Cytoreduction of Residual Tumor Burden Is Decisive for Prolonged Survival in Patients with Recurrent Brain Metastases-Retrospective Analysis of 219 Patients.
neuro-oncology
neurosurgery
overall survival (OS)
postoperative MRI
recurrent brain metastases
Journal
Cancers
ISSN: 2072-6694
Titre abrégé: Cancers (Basel)
Pays: Switzerland
ID NLM: 101526829
Informations de publication
Date de publication:
20 Oct 2023
20 Oct 2023
Historique:
received:
16
09
2023
revised:
10
10
2023
accepted:
18
10
2023
medline:
28
10
2023
pubmed:
28
10
2023
entrez:
28
10
2023
Statut:
epublish
Résumé
Despite advances in treatment for brain metastases (BMs), the prognosis for recurrent BMs remains poor and requires further research to advance clinical management and improve patient outcomes. In particular, data addressing the impact of tumor volume and surgical resection with regard to survival remain scarce. Adult patients with recurrent BMs between December 2007 and December 2022 were analyzed. A distinction was made between operated and non-operated patients, and the residual tumor burden (RTB) was determined by using (postoperative) MRI. Survival analysis was performed and RTB cutoff values were calculated using maximally selected log-rank statistics. In addition, further analyses on systemic tumor progression and (postoperative) tumor therapy were conducted. In total, 219 patients were included in the analysis. Median age was 60 years (IQR 52-69). Median preoperative tumor burden was 2.4 cm RTB is a strong prognostic factor for survival in patients with recurrent BMs. Operated patients with recurrent BMs showed longer survival independent of systemic progression. Maximal cytoreduction should be targeted to achieve better long-term outcomes.
Sections du résumé
BACKGROUND
BACKGROUND
Despite advances in treatment for brain metastases (BMs), the prognosis for recurrent BMs remains poor and requires further research to advance clinical management and improve patient outcomes. In particular, data addressing the impact of tumor volume and surgical resection with regard to survival remain scarce.
METHODS
METHODS
Adult patients with recurrent BMs between December 2007 and December 2022 were analyzed. A distinction was made between operated and non-operated patients, and the residual tumor burden (RTB) was determined by using (postoperative) MRI. Survival analysis was performed and RTB cutoff values were calculated using maximally selected log-rank statistics. In addition, further analyses on systemic tumor progression and (postoperative) tumor therapy were conducted.
RESULTS
RESULTS
In total, 219 patients were included in the analysis. Median age was 60 years (IQR 52-69). Median preoperative tumor burden was 2.4 cm
CONCLUSIONS
CONCLUSIONS
RTB is a strong prognostic factor for survival in patients with recurrent BMs. Operated patients with recurrent BMs showed longer survival independent of systemic progression. Maximal cytoreduction should be targeted to achieve better long-term outcomes.
Identifiants
pubmed: 37894435
pii: cancers15205067
doi: 10.3390/cancers15205067
pmc: PMC10605169
pii:
doi:
Types de publication
Journal Article
Langues
eng
Références
Curr Treat Options Oncol. 2016 Sep;17(9):46
pubmed: 27447703
JAMA. 2016 Jul 26;316(4):401-409
pubmed: 27458945
Cancers (Basel). 2020 Dec 10;12(12):
pubmed: 33321730
Front Oncol. 2022 May 04;12:869764
pubmed: 35600394
Acta Neurochir (Wien). 2022 Feb;164(2):451-457
pubmed: 33721109
J Clin Oncol. 2013 Jan 1;31(1):65-72
pubmed: 23213105
Acta Neurochir (Wien). 2013 Oct;155(10):1823-32
pubmed: 23913109
Dtsch Arztebl Int. 2016 Jun 17;113(24):415-21
pubmed: 27380757
Front Oncol. 2023 Apr 04;13:1149628
pubmed: 37081991
J Neurooncol. 2019 Jun;143(2):359-367
pubmed: 30989623
J Clin Oncol. 2022 Feb 10;40(5):492-516
pubmed: 34932393
Clin Exp Metastasis. 2017 Oct;34(6-7):377-389
pubmed: 28965270
World Neurosurg. 2019 Oct;130:e362-e367
pubmed: 31233927
Front Oncol. 2020 May 08;10:693
pubmed: 32477942
Neurooncol Adv. 2021 Nov 27;3(Suppl 5):v4-v15
pubmed: 34859228
Neuro Oncol. 2017 Jan;19(1):i1-i24
pubmed: 28031389
Neuro Oncol. 2021 Dec 1;23(12):2085-2094
pubmed: 34270740
Neurosurg Rev. 2018 Jan;41(1):77-86
pubmed: 27392678
J Clin Oncol. 2005 Sep 1;23(25):6207-19
pubmed: 16135488
Cancers (Basel). 2023 Jul 19;15(14):
pubmed: 37509330
J Neurosurg. 2016 Mar;124(3):799-810
pubmed: 26315005
JAMA. 2013 Nov 27;310(20):2191-4
pubmed: 24141714
Sci Rep. 2019 May 15;9(1):7431
pubmed: 31092876
BMC Cancer. 2020 Apr 17;20(1):331
pubmed: 32303195
Lancet Oncol. 2017 Aug;18(8):1040-1048
pubmed: 28687375
BMC Cancer. 2022 Mar 15;22(1):275
pubmed: 35291972
Acta Neurochir (Wien). 2015 Sep;157(9):1573-80
pubmed: 26156037
Acta Neurochir (Wien). 2019 Mar;161(3):555-565
pubmed: 30756241
Curr Treat Options Neurol. 2016 Jul;18(7):32
pubmed: 27225542
BMC Cancer. 2020 May 12;20(1):410
pubmed: 32398144
J Clin Oncol. 2011 Jan 10;29(2):134-41
pubmed: 21041710
Lancet Oncol. 2017 Aug;18(8):1049-1060
pubmed: 28687377
Cancer Med. 2020 Oct;9(20):7503-7510
pubmed: 32858763
Neurosurgery. 2019 Mar 1;84(3):550-552
pubmed: 30629218
Cancers (Basel). 2021 Mar 31;13(7):
pubmed: 33807384
J Neurooncol. 2010 Jan;96(1):85-96
pubmed: 19957016
Int J Radiat Oncol Biol Phys. 2010 Jul 1;77(3):655-61
pubmed: 19942357
J Neurooncol. 2010 Jan;96(1):33-43
pubmed: 19960230
Br J Neurosurg. 2017 Jun;31(3):369-373
pubmed: 28290227
Neuro Oncol. 2013 Dec;15(12):1664-72
pubmed: 24084410
J Neurooncol. 2019 Feb;141(3):547-553
pubmed: 30535595
Neurosurg Rev. 2018 Jul;41(3):813-823
pubmed: 29260342
Ther Adv Med Oncol. 2017 Dec;9(12):781-796
pubmed: 29449898