Evidence map›Paper›PMID 40690187›Full record

ArticleJournal of neuro-oncology2025

Incidence, demographics, and survival of patients with brain metastases from stage IV colorectal cancer: a population-based study from 2013 to 2023.

Melanie Alfonzo Horowitz, Marvin Li, Megan Parker, Alyssa Arbuiso, Ryan Gensler, Solmaz Sahebjam, Kristin J Redmond, Dung Le, Alodia Gabre-Kidan, Nilo Azad and 2 more

Abstract read
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In one paragraph

Article in Journal of neuro-oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Melanie Alfonzo HorowitzDepartment of Neurosurgery, Johns Hopkins School of Medicine, 600 N. Wolfe Street - Phipps 123, Baltimore, MD, 21287-0005, USA.
Marvin LiDepartment of Neurosurgery, Johns Hopkins School of Medicine, 600 N. Wolfe Street - Phipps 123, Baltimore, MD, 21287-0005, USA.
Megan ParkerDepartment of Neurosurgery, Johns Hopkins School of Medicine, 600 N. Wolfe Street - Phipps 123, Baltimore, MD, 21287-0005, USA.
Alyssa ArbuisoDepartment of Neurosurgery, Johns Hopkins School of Medicine, 600 N. Wolfe Street - Phipps 123, Baltimore, MD, 21287-0005, USA.
Ryan GenslerDepartment of Neurosurgery, Johns Hopkins School of Medicine, 600 N. Wolfe Street - Phipps 123, Baltimore, MD, 21287-0005, USA.
Solmaz SahebjamDepartment of Medical Oncology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Kristin J RedmondDepartment of Radiation Oncology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Dung LeDepartment of Medical Oncology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Alodia Gabre-KidanDepartment of Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Nilo AzadDepartment of Medical Oncology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Chetan BettegowdaDepartment of Neurosurgery, Johns Hopkins School of Medicine, 600 N. Wolfe Street - Phipps 123, Baltimore, MD, 21287-0005, USA.
Jordina Rincon-TorroellaDepartment of Neurosurgery, Johns Hopkins School of Medicine, 600 N. Wolfe Street - Phipps 123, Baltimore, MD, 21287-0005, USA. jrincon2@jhmi.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionColorectal cancer (CRC) is the third most common cancer globally with rising incidence in the young population. While rare, brain metastasis (BM) in CRC patients leads to significant morbidity and mortality. The incidence of BM is expected to rise due to improved screening and treatments extending patient survival. However, limited screening guidelines exist to detect BM in patients with CRC.

methodsAdult patients with colon and rectum tumors, with and without brain metastases, diagnosed between January 1, 2013, and December 31, 2023, were identified using ICD-10 codes from the TrinetX Oncology database. Statistical analyses were performed on TrinetX. The "incidence and prevalence" function assessed BM prevalence, while the "explore cohorts" function evaluated BM diagnoses over time. The "compare cohorts" function compared patient demographics and oncological characteristics, and the "compare outcomes" function generated Kaplan-Meier survival curves.

resultsThere were 8,621 patients with CRC diagnosed at Stage IV and 279 (3.4%) developed BM. Patients who develop BM were younger (58.5 ± 12.6 years vs. 62.3 ± 14 years, p < 0.001) and a greater proportion had a KRAS mutation (37.0% vs. 16.0%, p < 0.001) and HER2 amplification (23.0% vs. 12.0%). BM were more common in primary CRC located on the left, specifically in the rectum (41.0%, vs. 36.0%, p < 0.001) or rectosigmoid junction (48.0% vs. 24.0%, p < 0.001). Patients with lung metastasis (OR [95%CI]: 1.67 [1.11-2.57]) or bone (OR [95%CI]: 4.30 [3.05-5.85]) had increased odds of developing BM. Patients with bone metastases developed BM at a median time of less than six months. Stage IV CRC patients who developed BM had decreased overall survival compared to those without BM (liver HR [95%CI]: 1.35 [1.11-1.64]; lung: 1.98 [1.62-2.43]; bone: 1.69 [1.42-2.07]).

conclusionBrain metastasis significantly reduces overall survival in Stage IV CRC patients. Stage IV CRC with pulmonary or osseous metastases have increased risk of BM development. These patients merit increased surveillance to identify BM early and improve survival. Other risk factors include a younger age at diagnosis, left sided primary tumor, KRAS mutation, or HER2 amplification.

Indexed as

Brain NeoplasmsColorectal NeoplasmsAdultAgedFemaleHumansIncidenceMaleMiddle AgedNeoplasm StagingPrognosisSurvival RateBone metastasisBrain metastasisColorectal cancerPulmonary metastasisRisk factorsStage IV cancer

Identifiers

PMID40690187

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.