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Int. J. Mol. Sci. 2014, 15(9), 16816-16830; doi:10.3390/ijms150916816

Brain Metastases in Gastrointestinal Cancers: Is there a Role for Surgery?

1
Clinic of General and Visceral Surgery, University Hospital Ulm, Albert-Einstein-Allee 23, Ulm 89071, Germany
2
Clinic of Neurosurgery, University Hospital Ulm, Albert-Einstein-Allee 23, Ulm 89071, Germany
3
UCL Cancer Institute, University College London, 72 Huntley Street, London WC1E 6DD, UK
*
Author to whom correspondence should be addressed.
Received: 25 June 2014 / Revised: 11 September 2014 / Accepted: 15 September 2014 / Published: 22 September 2014
(This article belongs to the Special Issue Brain Metastasis 2014)
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Abstract

About 10% of all cancer patients will develop brain metastases during advanced disease progression. Interestingly, the vast majority of brain metastases occur in only three types of cancer: Melanoma, lung and breast cancer. In this review, we focus on summarizing the prognosis and impact of surgical resection of brain metastases originating from gastrointestinal cancers such as esophageal, gastric, pancreatic and colorectal cancer. The incidence of brain metastases is <1% in pancreatic and gastric cancer and <4% in esophageal and colorectal cancer. Overall, prognosis of these patients is very poor with a median survival in the range of only months. Interestingly, a substantial number of patients who had received surgical resection of brain metastases showed prolonged survival. However, it should be taken into account that all these studies were not randomized and it is likely that patients selected for surgical treatment presented with other important prognostic factors such as solitary brain metastases and exclusion of extra-cranial disease. Nevertheless, other reports have demonstrated long-term survival of patients upon resection of brain metastases originating from gastrointestinal cancers. Thus, it appears to be justified to consider aggressive surgical approaches for these patients. View Full-Text
Keywords: brain metastases; gastrointestinal cancer; esophageal cancer; gastric cancer; pancreatic cancer; colorectal cancer brain metastases; gastrointestinal cancer; esophageal cancer; gastric cancer; pancreatic cancer; colorectal cancer
This is an open access article distributed under the Creative Commons Attribution License (CC BY 3.0).

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MDPI and ACS Style

Lemke, J.; Scheele, J.; Kapapa, T.; von Karstedt, S.; Wirtz, C.R.; Henne-Bruns, D.; Kornmann, M. Brain Metastases in Gastrointestinal Cancers: Is there a Role for Surgery? Int. J. Mol. Sci. 2014, 15, 16816-16830.

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