Neurosurgical colonic adenocarcinoma metastasis in Northern Sydney/Central Coast area health service. A review

Cerebral metastases from gastrointestinal primaries constitute approximately 3–5% of surgically resected brain tumors. To date, there has been a paucity of data concerning the survival and clinical course of patients undergoing neurosurgical treatment for cerebral metastases from colorectal origin. We examined the clinical course and survival of 32 patients undergoing neurosurgical intervention for colorectal carcinoma metastases between 1999 and 2007. The 21 male and 11 female patients we examined had a median age of 61.8 years at diagnosis. The median interval between colon cancer diagnosis and cerebral metastatic disease was 27.6 months. Eighty-eight percent of patients underwent microsurgical resection. The median survival from neurosurgical intervention was 7.5 months. Perioperative mortality was 3%. Age, gender, and infratentorial location of lesions had no significant impact on survival. Patients who underwent whole brain radiotherapy (WBRT) had significantly longer survival than patients who did not undergo WBRT (median survival, 10.6 vs. 5.2 months; p=0.018). A randomized controlled trial of the utility of WBRT following surgical resection in this tumor subtype seems appropriate.