Risk factor analysis for brain metastasis after radical resection of colorectal cancer within 5 years / 第二军医大学学报

ABSTRACT

Objective To explore the risk factors of brain metastasis after radical resection of colorectal cancer within 5 years.Methods We retrospectively analyzed the clinical data of 1 104 patients with colorectal cancer in the Department of Colorectal Surgery of Changhai Hospital of Second Military Medical University from Jan.2003 to Dec.2011.Thirty of 1 104 cases (2.7％) had brain metastasis.All patients received radical resection of colorectal cancer,and the rectal cancer patients followed the total mesorectal excision (TME) principle.According to the TME stage,the patients of stage Ⅱ or later were treated with capecitabine combined with oxaliplatin (XELOX) or fluorouracil plus oxaliplatin (FOLFOX) chemotherapy.The clinicopathological features that might affect post-operative brain metastasis,including gender,age,tumor location,pre-operative serum carcino-embryonic antigen (CEA) level,tumor histological type,depth of tumor invasion,lymph node metastasis,pulmonary metastases and liver metastases,were analyzed by univariate analysis using Chi square test.Multivariate analysis was performed to search for the independent risk factors of brain metastasis from colorectal cancer using logistic regression.Results Univariate Chi square test indicated that the relative factors associated with the brain metastasis of colorectal cancer within 5 years were tumor location (x2=5.844,P=0.016),pre-operative CEA level (x2 =5.395,P =0.020),tumor histological type (x2 =4.950,P =0.026) and with pulmonary metastasis (x2=52.569,P=0.000).Multivariate analysis showed that the tumor location (OR=0.278,95％CI:0.095-0.817,P=0.020),pre-operative CEA level (OR=0.423,95％CI:0.192-0.933,P=0.033) and with pulmonary metastasis (OR=-10.814,95％CI:4.705-24.856,P=0.000) were the independent risk factors of brain metastasis of colorectal cancer within 5 years.Conclusion Patients with rectal cancer,higher pre-operative CEA level and pulmonary metastasis have a high risk of brain metastasis of colorectal cancer within 5 years.