaging does not routinely include the brain. The reported incidence of brain metastases ranges from 0.6% to 3.2%. <b>Methods: </b> The South Australian mCRC Registry (SAmCRC) was analyzed to assess the number of patients presenting with brain metastasis during their lifetime. Due to small numbers, a descriptive analysis is presented. <b>Results: </b> Only 59 patients of 4,100 on the registry at the time of analysis had developed brain metastasis (1.4%). The clinical characteristics of those with brain metastasis were as follows: the median age was 65.3 years and 51% were female. Where the V-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog (<i>KRAS</i>) mutation status of the tumor was known, the majority harbored a <i>KRAS</i> mutation (55%); 31 (53%) underwent craniotomy and 55 (93%) underwent whole-brain radiotherapy. The median survival time from diagnosis of brain metastasis was 4.2 months (95% confidence interval 2.9–5.5). Patients who underwent craniotomy and radiotherapy had superior survival compared to those who underwent whole-brain radiotherapy (8.5 months <i>vs</i>. 2.2 months, respectively). Data from the SAmCRC (a population-based registry) confirm that brain metastases are rare and the median time to development is approximately 2 years. <b>Conclusions: </b> Brain metastasis is a rare outcome in advanced CRC. Patients within the registry tended to be female, young in age, and harbored with higher rates of <i>KRAS</i> mutations. Whether routine surveillance brain scanning should be considered remains controversial given the relative rarity of developing brain metastases in mCRC and ultimately, most patients with central nervous system involvement die from their extracranial disease.http://www.cancerbiomed.org/index.php/cocr/article/view/1072Brain metastasiscolorectal cancersurvivalsurveillance |
| spellingShingle | Gonzalo Tapia Rico Timothy J. Price Christos Karapetis Cynthia Piantadosi Rob Padbury Amitesh Roy Guy Maddern James Moore Scott Carruthers David Roder Amanda R. Townsend Brain metastasis in advanced colorectal cancer: results from the South Australian metastatic colorectal cancer (SAmCRC) registry Cancer Biology & Medicine Brain metastasis colorectal cancer survival surveillance |
| title | Brain metastasis in advanced colorectal cancer: results from the South Australian metastatic colorectal cancer (SAmCRC) registry |
| title_full | Brain metastasis in advanced colorectal cancer: results from the South Australian metastatic colorectal cancer (SAmCRC) registry |
| title_fullStr | Brain metastasis in advanced colorectal cancer: results from the South Australian metastatic colorectal cancer (SAmCRC) registry |
| title_full_unstemmed | Brain metastasis in advanced colorectal cancer: results from the South Australian metastatic colorectal cancer (SAmCRC) registry |
| title_short | Brain metastasis in advanced colorectal cancer: results from the South Australian metastatic colorectal cancer (SAmCRC) registry |
| title_sort | brain metastasis in advanced colorectal cancer results from the south australian metastatic colorectal cancer samcrc registry |
| topic | Brain metastasis colorectal cancer survival surveillance |
| url | http://www.cancerbiomed.org/index.php/cocr/article/view/1072 |
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