Risk Factors on the Incidence and Prognostic Effects of Colorectal Cancer With Brain Metastasis: A SEER-Based Study

Frontiers in Oncology

Yanli Xiong¹  Xiang Xu¹  Le He¹  Xiaofeng Wu²  Yuhong Li³  Chenghai Zuo⁴  Mengxia Li⁴  Quan Chen⁵  Juan Li⁵  Rongrui Tang⁵  Chengxiu Pu⁵ 

[1] Regenerative Medicine, State Key Laboratory of Trauma, Burn and Combined Injury, Daping Hospital, Army Medical University, Chongqing, China;Cancer Center, Daping Hospital, Army Medical University, Chongqing, China;Department of Gastroenterology, Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing, China;Department of Neurosurgery and Key Laboratory of Neurotrauma, Southwest Hospital, the Third Military Medical University, Chongqing, China;;Department of Stem Cell &

关键词: colorectal cancer;    brain metastasis;    incidence;    risk factor;    prognosis;    SEER;   

DOI  :  10.3389/fonc.2022.758681

来源: DOAJ

【 摘 要 】

BackgroundColorectal cancer (CRC) with brain metastases (BM) is uncommon and often diagnosed at a late stage. The aims of this study were to identify the clinical factors that can influence the incidence of CRC patients with BM (CRCBM) and to investigate the impact of clinical factors and therapies on the outcomes of CRCBM.MethodsBetween 2010 and 2018, patients with CRCBM were enrolled under the Surveillance, Epidemiology, and End Results (SEER) program. Multivariable logistic and Cox regression models were used to identify risk factors and prognostic factors of BM. Kaplan–Meier curve and log-rank test were used to evaluate overall survival (OS) and tumor-specific survival (CSS) of CRCBM patients.ResultsA total of 195 (0.34%) CRC patients initially diagnosed with BM were included for analysis. The positive level of CEA, pN2a-b, and additional organ metastases were positively associated with developing BM from the CRC cohort (p < 0.05). The median OS and CSS of the BM patients were both 4.0 months, while the corresponding survival time in CRC patients without BM was 14.0 and 16.0 months, respectively (HR = 2.621, 95% CI = 2.061–3.333 for CSS; HR = 2.556, 95% CI = 2.026–3.225 for OS; log rank p < 0.001, each). Only systematic treatment was independently associated with better survival (p < 0.05, each).ConclusionsAlthough the overall prognosis of CRCBM patients was extremely poor, the positive level of CEA, pN2a-b, and distant metastases could be bad risk factors for the incidence of CRCBM. In addition, only systematic treatment was found to be a negative prognostic factor for CRCBM patients. These related factors can provide more valuable reference for clinical individualized treatments.

【 授权许可】

Unknown