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目的探讨大肠癌脑转移的临床特征及其手术治疗转归。方法对我院2004年7月至2011年7月手术治疗大肠癌脑转移15例进行回顾性分析。结果大肠癌继发脑转移的中位年龄为56.5(41～73)岁,原发肿瘤与转移瘤的中位时间为13.4个月,其中合并颅外(肺、肝、骨)转移占60%,仅有脑转移的占40%。脑转移瘤主要表现为头痛、呕吐等颅内压升高症候群和偏瘫、下肢乏力、失语等定位症状以及癫痫等,颅内转移瘤以单发病灶为多见,占81%,位于幕上(枕叶、顶叶、额叶)者占42%,位于幕下(小脑)者占43%,转移瘤手术切除后中位生存时间为9.3个月,1年生存率为28.8%,5年生存率为7.1%。结论大肠癌脑转移临床已属晚期,预后欠佳,手术切除脑转移病灶可延长部分患者的存活时间。
Objective To investigate the clinical characteristics of brain metastases from colorectal cancer and the outcome of surgical treatment. Methods A retrospective analysis was performed on 15 patients with colorectal cancer brain metastases from July 2004 to July 2011 in our hospital. Results The median age of secondary brain metastases of colorectal cancer was 56.5 (41-73) years. The median time of primary tumors and metastases was 13.4 months, of which the extracranial (lung, liver and bone) metastases accounted for 60% , Only 40% of brain metastases. Brain metastases mainly manifested as headache, vomiting and other intracranial hypertension syndrome and hemiplegia, lower limb fatigue, aphasia and other symptoms and epilepsy, intracranial metastases to single lesions are more common, accounting for 81%, located in the screen ( Occipital lobe, parietal lobe, frontal lobe) accounted for 42%, located in the tentorium (cerebellum) accounted for 43%, metastatic tumor surgical excision median survival time was 9.3 months, 1-year survival rate was 28.8%, 5-year survival rate 7.1%. Conclusion The metastasis of brain metastasis of colorectal cancer is late, the prognosis is poor. Surgical resection of brain metastasis can prolong the survival time of some patients.