| Autor: |
Thurmaier, Johannes, Heinemann, Volker, Engel, Jutta, Schubert‐Fritschle, Gabriele, Wiedemann, Max, Nüssler, Natascha C., Ruppert, Reinhard, Kleeff, Jörg, Schepp, Wolfgang, Löhe, Florian, Karthaus, Meinolf, Neumann, Jens, Kumbrink, Jörg, Taverna, Francesco, Stahler, Arndt, Heinrich, Kathrin, Westphalen, Christoph Benedikt, Holch, Julian W., Kirchner, Thomas, Michl, Marlies |
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| Zdroj: |
International Journal of Cancer; Apr2021, Vol. 148 Issue 8, p1919-1927, 9p |
| Abstrakt: |
The aim of the study was to investigate the predictive impact of extracranial metastatic patterns on course of disease and survival in patients with colorectal cancer (CRC) and brain metastasis (BM). A total of 228 patients (134 male [59%], 94 female [41%]) with histologically proven CRC and BM were classified into different groups according to extracranial metastatic patterns. Time intervals to metastatic events and survival times from initial CRC diagnosis, extracranial and intracranial metastasis were analyzed. Extracranial organs mostly affected were liver (102 of 228 [44.7%]) and lung (96 of 228 [42.1%]). Liver and lung metastases were detected in 31 patients (13.6%). Calculated over the entire course of disease, patients with lung metastasis showed longer overall survival (OS) than patients with liver metastasis or patients without lung metastasis (43.9 vs 34.6 [P =.002] vs 35.0 months [P =.002]). From the date of initial CRC diagnosis, lung metastasis occurred later in CRC history than liver metastasis (24.3 vs 7.5 months). Once lung metastasis was diagnosed, BM occurred faster than in patients with liver metastasis (15.8 vs 26.0 months; Δ 10.2 months). Accordingly, OS from the diagnosis of liver metastasis was longer than from lung metastasis (27.1 vs 19.6 months [P =.08]). Once BM was present, patients with lung metastasis lived longer than patients with liver metastasis (3.8 vs 1.1 months [P =.028]). Shortest survival times in all survival categories analyzed revealed patients with concurrent liver and lung metastasis. Patients with CRC and BM form a heterogeneous cohort where extracranial metastasis to liver or lungs predicts survival. What's new? Brain metastases occur in around 5% of patients with colorectal cancer. These are generally not diagnosed until symptoms arise, and usually after other metastases have been found. Here, the authors evaluated patterns of metastases to the liver, lung, or both, looking for an association with survival. Brain metastasis occurs later in patients with lung metastasis than with liver metastasis, and overall survival is longer in patients with lung than with liver metastasis. This is the first analysis of metastasis patterns and survival in CRC patients, and the authors recommend routine cerebral imaging for CRC patients to detect brain metastases. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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