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Prognostic assessment in patients operated for brain metastasis from systemic tumors

BACKGROUND: Established models for prognostic assessment in patients with brain metastasis do not stratify for prior surgery. Here we tested the prognostic accuracy of the Graded Prognostic Assessment (GPA) score model in patients operated for BM and explored further prognostic factors. METHODS: We...

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Autores principales: Grossenbacher, Bettina, Lareida, Anna, Moors, Selina, Roth, Patrick, Kulcsar, Zsolt, Regli, Luca, Le Rhun, Emilie, Weller, Michael, Wolpert, Fabian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10278502/
https://www.ncbi.nlm.nih.gov/pubmed/37039262
http://dx.doi.org/10.1002/cam4.5928
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author Grossenbacher, Bettina
Lareida, Anna
Moors, Selina
Roth, Patrick
Kulcsar, Zsolt
Regli, Luca
Le Rhun, Emilie
Weller, Michael
Wolpert, Fabian
author_facet Grossenbacher, Bettina
Lareida, Anna
Moors, Selina
Roth, Patrick
Kulcsar, Zsolt
Regli, Luca
Le Rhun, Emilie
Weller, Michael
Wolpert, Fabian
author_sort Grossenbacher, Bettina
collection PubMed
description BACKGROUND: Established models for prognostic assessment in patients with brain metastasis do not stratify for prior surgery. Here we tested the prognostic accuracy of the Graded Prognostic Assessment (GPA) score model in patients operated for BM and explored further prognostic factors. METHODS: We included 285 patients operated for brain metastasis at the University Hospital Zurich in the analysis. Information on patient characteristics, imaging, staging, peri‐ and postoperative complications and survival were extracted from the files and integrated into a multivariate Cox hazard model. RESULTS: The GPA score showed an association with outcome. We further identified residual tumor after surgery (p = 0.007, hazard ratio (HR) 1.6, 95% confidence interval (CI) 1.1–2.3) steroid use (p = 0.021, HR 1.7, 95% CI 1.1–2.6) and number of extracranial metastasis sites (p = 0.009, HR 1.4, 95% CI 1.1–1.6) at the time of surgery as independent prognostic factors. A trend was observed for postoperative infection of the subarachnoid space (p = 0.102, HR 3.5, 95% CI 0.8–15.7). CONCLUSIONS: We confirm the prognostic capacity of the GPA score in a cohort of operated patients with brain metastasis. However, extent of resection and steroid use provide additional aid for the prognostic assessment in these patients.
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spelling pubmed-102785022023-06-20 Prognostic assessment in patients operated for brain metastasis from systemic tumors Grossenbacher, Bettina Lareida, Anna Moors, Selina Roth, Patrick Kulcsar, Zsolt Regli, Luca Le Rhun, Emilie Weller, Michael Wolpert, Fabian Cancer Med RESEARCH ARTICLES BACKGROUND: Established models for prognostic assessment in patients with brain metastasis do not stratify for prior surgery. Here we tested the prognostic accuracy of the Graded Prognostic Assessment (GPA) score model in patients operated for BM and explored further prognostic factors. METHODS: We included 285 patients operated for brain metastasis at the University Hospital Zurich in the analysis. Information on patient characteristics, imaging, staging, peri‐ and postoperative complications and survival were extracted from the files and integrated into a multivariate Cox hazard model. RESULTS: The GPA score showed an association with outcome. We further identified residual tumor after surgery (p = 0.007, hazard ratio (HR) 1.6, 95% confidence interval (CI) 1.1–2.3) steroid use (p = 0.021, HR 1.7, 95% CI 1.1–2.6) and number of extracranial metastasis sites (p = 0.009, HR 1.4, 95% CI 1.1–1.6) at the time of surgery as independent prognostic factors. A trend was observed for postoperative infection of the subarachnoid space (p = 0.102, HR 3.5, 95% CI 0.8–15.7). CONCLUSIONS: We confirm the prognostic capacity of the GPA score in a cohort of operated patients with brain metastasis. However, extent of resection and steroid use provide additional aid for the prognostic assessment in these patients. John Wiley and Sons Inc. 2023-04-11 /pmc/articles/PMC10278502/ /pubmed/37039262 http://dx.doi.org/10.1002/cam4.5928 Text en © 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle RESEARCH ARTICLES
Grossenbacher, Bettina
Lareida, Anna
Moors, Selina
Roth, Patrick
Kulcsar, Zsolt
Regli, Luca
Le Rhun, Emilie
Weller, Michael
Wolpert, Fabian
Prognostic assessment in patients operated for brain metastasis from systemic tumors
title Prognostic assessment in patients operated for brain metastasis from systemic tumors
title_full Prognostic assessment in patients operated for brain metastasis from systemic tumors
title_fullStr Prognostic assessment in patients operated for brain metastasis from systemic tumors
title_full_unstemmed Prognostic assessment in patients operated for brain metastasis from systemic tumors
title_short Prognostic assessment in patients operated for brain metastasis from systemic tumors
title_sort prognostic assessment in patients operated for brain metastasis from systemic tumors
topic RESEARCH ARTICLES
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10278502/
https://www.ncbi.nlm.nih.gov/pubmed/37039262
http://dx.doi.org/10.1002/cam4.5928
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