Brain metastases from colorectal carcinoma: The long term survivors

Gerald F. Farnell, Jan Craig Buckner, Terrence L. Cascino, Michael J. O'Connell, Paula J. Schomberg, Vera Jean Suman

Research output: Contribution to journalArticle

108 Citations (Scopus)

Abstract

BACKGROUND. Brain metastases occur in 25% to 35% of all cancer patients, with colorectal carcinoma accounting for approximately 8% of these. Information about patients with brain metastases from colorectal carcinoma is limited, with the largest previous series reporting only 40 patients. To date there have been no reports describing the subgroup of patients with long term survival (>1 yr). METHODS. A retrospective review of 150 patients seen at the Mayo Clinic between 1976 and 1993 with pathologic (56) and/or radiographic (94) confirmation of brain metastases from colorectal carcinoma is presented. RESULTS. The majority of patients (82%) with brain metastases from colorectal carcinoma have concomitant extracerebral metastases, especially in the lungs. Only 16% of the patients survived >1 year after diagnosis (4 > 4 yrs., 2 > 10 yrs). Of these 92% has single cerebral metastases and 38% had no systemic metastases. In addition, young age and the absence of bony metastases or memory loss were associated with increased survival. Median survival for all of the patients receiving surgery and radiotherapy (39) surgery alone (11), radiotherapy alone (79) and supportive care (17) are 42, 45, 16, and 8 weeks, respectively. Thirty percent of the patients treated with radiotherapy showed regression of their tumors on follow-up head scans; three had completed regression. CONCLUSIONS. One year survivors of brain metastases from colorectal carcinoma were in common, accounting for 16% of the patients and most of these (92%) had solitary lesions. Nineteen of 24 long term survivors had surgical resection as part of their treatment. Given the similar results in patients treated with surgery plus radiotherapy and those treated with surgery alone, as well as the potential long term side effects of radiotherapy, withholding radiotherapy for those for those patients with the possibility of long term survival should be considered.

Original languageEnglish (US)
Pages (from-to)711-716
Number of pages6
JournalCancer
Volume78
Issue number4
DOIs
StatePublished - Aug 15 1996

Fingerprint

Survivors
Colorectal Neoplasms
Neoplasm Metastasis
Brain
Radiotherapy
Survival
Memory Disorders
Neoplasms
Head
Lung

Keywords

  • brain metastasis
  • colorectal carcinoma
  • radiation therapy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Brain metastases from colorectal carcinoma : The long term survivors. / Farnell, Gerald F.; Buckner, Jan Craig; Cascino, Terrence L.; O'Connell, Michael J.; Schomberg, Paula J.; Suman, Vera Jean.

In: Cancer, Vol. 78, No. 4, 15.08.1996, p. 711-716.

Research output: Contribution to journalArticle

Farnell, Gerald F. ; Buckner, Jan Craig ; Cascino, Terrence L. ; O'Connell, Michael J. ; Schomberg, Paula J. ; Suman, Vera Jean. / Brain metastases from colorectal carcinoma : The long term survivors. In: Cancer. 1996 ; Vol. 78, No. 4. pp. 711-716.
@article{a0482e6e7beb477096ab14e97dcfb977,
title = "Brain metastases from colorectal carcinoma: The long term survivors",
abstract = "BACKGROUND. Brain metastases occur in 25{\%} to 35{\%} of all cancer patients, with colorectal carcinoma accounting for approximately 8{\%} of these. Information about patients with brain metastases from colorectal carcinoma is limited, with the largest previous series reporting only 40 patients. To date there have been no reports describing the subgroup of patients with long term survival (>1 yr). METHODS. A retrospective review of 150 patients seen at the Mayo Clinic between 1976 and 1993 with pathologic (56) and/or radiographic (94) confirmation of brain metastases from colorectal carcinoma is presented. RESULTS. The majority of patients (82{\%}) with brain metastases from colorectal carcinoma have concomitant extracerebral metastases, especially in the lungs. Only 16{\%} of the patients survived >1 year after diagnosis (4 > 4 yrs., 2 > 10 yrs). Of these 92{\%} has single cerebral metastases and 38{\%} had no systemic metastases. In addition, young age and the absence of bony metastases or memory loss were associated with increased survival. Median survival for all of the patients receiving surgery and radiotherapy (39) surgery alone (11), radiotherapy alone (79) and supportive care (17) are 42, 45, 16, and 8 weeks, respectively. Thirty percent of the patients treated with radiotherapy showed regression of their tumors on follow-up head scans; three had completed regression. CONCLUSIONS. One year survivors of brain metastases from colorectal carcinoma were in common, accounting for 16{\%} of the patients and most of these (92{\%}) had solitary lesions. Nineteen of 24 long term survivors had surgical resection as part of their treatment. Given the similar results in patients treated with surgery plus radiotherapy and those treated with surgery alone, as well as the potential long term side effects of radiotherapy, withholding radiotherapy for those for those patients with the possibility of long term survival should be considered.",
keywords = "brain metastasis, colorectal carcinoma, radiation therapy",
author = "Farnell, {Gerald F.} and Buckner, {Jan Craig} and Cascino, {Terrence L.} and O'Connell, {Michael J.} and Schomberg, {Paula J.} and Suman, {Vera Jean}",
year = "1996",
month = "8",
day = "15",
doi = "10.1002/(SICI)1097-0142(19960815)78:4<711::AID-CNCR3>3.0.CO;2-H",
language = "English (US)",
volume = "78",
pages = "711--716",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "4",

}

TY - JOUR

T1 - Brain metastases from colorectal carcinoma

T2 - The long term survivors

AU - Farnell, Gerald F.

