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Predicting Prognosis of Breast Cancer Patients with Brain Metastases in the BMBC Registry—Comparison of Three Different GPA Prognostic Scores
SIMPLE SUMMARY: The incidence of brain metastases from breast cancer is increasing and the treatment is still a major challenge. Several scores have been developed in order to estimate the prognosis of patients with brain metastases by objective criteria. Here, we validated all three published grade...
Autores principales: | , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7922206/ https://www.ncbi.nlm.nih.gov/pubmed/33671376 http://dx.doi.org/10.3390/cancers13040844 |
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author | Riecke, Kerstin Müller, Volkmar Weide, Rudolf Schmidt, Marcus Park-Simon, Tjoung-Won Möbus, Volker Mundhenke, Christoph Polasik, Arkadius Lübbe, Kristina Hesse, Tobias Laakmann, Elena Thill, Marc A. Fasching, Peter Denkert, Carsten Fehm, Tanja Nekljudova, Valentina Rey, Julia Loibl, Sibylle Witzel, Isabell |
author_facet | Riecke, Kerstin Müller, Volkmar Weide, Rudolf Schmidt, Marcus Park-Simon, Tjoung-Won Möbus, Volker Mundhenke, Christoph Polasik, Arkadius Lübbe, Kristina Hesse, Tobias Laakmann, Elena Thill, Marc A. Fasching, Peter Denkert, Carsten Fehm, Tanja Nekljudova, Valentina Rey, Julia Loibl, Sibylle Witzel, Isabell |
author_sort | Riecke, Kerstin |
collection | PubMed |
description | SIMPLE SUMMARY: The incidence of brain metastases from breast cancer is increasing and the treatment is still a major challenge. Several scores have been developed in order to estimate the prognosis of patients with brain metastases by objective criteria. Here, we validated all three published graded-prognostic-assessment (GPA)-scores in a subcohort of 882 breast cancer patients with brain metastases in the Brain Metastases in the German Breast Cancer (BMBC) registry. Although all three available GPA-scores were associated with OS, they all show limitations mainly in predicting short-term (below 3 months) survival but also in long-term (above 12 months) survival. We discuss the test performances of all scores in our work and provide evidence how physicians should use them as a tool to select patients for different treatment options. ABSTRACT: Several scores have been developed in order to estimate the prognosis of patients with brain metastases (BM) by objective criteria. The aim of this analysis was to validate all three published graded-prognostic-assessment (GPA)-scores in a subcohort of 882 breast cancer (BC) patients with BM in the Brain Metastases in the German Breast Cancer (BMBC) registry. The median age at diagnosis of BM was 57 years. All in all, 22.3% of patients (n = 197) had triple-negative, 33.4% (n = 295) luminal A like, 25.1% (n = 221) luminal B/HER2-enriched like and 19.2% (n = 169) HER2 positive like BC. Age ≥60 years, evidence of extracranial metastases (ECM), higher number of BM, triple-negative subtype and low Karnofsky-Performance-Status (KPS) were all associated with worse overall survival (OS) in univariate analysis (p < 0.001 each). All three GPA-scores were associated with OS. The breast-GPA showed the highest probability of classifying patients with survival above 12 months in the best prognostic group (specificity 68.7% compared with 48.1% for the updated breast-GPA and 21.8% for the original GPA). Sensitivities for predicting 3 months survival were very low for all scores. In this analysis, all GPA-scores showed only moderate diagnostic accuracy in predicting the OS of BC patients with BM. |
format | Online Article Text |
