Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Feb 15, 2020; 12(2): 195-204
Published online Feb 15, 2020. doi: 10.4251/wjgo.v12.i2.195
Prognostic scoring system for synchronous brain metastasis at diagnosis of colorectal cancer: A population-based study
Ji-Chuan Quan, Xu Guan, Chen-Xi Ma, Zheng Liu, Ming Yang, Zhi-Xun Zhao, Peng Sun, Meng Zhuang, Song Wang, Zheng Jiang, Xi-Shan Wang
Ji-Chuan Quan, Xu Guan, Chen-Xi Ma, Zheng Liu, Ming Yang, Zhi-Xun Zhao, Meng Zhuang, Zheng Jiang, Xi-Shan Wang, Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Peng Sun, Song Wang, Department of Colorectal Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin 150000, Heilongjiang Province, China
Author contributions: Quan JC and Guan X wrote the manuscript and contributed equally to this work; Jiang Z and Wang XS conceived and designed the study and are the co-corresponding authors; Quan JC, Guan X and Ma CX collected the data; Ma CX, Liu Z, Yang M, Zhao ZX, Zhuang M, Sun P and Wang S analyzed the data; all authors made critical revisions for the manuscript and approved the final version.
Supported by National Key Research and Development Program of the Ministry of Science and Technology of China, No. 2016YFC0905303, 2016YFC0905300; and Beijing Science and Technology Program, No. D171100002617004.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Informed consent statement: Informed consent was not required as the study is based on a publicly available database.
Conflict-of-interest statement: All authors declare no conflicts-of-interest related to this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Xi-Shan Wang, MD, Professor, Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China. wangxsh@126.com
Received: September 8, 2019
Peer-review started: September 8, 2019
First decision: November 11, 2019
Revised: November 14, 2019
Accepted: November 28, 2019
Article in press: November 28, 2019
Published online: February 15, 2020
ARTICLE HIGHLIGHTS
Research background

Synchronous brain metastasis (BM) from colorectal cancer (CRC) is rare, and the prognosis is poor. However, only a few studies have focused on the analysis of synchronous BM, and there is no prognostic scoring system specifically for synchronous BM from CRC to date. Therefore, more studies on synchronous BM from CRC are needed.

Research motivation

We comprehensively evaluated the prognostic factors of synchronous BM, and further constructed a scoring system to accurately predict survival.

Research objectives

This study was designed to confirm the clinical value of the prognostic scoring system for synchronous BM at diagnosis of CRC.

Research methods

We retrospectively studied patients with synchronous BM from CRC using the Surveillance, Epidemiology, and End Results database. The Kaplan-Meier method was used to assess the median survival time, and Cox proportional hazards models were used to determine the independent prognostic factors. A scoring system was constructed to stratify the patients into different subgroups, and the survival differences among different subgroups were compared.

Research results

The results showed that age, carcinoembryonic antigen level and extracranial metastasis to liver, lung or bone were independent prognostic factors. A scoring system based on the three independent prognostic factors classified the patients into three prognostic subgroups: group I (score 0-1), group II (score 2-3), and group III (score 4). The median survival was 14 mo for group I, 5 mo for group II, and 2 mo for group III, and there were significant differences in prognosis among the groups (P < 0.001).

Research conclusions

This study is the first to construct a scoring system specifically for synchronous BM from CRC, and we confirm that the scoring system accurately distinguishes the survival differences among different patients.

Research perspectives

The scoring system can be used as an effective prognostic predictive tool to help clinicians quickly and conveniently predict survival.