AU - Buckner, Jan Craig

AU - Cascino, Terrence L.

AU - O'Connell, Michael J.

AU - Schomberg, Paula J.

AU - Suman, Vera Jean

PY - 1996/8/15

Y1 - 1996/8/15

N2 - BACKGROUND. Brain metastases occur in 25% to 35% of all cancer patients, with colorectal carcinoma accounting for approximately 8% of these. Information about patients with brain metastases from colorectal carcinoma is limited, with the largest previous series reporting only 40 patients. To date there have been no reports describing the subgroup of patients with long term survival (>1 yr). METHODS. A retrospective review of 150 patients seen at the Mayo Clinic between 1976 and 1993 with pathologic (56) and/or radiographic (94) confirmation of brain metastases from colorectal carcinoma is presented. RESULTS. The majority of patients (82%) with brain metastases from colorectal carcinoma have concomitant extracerebral metastases, especially in the lungs. Only 16% of the patients survived >1 year after diagnosis (4 > 4 yrs., 2 > 10 yrs). Of these 92% has single cerebral metastases and 38% had no systemic metastases. In addition, young age and the absence of bony metastases or memory loss were associated with increased survival. Median survival for all of the patients receiving surgery and radiotherapy (39) surgery alone (11), radiotherapy alone (79) and supportive care (17) are 42, 45, 16, and 8 weeks, respectively. Thirty percent of the patients treated with radiotherapy showed regression of their tumors on follow-up head scans; three had completed regression. CONCLUSIONS. One year survivors of brain metastases from colorectal carcinoma were in common, accounting for 16% of the patients and most of these (92%) had solitary lesions. Nineteen of 24 long term survivors had surgical resection as part of their treatment. Given the similar results in patients treated with surgery plus radiotherapy and those treated with surgery alone, as well as the potential long term side effects of radiotherapy, withholding radiotherapy for those for those patients with the possibility of long term survival should be considered.

AB - BACKGROUND. Brain metastases occur in 25% to 35% of all cancer patients, with colorectal carcinoma accounting for approximately 8% of these. Information about patients with brain metastases from colorectal carcinoma is limited, with the largest previous series reporting only 40 patients. To date there have been no reports describing the subgroup of patients with long term survival (>1 yr). METHODS. A retrospective review of 150 patients seen at the Mayo Clinic between 1976 and 1993 with pathologic (56) and/or radiographic (94) confirmation of brain metastases from colorectal carcinoma is presented. RESULTS. The majority of patients (82%) with brain metastases from colorectal carcinoma have concomitant extracerebral metastases, especially in the lungs. Only 16% of the patients survived >1 year after diagnosis (4 > 4 yrs., 2 > 10 yrs). Of these 92% has single cerebral metastases and 38% had no systemic metastases. In addition, young age and the absence of bony metastases or memory loss were associated with increased survival. Median survival for all of the patients receiving surgery and radiotherapy (39) surgery alone (11), radiotherapy alone (79) and supportive care (17) are 42, 45, 16, and 8 weeks, respectively. Thirty percent of the patients treated with radiotherapy showed regression of their tumors on follow-up head scans; three had completed regression. CONCLUSIONS. One year survivors of brain metastases from colorectal carcinoma were in common, accounting for 16% of the patients and most of these (92%) had solitary lesions. Nineteen of 24 long term survivors had surgical resection as part of their treatment. Given the similar results in patients treated with surgery plus radiotherapy and those treated with surgery alone, as well as the potential long term side effects of radiotherapy, withholding radiotherapy for those for those patients with the possibility of long term survival should be considered.

KW - brain metastasis

KW - colorectal carcinoma

KW - radiation therapy

UR - http://www.scopus.com/inward/record.url?scp=0029758389&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0029758389&partnerID=8YFLogxK

U2 - 10.1002/(SICI)1097-0142(19960815)78:4<711::AID-CNCR3>3.0.CO;2-H

DO - 10.1002/(SICI)1097-0142(19960815)78:4<711::AID-CNCR3>3.0.CO;2-H

M3 - Article

C2 - 8756361

AN - SCOPUS:0029758389

VL - 78

SP - 711

EP - 716

JO - Cancer

JF - Cancer

SN - 0008-543X

IS - 4

ER -