Hutchinson HJ, Gonzalez M, Feier D, Welch CE, Lucke-Wold B. Colorectal cancer metastasis to the brain: A scoping review of incidence, treatment, and outcomes. World J Gastrointest Pathophysiol 2025; 16(4): 110961 [DOI: 10.4291/wjgp.v16.i4.110961]
Corresponding Author of This Article
Hunter J Hutchinson, BS, College of Medicine, University of Florida, 1600 SW Archer Rd, Gainesville, FL 32610, United States. hutchinsonhunter@ufl.edu
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Oncology
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Systematic Reviews
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dec 22, 2025 (publication date) through Dec 22, 2025
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World Journal of Gastrointestinal Pathophysiology
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2150-5330
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Hutchinson HJ, Gonzalez M, Feier D, Welch CE, Lucke-Wold B. Colorectal cancer metastasis to the brain: A scoping review of incidence, treatment, and outcomes. World J Gastrointest Pathophysiol 2025; 16(4): 110961 [DOI: 10.4291/wjgp.v16.i4.110961]
World J Gastrointest Pathophysiol. Dec 22, 2025; 16(4): 110961 Published online Dec 22, 2025. doi: 10.4291/wjgp.v16.i4.110961
Colorectal cancer metastasis to the brain: A scoping review of incidence, treatment, and outcomes
Hunter J Hutchinson, Melanie Gonzalez, Diana Feier, Colin E Welch, Brandon Lucke-Wold
Hunter J Hutchinson, Melanie Gonzalez, Diana Feier, Colin E Welch, College of Medicine, University of Florida, Gainesville, FL 32610, United States
Brandon Lucke-Wold, Department of Neurosurgery, University of Florida, Gainesville, FL 32608, United States
Author contributions: Hutchinson HJ and Lucke-Wold B conceptualized and designed the study; Hutchinson HJ and Gonzalez M conducted the database search and screen; Hutchinson HJ, Gonzalez M, Feier D, and Welch CE interpreted the literature and drafted the original manuscript; All authors prepared the draft and approved the submitted version.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hunter J Hutchinson, BS, College of Medicine, University of Florida, 1600 SW Archer Rd, Gainesville, FL 32610, United States. hutchinsonhunter@ufl.edu
Received: June 20, 2025 Revised: July 13, 2025 Accepted: October 22, 2025 Published online: December 22, 2025 Processing time: 185 Days and 14.4 Hours
Abstract
BACKGROUND
Over 150000 new diagnoses of colorectal cancer (CRC) are diagnosed yearly, and 1 in 5 patients have distant metastases on diagnosis. Previous estimates approximate that brain metastases (BM) occur in 0.6% to 3.2% of patients with CRC.
AIM
To describe the updated literature about the incidence and risk factors of BM in CRC as well as their treatment with surgery, chemotherapy, and radiation.
METHODS
We systematically searched the literature published between January 1, 2010 and April 1, 2025 in PubMed, Cochrane, Scopus, and EMBASE. All studies about BM from CRC were included. Studies only containing information about the treatment of primary CRC or primary brain tumors were not included. Articles were categorized and described as incidence, surgery, chemotherapy, or radiation to provide an overview of the state of research on BM from CRC.
RESULTS
Our primary search resulted in 1648 articles that were eventually screened to 147. These articles were analyzed to provide the state of current literature on incidence and risk factors of BM from CRC as well as how these metastases are treated with chemotherapy, radiation, and surgery.
CONCLUSION
Prognosis is influenced by tumor burden, performance status, and emerging molecular markers. Stereotactic radiotherapy and surgical resection provide favorable outcomes for select patients, whereas chemotherapy and immunotherapy remain areas of limited evidence. Continued research is needed to identify high-risk patients and optimize multidisciplinary treatment approaches.
Core Tip: Brain metastases (BM) from colorectal cancer are becoming more common as overall survival increases. Socioeconomic factors are associated with worse prognosis in colorectal cancer BM but not an increased incidence. Primary colorectal tumor characteristics that increase the incidence of brain metastasis and have a worse prognosis are right-sidedness, rectal origin, adenocarcinoma histology, and high carcinoembryonic antigen. Kirsten rat sarcoma viral oncogene homolog and human epidermal growth factor 2-mutated colorectal tumors have a higher incidence of BM but inconclusive prognostic value. Patients with smaller, less numerous BM can be treated with stereotactic ablative radiotherapy while patients with larger, more numerous tumors should receive whole-brain radiotherapy and surgical resection.
