Prognostic Implications of Cutaneous Metastases in Colorectal Cancer: A Comprehensive Systematic Review and Meta-Analysis

Background

Management of cutaneous metastases in colorectal cancer is crucial because it can significantly impact patient survival.

Objective

To assess the global prognosis of skin metastases among patients treated for colorectal cancer.

Methods

A systematic review of the PubMed database only was conducted for English articles or reports published between 1 January 1990 and 1 November 2023. Reports concerning clinical outcomes of patients with cutaneous metastases of colorectal cancer and systematic reviews of the literature were included. Study characteristics and results of eligible studies were independently extracted by two reviewers (A.C.E., E.T.). The histology, locations, and prognosis of patients with skin metastases of colorectal cancer were analyzed.

Results

Data were obtained from almost 100 articles, most of which were case reports. Follow-up data were available for 62 patients. The most common site was rectal adenocarcinoma (58%), followed by right and left colon adenocarcinomas. A significant number of these metastases were metachronous (61%). The median time to death was 5.5 months [interquartile range, 3–10], ranging from 1 to 60 months. Treatment of cutaneous metastases, even if associated with other metastases, significantly improved overall survival (p < 0.001; hazard ratio, 0.15), regardless of the proposed treatment.

Conclusions

We carried out the most extensive review of the literature concerning cutaneous metastases of colorectal cancer to date. The review showed that cutaneous metastases are associated with a poor prognosis and short survival time. We suggest treating patients with cutaneous metastasis as if such metastasis were a surrogate marker or sentinel for aggressive metastatic disease.