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. 2025 Mar 17;29(5):233.
doi: 10.3892/ol.2025.14979. eCollection 2025 May.

Comparative survival outcome of synchronous and metachronous brain metastasis from colorectal cancer: A meta‑analysis

Tsung-Chiao Tsai  1 , Junmin Song  2 , Kuan-Yu Chi  2 , Hong-Min Lin  3 , Yu Chang  1
Affiliations

Comparative survival outcome of synchronous and metachronous brain metastasis from colorectal cancer: A meta‑analysis

Tsung-Chiao Tsai et al. Oncol Lett. .

Abstract

Synchronous and metachronous brain metastases (BM) are increasingly recognized in patients with colorectal cancer (CRC). This study aimed to assess whether the timing of BM development affects survival outcomes by conducting a systematic review and meta-analysis. A comprehensive search of the Cochrane Library, Embase and MEDLINE databases was performed, covering studies from January 1900 to December 2023. To compare survival outcomes between synchronous and metachronous BM, hazard ratios (HRs) for overall survival (OS) were extracted from the included studies and pooled using a random-effects model. The systematic review included nine retrospective cohort studies comprising 910 patients with BM from CRC. Meta-analysis results showed no significant difference in OS between patients with synchronous and metachronous BM (HR, 0.90; 95% confidence interval, 0.59-1.38; P=0.63). In conclusion, this meta-analysis suggests that the timing of BM development does not impact OS in patients with BM from CRC.

Keywords: brain metastasis; colorectal cancer; metachronous; synchronous.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1.
Figure 1.
Preferred Reporting Items for Systematic Reviews and Meta-Analyses diagram of the selection of eligible studies.
Figure 2.
Figure 2.
Summary of risk of bias assessment using ROBINS-I tool. Green indicates low risk of bias, yellow indicates moderate risk of bias and red indicates serious risk of bias. D1, bias due to confounding factors; D2, bias in selection of participants into the study; D3, bias in classification of interventions; D4, bias due to deviations from intended interventions; D5, bias due to missing data; D6, bias in measurement of outcomes; D7, bias in selection of the reported result.
Figure 3.
Figure 3.
Forest plot for the overall survival of patients with synchronous vs. metachronous brain metastasis from colorectal cancer. HR, hazard ratio; SE, standard error; CI, confidence interval; IV, inverse variance; df, degrees of freedom.
See this image and copyright information in PMC

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