학술논문

Surgical excision and radiotherapy for brain metastasis from colorectal cancer: How frailty and comorbidity indices influence outcome
Document Type
Report
Source
The Kaohsiung Journal of Medical Sciences. April, 2024, Vol. 40 Issue 4, p395, 9 p.
Subject
Oncology, Experimental
Metastasis
Comorbidity
Colorectal cancer
Cancer -- Research
Radiotherapy
Language
English
ISSN
1607-551X
Abstract
The incidence of brain metastasis (BM) from colorectal cancer (CRC) is increasing. This study aims to identify the clinical prognosticators and evaluate the prognostic validity of common comorbidity indices in patients with BM from CRC. This retrospective single‐center study analyzed 93 patients with BM from CRC who received surgical excision and/or radiotherapy. The clinical characteristics and prognostic indices including the 5‐item modified frailty index (mFI‐5) and prognostic nutritional index (PNI) were calculated from the collected patient data and analyzed. In this study, 66 (71.0%), 10 (10.8%), and 17 (18.3%) patients received whole‐brain radiotherapy (WBRT) alone, surgery alone, and surgery plus WBRT, respectively. The median survival of all patients was 3.98 months (IQR: 1.74–7.99). The 2‐ and 3‐year survival rates were 7.4% and 3.7%, respectively. Controlled primary tumor (p = 0.048), solitary BM (p = 0.001), surgery + radiation (p < 0.001), and greater PNI (p = 0.001) were independent predictors of favorable survival. In surgically treated patients, uncontrolled primary tumor (p = 0.006), presence of multiple BM (p < 0.001), and MFI‐5 ≥ 2 (p = 0.038) were independent prognosticators. For patients who received WBRT, the presence of two (p = 0.004) or multiple (p < 0.001) BM and PNI (p < 0.001) were independent survival predictors MFI‐5, multiple BM, and the status of the primary tumor were independent prognosticators for patients who underwent surgery for CRCBM. For patients who received WBRT, the PNI and the number of BM were independent survival predictors.
INTRODUCTION Brain metastasis (BM) from colorectal cancer (CRC) is an emerging challenge for neurosurgeons and neuro‐oncologists because of the advances in therapeutic modalities and improved survival in patients with CRC.[sup.1] [...]