KEY TAKEAWAYS
- The study aimed to identify the clinical characteristics and predictors of brain BM at the time of initial diagnosis in CRC.
- The results showed BM in mCRC leads to worse outcomes, underscoring the need for increased screening.
Colorectal cancer (CRC) is a leading cause of cancer-related deaths worldwide. While the liver is a common site for metastasis, brain metastasis (BM) is less frequent, occurring in a smaller percentage of cases. Risk factors for BM include lung metastasis at diagnosis, rectal cancer, and specific gene mutations. Due to its lower occurrence rate, guidelines for BM screening and treatment are limited.
Antoine Jeri-Yabar and the team aimed to identify the clinical characteristics and predictors of BM in patients with CRC at the time of initial diagnosis.
The study included data from patients aged 18 years and older with metastatic CRC (mCRC) and BM at diagnosis, sourced from the SEER database (2010-2021). A retrospective cohort study design was employed to analyse overall survival (OS) and predictive factors for BM.
Statistical analysis methods used included multivariate logistic regression, Kaplan-Meier survival analysis, and Cox proportional hazards models. A p-value less than 0.05 was considered statistically significant.
Of 24,703 patients with mCRC, 228 (0.92%) had BM at diagnosis. BM was more common in those with average-onset mCRC (≥50 years) compared to early-onset (<50 years) (1% vs. 0.55%, P= 0.004). Factors such as older age and adenocarcinoma subtype were linked to BM.
Additionally, Asians/Pacific Islanders (HR 1.83 CI: 1.01-3.33, P= 0.045) and American Indians/Alaska Natives (HR 4.79 CI: 1.15-19.97, P= 0.032) had higher mortality rates, while surgical treatment and chemotherapy were associated with lower mortality. Those with BM had significantly worse overall survival (6 months vs. 21 months, P< 0.001).
While BM is uncommon in mCRC, it is associated with significantly worse outcomes, including reduced overall survival.
The study findings highlighted several factors associated with BM, including older age and specific racial/ethnic groups. These findings may inform risk stratification and early detection strategies, emphasizing the need for increased awareness and screening for BM in high-risk patients with mCRC.
This research received no external funding.
Source: https://pubmed.ncbi.nlm.nih.gov/39311160/
Jeri-Yabar A, Vittini-Hernandez L, Benites-Meza JK, et al. (2024). “Survival Analysis, Clinical Characteristics, and Predictors of Cerebral Metastases in Patients with Colorectal Cancer.” Med Sci (Basel). 2024;12(3):47. Published 2024 Sep 2. doi:10.3390/medsci12030047
