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International Journal of Clinical Oncology

Erschienen in:

03.08.2018 | Original Article

Novel graded prognostic assessment for colorectal cancer patients with brain metastases

verfasst von: Byoung Hyuck Kim, Hae Jin Park, Kyubo Kim, Sae-Won Han, Tae-You Kim, Seung-Yong Jeong, Kyu Joo Park, Eui Kyu Chie

Erschienen in: International Journal of Clinical Oncology | Ausgabe 6/2018

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Abstract

Purpose

It is important to take into account potential prognostic factors to select patients with brain metastasis from colorectal cancer (CRC) who will benefit from active neurosurgical treatment. Therefore, we experimentally investigated our single institutional data to develop a novel CRC-specific graded prognostic assessment (GPA) and to help clinicians determine the optimal management.

Methods and materials

We retrospectively reviewed the records of 107 patients with brain metastases from CRC who received any kind of treatment in our hospital and had sufficient clinical information.

Results

The median overall survival was 5.2 months, and the 1- and 2-year overall survival rates were 23.7 and 6.6%, respectively. Multivariate analysis revealed that the number of brain metastases ≥ 6, presence of neurologic symptoms, and elevated serum carcinoembryonic antigen (≥ 30 ng/ml) were the independent prognostic factors for poor overall survival, while performance status was not. Based on this, we developed the CRC-specific GPA index and stratified patients into three categories. The median overall survival for patients with GPA scores of 0–0.5, 1.0–1.5, and 2.0–2.5 was 2.3, 4.3, and 12.7 months, respectively (p < 0.001). Surgery or stereotactic radiosurgery ± whole-brain radiotherapy showed a better survival than palliative whole-brain radiotherapy alone in patients with high GPA scores.

Conclusions

We developed a novel CRC-specific GPA index, which could help physicians to stratify patients with brain metastases. Further efforts are needed to validate and improve this index.

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Titel: Novel graded prognostic assessment for colorectal cancer patients with brain metastases
verfasst von: Byoung Hyuck Kim
Hae Jin Park
Kyubo Kim
Sae-Won Han
Tae-You Kim
Seung-Yong Jeong
Kyu Joo Park
Eui Kyu Chie
Publikationsdatum: 03.08.2018
Verlag: Springer Japan
Erschienen in: International Journal of Clinical Oncology / Ausgabe 6/2018
Print ISSN: 1341-9625
Elektronische ISSN: 1437-7772
DOI: https://doi.org/10.1007/s10147-018-1329-9

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Novel graded prognostic assessment for colorectal cancer patients with brain metastases