Surgery for brain metastases: radiooncology scores predict survival-score index for radiosurgery, graded prognostic assessment, recursive partitioning analysis.
Cerebral metastasis
Neurooncology
Scores
Surgery for brain tumors
Survival
Journal
Acta neurochirurgica
ISSN: 0942-0940
Titre abrégé: Acta Neurochir (Wien)
Pays: Austria
ID NLM: 0151000
Informations de publication
Date de publication:
01 2023
01 2023
Historique:
received:
19
12
2021
accepted:
25
08
2022
pubmed:
25
9
2022
medline:
18
1
2023
entrez:
24
9
2022
Statut:
ppublish
Résumé
Radiooncological scores are used to stratify patients for radiation therapy. We assessed their ability to predict overall survival (OS) in patients undergoing surgery for metastatic brain disease. We performed a post-hoc single-center analysis of 175 patients, prospectively enrolled in the MetastaSys study data. Score index of radiosurgery (SIR), graded prognostic assessment (GPA), and recursive partitioning analysis (RPA) were assessed. All scores consider age, systemic disease, and performance status prior to surgery. Furthermore, GPA and SIR include the number of intracranial lesions while SIR additionally requires metastatic lesion volume. Predictive values for case fatality at 1 year after surgery were compared among scoring systems. All scores produced accurate reflections on OS after surgery (p ≤ 0.003). Median survival was 21-24 weeks in patients scored in the unfavorable cohorts, respectively. In cohorts with favorable scores, median survival ranged from 42 to 60 weeks. Favorable SIR was associated with a hazard ratio (HR) of 0.44 [0.29, 0.66] for death within 1 year. For GPA, the HR amounted to 0.44 [0.25, 0.75], while RPA had a HR of 0.30 [0.14, 0.63]. Overall test performance was highest for the SIR. All scores proved useful in predicting OS. Considering our data, we recommend using the SIR for preoperative prognostic evaluation and counseling.
Sections du résumé
BACKGROUND
Radiooncological scores are used to stratify patients for radiation therapy. We assessed their ability to predict overall survival (OS) in patients undergoing surgery for metastatic brain disease.
METHODS
We performed a post-hoc single-center analysis of 175 patients, prospectively enrolled in the MetastaSys study data. Score index of radiosurgery (SIR), graded prognostic assessment (GPA), and recursive partitioning analysis (RPA) were assessed. All scores consider age, systemic disease, and performance status prior to surgery. Furthermore, GPA and SIR include the number of intracranial lesions while SIR additionally requires metastatic lesion volume. Predictive values for case fatality at 1 year after surgery were compared among scoring systems.
RESULTS
All scores produced accurate reflections on OS after surgery (p ≤ 0.003). Median survival was 21-24 weeks in patients scored in the unfavorable cohorts, respectively. In cohorts with favorable scores, median survival ranged from 42 to 60 weeks. Favorable SIR was associated with a hazard ratio (HR) of 0.44 [0.29, 0.66] for death within 1 year. For GPA, the HR amounted to 0.44 [0.25, 0.75], while RPA had a HR of 0.30 [0.14, 0.63]. Overall test performance was highest for the SIR.
CONCLUSIONS
All scores proved useful in predicting OS. Considering our data, we recommend using the SIR for preoperative prognostic evaluation and counseling.
Identifiants
pubmed: 36152217
doi: 10.1007/s00701-022-05356-x
pii: 10.1007/s00701-022-05356-x
pmc: PMC9840567
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
231-238Informations de copyright
© 2022. The Author(s).
Références
Int J Radiat Oncol Biol Phys. 2000 Jan 15;46(2):297-302
pubmed: 10661335
Acta Oncol. 2021 Sep;60(9):1161-1168
pubmed: 34032547
Rev Assoc Med Bras (1992). 2018 Aug;64(8):717-722
pubmed: 30673042
Acta Oncol. 2009;48(3):457-9
pubmed: 18781455
J Radiosurg SBRT. 2013;2(2):119-126
pubmed: 29296350
J Clin Oncol. 2012 Feb 1;30(4):419-25
pubmed: 22203767
Int J Mol Sci. 2013 Apr 24;14(5):8708-18
pubmed: 23615466
Int J Radiat Oncol Biol Phys. 2004 Sep 1;60(1):218-24
pubmed: 15337559
Int J Radiat Oncol Biol Phys. 1998 Aug 1;42(1):155-9
pubmed: 9747833
Int J Radiat Oncol Biol Phys. 2000 Mar 15;46(5):1155-61
pubmed: 10725626
J Neurooncol. 2010 Jan;96(1):33-43
pubmed: 19960230
Clin Transl Oncol. 2018 Jan;20(1):22-28
pubmed: 29086250
Neurosurgery. 2019 Mar 1;84(3):E180-E182
pubmed: 30629219
J Neurooncol. 2003 Jan;61(1):73-80
pubmed: 12587798
Int J Radiat Oncol Biol Phys. 2007 Apr 1;67(5):1492-8
pubmed: 17276617
J Neurosurg. 2020 Jun 12;134(6):1743-1750
pubmed: 32534490
Int J Radiat Oncol Biol Phys. 1997 Mar 1;37(4):745-51
pubmed: 9128946
Neoplasma. 2017;64(1):136-139
pubmed: 27881015
BMC Cancer. 2019 Jul 31;19(1):755
pubmed: 31366387
Curr Oncol Rep. 2012 Feb;14(1):48-54
pubmed: 22012633
Cancers (Basel). 2020 Mar 30;12(4):
pubmed: 32235637
Handb Clin Neurol. 2018;149:27-42
pubmed: 29307358
Clin Breast Cancer. 2019 Aug;19(4):e501-e510
pubmed: 31204290
J Neurosurg. 2008 Dec;109 Suppl:77-86
pubmed: 19123892
Neurol India. 2019 Nov-Dec;67(6):1431-1436
pubmed: 31857529
Brain Sci. 2017 Dec 25;8(1):
pubmed: 29295569
J Am Coll Surg. 2006 Dec;203(6):865-77
pubmed: 17116555
Pract Radiat Oncol. 2012 Jul-Sep;2(3):210-225
pubmed: 25925626