SDPS-36 CLINICAL PRESENTATION IS A USEFUL PROGNOSTIC MARKER IN PATIENTS WITH BRAIN METASTASES

BACKGROUND: Brain metastases are the most common malignant intracranial tumors and a leading cause of cancer-associated death. The influence on survival of their clinical presentation is scarce. AIM: To determine if the clinical presentation of patients with brain metastases is associated with survival. METHODS: A retrospective database of patients with brain metastases seen at a single center from 2010 to 2022 was analyzed. Clinical presentation and its association with survival were measured individually and adjusted for other prognostic variables. RESULTS: From 822 patients, the most common symptoms were headache 53%, focal weakness 35%, visual disorders 24%, nausea/vomiting 23%, seizures 22%, and altered mental status 18%. Clinical presentations associated with survival after multivariate analysis were no symptoms [HR 0.55 (95%CI 0.39-0.79), P = 0.001], focal weakness [HR 1.21 (95%CI 1.01-1.44), P = 0.032], altered mental status [HR 1.24 (95%CI 1.01 – 1.52), P = 0.038], and visual disorders [HR 1.29 (95%CI 1.07-1.46), P = 0.007. Adding the clinical information to the graduated prognostic score improved its prognostic performance measured by both the C-statistic and the Akaike information criteria. CONCLUSION: Clinical symptoms should be considered in all patients with brain metastases for they are associated with outcomes.