660 - Brain metastases in gastrointestinal cancers

Date 28 September 2012
Event ESMO Congress 2012
Session Publication Only
Topics Gastrointestinal Cancers
Presenter Dilek Erdem
Authors D. Erdem1, I. Yücel1, B. Yilmaz1, G. Demirag1, E. Kut1, F. Cilingir2, Y. Kemal1, F. Teker1
  • 1Medical Oncology, Ondokuzmayis University, 55210 - Samsun/TR
  • 2Internal Medicine, Ondokuzmayis University, Samsun/TR

Abstract

Aim

Only 4% of cranial metastasis occur with gastrointestinal cancer. The aim of this study is to evaluate the characteristics of cranial metastasis derived from gastrointestinal system tumors.

Material-method

1863 patients diagnosed with gastrointestinal cancers between 1997-2011 years were included. Among the patients; 51 esophageal cancer, 516 gastric cancer, 5 small intestine tumor, 878 colorectal cancer, 11 gallbladder cancer, 190 pancreas cancer, 119 hepatocellular cancer, 63 cholangiocarcinoma and 30 GIST were involved. SPSS 16 is used.

Results

20 gastrointestinal cancer patients with cranial metastases (1.07%) were included. The average age was 54.6 ± 1.1 years and 70% (n = 14) of the patients were male. 20 patients cancers were as follows: 4 gastric cancer (20%), 15 colorectal cancer ( 75%) and 1 pancreas cancer (5%). 3 patients had no extracranial metastases (15%). Lung metastases was the most common extracranial metastatic site in general, but liver was the most solitary extracranial metastatic site. The median interval of diagnosis-recurrence/metastases was 20.6 months (range 0-89 months) and the median interval of diagnosis-cranial metastases was 30.1 months (range 0-138 months). Mean OS was 36.6 months in 3 patients without extracranial metastases and 31.6 months in 17 patients with extracranial metastases.

Discussion

The most common primary sites that intend to metastasize to brain are lung and breast. Gastrointestinal tumors rarely metastasize to cranium. Our results were similar with literature: 0.7% of cranial metastases in gastric cancer and 1.7% cranial metastases in colorectal cancer.The arguing site in our study were as follows: in the literature lung was the most common site of extracranial metastases; but in our study despite being general most common extracranial metastatic site, it was not the solitary site of metastases. In 10 metastatic patients at the diagnosis, 5 were solely had liver metastases without lung metastases.

Conclusion

Cranial metastases is a rare and late sign of gastrointestinal cancers. By new approaches in diagnosis and therapy of cancer, cranial metastases is more common. All symptomatic patients and asymptomatic patients with liver or lung metastases may be suggested to be screened for brain.

Disclosure

All authors have declared no conflicts of interest.