Institutional, Retrospective Analysis of 777 Patients With Brain Metastases: Treatment Outcomes and Diagnosis-Specific Prognostic Factors

Antoni, D.; Clavier, Jean-Baptiste; Pop, Marius; Schumacher, C.; Lefèbvre, François; Noël, Georges

doi:10.1016/j.ijrobp.2013.02.027

Cited by 25 publications

(10 citation statements)

References 11 publications

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“…[11][12][13][14][15] Other studies have also identified performance status, number of brain metastasis, and systemic therapy use as additional prognostic factors for survival that may be used in individualizing therapeutic decisions. [9][10][11][12][13]15,21,22 In the current study, patients diagnosed in the later time period from 2001 to 2005 were observed to have longer survival compared with the older era from 1996 to 2000. Although it is difficult to attribute this difference to evolved treatment over time in our small cohort, similar trends in improved survival over time have been reported and attributed to advances in systemic therapy for women with metastatic disease.…”

Section: Discussionmentioning

confidence: 89%

Population-based Analysis of Treatment and Survival in Women Presenting With Brain Metastasis at Initial Breast Cancer Diagnosis

Wiksyk

Nguyen²,

Alexander³

et al. 2016

American Journal of Clinical Oncology

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Section: Discussionmentioning

confidence: 89%

Population-based Analysis of Treatment and Survival in Women Presenting With Brain Metastasis at Initial Breast Cancer Diagnosis

Wiksyk

Nguyen²,

Alexander³

et al. 2016

American Journal of Clinical Oncology

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“…The KPS score has always been shown to be a critical factor in various outcomes of treatment, including both complications and survival. 1,6,15,17 Very low KPS scores are often a contraindication for surgery.…”

Section: Resultsmentioning

confidence: 99%

Impact of surgical methodology on the complication rate and functional outcome of patients with a single brain metastasis

Patel

Suki

Hatiboğlu

et al. 2015

JNS

105

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obJect Brain metastases are the most common intracranial neoplasms and are on the increase. As radiation side effects are increasingly better understood, more patients are being treated with surgery alone with varying outcomes. The authors previously reported that en bloc resection of a single brain metastasis was associated with decreased incidences of leptomeningeal disease and local recurrence compared with piecemeal resection. However, en bloc resection is often feared to cause an increased incidence of postoperative complications. This study aimed to answer this question. methods The authors reviewed data from patients with a previously untreated single brain metastasis, who were treated with resection at The University of Texas M.D. Anderson Cancer Center (1993-2012. Data related to the patient, tumor, and methods of resection were obtained. Discharge Karnofsky Performance Scale (KPS) scores and 30-day postoperative complications were noted. Complications were considered major when they persisted for longer than 30 days, resulted in hospitalization or prolongation of hospital stay, required aggressive treatment, and/or were life threatening. results During the study period, 1033 eligible patients were identified. The median age was 58 years, 83% had a KPS score greater than 70, and 81% were symptomatic at surgery. Sixty-two percent of the patients underwent en bloc resection of their tumor, and 38% underwent piecemeal resection. There were significant differences between the 2 groups in terms of preoperative tumor volume, tumor functional grade, and symptoms at presentation, among others. The overall complication rates were 13% for patients undergoing en bloc resection and 19% for patients undergoing piecemeal resection (p = 0.007). The incidences of major complications and neurological complications were also significantly different. There was a trend in the same direction for major neurological complications, although it was not significant. Among patients undergoing piecemeal resection of tumors in eloquent cortex, 24% had complications (13% had major, 18% had neurological, 9% had major neurological, and 13% had select neurological complications; 4% died within 1 month of surgery). Among those undergoing en bloc resection of such tumors, 11% had complications (6% had major, 8% had neurological, 4% had major neurological, and 4% had select neurological; 2% died within 1 month of surgery). The differences in overall, major, neurological, and select neurological complications were statistically significant, but 1-month mortality and major neurological complications were not. In addition, within subcategories of tumor volume, the incidence of various complications was generally higher for patients undergoing piecemeal resection than for those undergoing en bloc resection. coNclusioNs The authors' results indicate that postoperative complication rates are not increased by en bloc resection, including for lesions in eloquent brain regions or for large tumors. This gives credence to the idea that en bloc resec...

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“…They contain some type of assessment of extracranial disease activity [1,3,5,[13][14][15][16][17][18]. Our previous study suggested that integration of surrogate markers such as LDH and albumin, which were confirmed as independent prognostic factors for survival, should be examined in greater detail and large databases [7].…”

Section: Discussionmentioning

confidence: 99%

Tumor marker analyses in patients with brain metastases: patterns of practice and implications for survival prediction research

et al. 2015

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This study aims to explore patterns of practice of tumor marker analyses and potential prognostic impact of abnormal markers in patients with brain metastases from solid tumors. Previously, lactate dehydrogenase (LDH) and albumin were identified as relevant biomarkers. We performed a retrospective analysis of 120 patients with known LDH and albumin treated with whole-brain radiotherapy (WBRT) in two different situations: (1) brain metastases detected at initial cancer diagnosis (n = 46) and (2) brain metastases at later time points (n = 74, median interval 13 months). Twenty-six patients (57 %) from group 1 had at least one tumor marker analyzed, and 11 patients (24 %) had abnormal results. Twenty-two patients (30 %) from group 2 had at least one tumor marker analyzed, and 16 patients (22 %) had abnormal results. When assuming that LDH and albumin would be standard tests before WBRT, additional potential biomarkers were found in 36 % of patients with normal LDH and albumin. Marker positivity rates were for example 80 % for carcinoembryonic antigen (CEA) in colorectal cancer and 79 % for CA 15-3 in breast cancer. Abnormal markers were associated with presence of liver metastases. CA 15-3 values above median predicted shorter survival in patients with breast cancer (median 1.9 vs. 13.8 months, p = 0.1). Comparable trends were not observed for various markers in other tumor types. In conclusion, only a minority of patients had undergone tumor marker analyses. Final group sizes were too small to perform multivariate analyses or draw definitive conclusions. We hypothesize that CA 15-3 could be a promising biomarker that should be studied further.

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Institutional, Retrospective Analysis of 777 Patients With Brain Metastases: Treatment Outcomes and Diagnosis-Specific Prognostic Factors

Cited by 25 publications

References 11 publications

Population-based Analysis of Treatment and Survival in Women Presenting With Brain Metastasis at Initial Breast Cancer Diagnosis

Population-based Analysis of Treatment and Survival in Women Presenting With Brain Metastasis at Initial Breast Cancer Diagnosis

Impact of surgical methodology on the complication rate and functional outcome of patients with a single brain metastasis

Tumor marker analyses in patients with brain metastases: patterns of practice and implications for survival prediction research

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