id | pubmed-7922206 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-79222062021-03-03 Predicting Prognosis of Breast Cancer Patients with Brain Metastases in the BMBC Registry—Comparison of Three Different GPA Prognostic Scores Riecke, Kerstin Müller, Volkmar Weide, Rudolf Schmidt, Marcus Park-Simon, Tjoung-Won Möbus, Volker Mundhenke, Christoph Polasik, Arkadius Lübbe, Kristina Hesse, Tobias Laakmann, Elena Thill, Marc A. Fasching, Peter Denkert, Carsten Fehm, Tanja Nekljudova, Valentina Rey, Julia Loibl, Sibylle Witzel, Isabell Cancers (Basel) Article SIMPLE SUMMARY: The incidence of brain metastases from breast cancer is increasing and the treatment is still a major challenge. Several scores have been developed in order to estimate the prognosis of patients with brain metastases by objective criteria. Here, we validated all three published graded-prognostic-assessment (GPA)-scores in a subcohort of 882 breast cancer patients with brain metastases in the Brain Metastases in the German Breast Cancer (BMBC) registry. Although all three available GPA-scores were associated with OS, they all show limitations mainly in predicting short-term (below 3 months) survival but also in long-term (above 12 months) survival. We discuss the test performances of all scores in our work and provide evidence how physicians should use them as a tool to select patients for different treatment options. ABSTRACT: Several scores have been developed in order to estimate the prognosis of patients with brain metastases (BM) by objective criteria. The aim of this analysis was to validate all three published graded-prognostic-assessment (GPA)-scores in a subcohort of 882 breast cancer (BC) patients with BM in the Brain Metastases in the German Breast Cancer (BMBC) registry. The median age at diagnosis of BM was 57 years. All in all, 22.3% of patients (n = 197) had triple-negative, 33.4% (n = 295) luminal A like, 25.1% (n = 221) luminal B/HER2-enriched like and 19.2% (n = 169) HER2 positive like BC. Age ≥60 years, evidence of extracranial metastases (ECM), higher number of BM, triple-negative subtype and low Karnofsky-Performance-Status (KPS) were all associated with worse overall survival (OS) in univariate analysis (p < 0.001 each). All three GPA-scores were associated with OS. The breast-GPA showed the highest probability of classifying patients with survival above 12 months in the best prognostic group (specificity 68.7% compared with 48.1% for the updated breast-GPA and 21.8% for the original GPA). Sensitivities for predicting 3 months survival were very low for all scores. In this analysis, all GPA-scores showed only moderate diagnostic accuracy in predicting the OS of BC patients with BM. MDPI 2021-02-17 /pmc/articles/PMC7922206/ /pubmed/33671376 http://dx.doi.org/10.3390/cancers13040844 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Riecke, Kerstin Müller, Volkmar Weide, Rudolf Schmidt, Marcus Park-Simon, Tjoung-Won Möbus, Volker Mundhenke, Christoph Polasik, Arkadius Lübbe, Kristina Hesse, Tobias Laakmann, Elena Thill, Marc A. Fasching, Peter Denkert, Carsten Fehm, Tanja Nekljudova, Valentina Rey, Julia Loibl, Sibylle Witzel, Isabell Predicting Prognosis of Breast Cancer Patients with Brain Metastases in the BMBC Registry—Comparison of Three Different GPA Prognostic Scores |
title | Predicting Prognosis of Breast Cancer Patients with Brain Metastases in the BMBC Registry—Comparison of Three Different GPA Prognostic Scores |
title_full | Predicting Prognosis of Breast Cancer Patients with Brain Metastases in the BMBC Registry—Comparison of Three Different GPA Prognostic Scores |
title_fullStr | Predicting Prognosis of Breast Cancer Patients with Brain Metastases in the BMBC Registry—Comparison of Three Different GPA Prognostic Scores |
title_full_unstemmed | Predicting Prognosis of Breast Cancer Patients with Brain Metastases in the BMBC Registry—Comparison of Three Different GPA Prognostic Scores |
title_short | Predicting Prognosis of Breast Cancer Patients with Brain Metastases in the BMBC Registry—Comparison of Three Different GPA Prognostic Scores |
title_sort | predicting prognosis of breast cancer patients with brain metastases in the bmbc registry—comparison of three different gpa prognostic scores |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7922206/ https://www.ncbi.nlm.nih.gov/pubmed/33671376 http://dx.doi.org/10.3390/cancers13040844 |
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