Description:
<jats:p> 3562 </jats:p><jats:p> Background: Brian metastases (BM) are a rare but devastating complication of colorectal cancer. We aimed to analyse prognostic factors in patients suffering from colorectal cancer (CRC) BM. Methods: Patients with histological proven CRC and BM were identified from the brain metastasis database of the Comprehensive Cancer Center Vienna. Clinical characteristics including established prognostic factors were retrieved by chart review. Established clinical prognostic scores for BM patients including the graded prognostic assessment (GPA) and the GPA for gastrointestinal tumours (GI-GPA) were calculated based on clinical characteristics as previously published. Results: 215 (male: 125/215 (58.1%); female 90/215 (41.9%)) patients with CRC BM were available for this study. The following established clinical prognostic factors showed a significant association with median overall survival (OS) times from BM diagnosis: number of brain metastases (n = 1: 6 months; n = 2-3: 4 months; n > 3: 3 months; p = 0.001), age at BM diagnosis ( < 65 years: 6 months; > 65 years: 4 months; p = 0.047), extracranial disease (present: 4 months; absent: 8 months; p = 0.002) and Karfnofsky performance score (KPS < 70%: 3 months; KPS > 70%: 5 months; p = 0.002), graded prognostic assessment (GPA) class (class I: 15 months; class II: 13 months; class III: 4 months; class IV: 4 months) and the gastro-intestinal disease-specific GI-GPA (class I: 11 months; class II: 6 months; class III: 6 months; class IV: 3 months; p < 0.001). In addition, the location of the primary tumour in the left colon (n = 176 (81.9%); 5 months) was associated with significantly longer median overall survival times from diagnosis of BM than primary tumour location in the right colon (n = 39 (18.1%); 3 months; p = 0.010). Primary tumor sidedness (HR 0.577; 95% CI 0.397-0.841; p = 0.004) remained a strong prognostic factor at multivariate analysis independently of GI-GPA (HR 0.718; 95% CI 0.612-0.842). Conclusions: Primary tumor sidedness is an independent prognostic factor in patients with CRC BM and should be included in disease-specific prognostic scores. </jats:p>