SURVIVAL ANALYSIS IN PATIENTS WITH BRAIN METASTASES: A RETROSPECTIVE CASE SERIES
DOI:
https://doi.org/10.56238/levv16n54-112Keywords:
Brain Metastases, Treatment, SurvivalAbstract
Objective: The objective of this study was to analyze medical data from patients diagnosed with brain metastasis, to determine which factors influence patient survival.
Methods: The medical data used in this retrospective study ranges from 2018 to 2021. The medical records of patients diagnosed with brain metastasis were obtained from a reference hospital in the interior of São Paulo, Brazil. After data acquisition, survival analyses were performed, including the Log-Rank test, Kaplan-Meier survival curves, and Cox proportional hazards regression, using a significance level of 5%.
Results: Gender, age, primary tumor, number of brain metastases, size of brain metastases, location of brain metastases, extra-brain implantation site and treatment of brain metastasis were analyzed. Both univariate and multivariate analysis found significant variation in survival when correlating the number of brain metastases and whether patients underwent neurosurgery.
Conclusion: Patients with more than three brain metastases brain had shorter survival compared to those with three or fewer (p = 0.018), indicating a better prognosis for patients with a single metastasis or fewer lesions. Additionally, patients who underwent neurosurgery demonstrated longer survival compared to those who did not (p = 0.037) suggesting that surgical intervention is associated with improved prognosis in appropriately selected patients.
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References
1. Reardon, M. J. (2010). Malignant tumor overview. Methodist DeBakey Cardiovascular Journal, 6(3), 35–37.
2. Habbous, S., Forster, K., Darling, G., Jerzak, K., Holloway, C. M. B., Sahgal, A., et al. (2021). Incidence and real-world burden of brain metastases from solid tumors and hematologic malignancies in Ontario: A population-based study. Neuro-Oncology Advances, 3(1), Article vdaa178. https://doi.org/10.1093/noajnl/vdaa178
3. Rogers, L. R. (2009). Neurologic complications of cancer (2nd ed.). Contemporary Neurology Series. Neuro-Oncology, 11(1), 96–97.
4. Biswas, G., Bhagwat, R., Khurana, R., Menon, H., Prasad, N., & Parikh, P. M. (2006). Brain metastasis—evidence based management. Journal of Cancer Research and Therapeutics, 2(1), 5–13.
5. Soffietti, R., Rudà, R., & Trevisan, E. (2008). Brain metastases: Current management and new developments. Current Opinion in Oncology, 20(6), 676–684.
6. Divine, L. M., Kizer, N. T., Hagemann, A. R., Pittman, M. E., Chen, L., Powell, M. A., et al. (2016). Clinicopathologic characteristics and survival of patients with gynecologic malignancies metastatic to the brain. Gynecologic Oncology, 142(1), 76–82.
7. Uccella, S., Morris, J. M., Multinu, F., Cliby, W. A., Podratz, K. C., Gostout, B. S., et al. (2016). Primary brain metastases of endometrial cancer: A report of 18 cases and review of the literature. Gynecologic Oncology, 142(1), 70–75.
8. Gressel, G. M., Lundsberg, L. S., Altwerger, G., Katchi, T., Azodi, M., Schwartz, P. E., et al. (2015). Factors predictive of improved survival in patients with brain metastases from gynecologic cancer: A single institution retrospective study of 47 cases and review of the literature. International Journal of Gynecological Cancer, 25(9), 1711–1716.
9. Laakmann, E., Witzel, I., Neunhöffer, T., Weide, R., Schmidt, M., Park-Simon, T. W., et al. (2020). Characteristics and clinical outcome of breast cancer patients with asymptomatic brain metastases. Cancers, 12(10), Article 2787. https://doi.org/10.3390/cancers12102787
10. Shao, J., Li, J., Song, L., He, Q., Wu, Y., Li, L., et al. (2022). The number of brain metastases predicts the survival of non-small cell lung cancer patients with EGFR mutation status. Cancer Reports, 5(9), Article e1550.
11. Knoll, M. A., Oermann, E. K., Yang, A. I., Paydar, I., Steinberger, J., Collins, B., et al. (2018). Survival of patients with multiple intracranial metastases treated with stereotactic radiosurgery: Does the number of tumors matter? American Journal of Clinical Oncology, 41(5), 425–431.
12. Rozati, H., & Williams, M. (2022). Survival outcomes of stereotactic radiotherapy for ten or more brain metastases. Neuro-Oncology, 24(Supplement_4), iv9.
13. Hao, P., Chen, L., Ge, Y., You, Y., Yan, G., & Jin, Z. W. (2022). Time taken for a primary tumor to metastasize to the brain and the overall survival of patients with brain metastasis: An analysis of outcomes and factors affecting survival. Technology and Health Care, 30(S1), 259–270.
14. Cagney, D. N., Martin, A. M., Catalano, P. J., Redig, A. J., Lin, N. U., Lee, E. Q., et al. (2017). Incidence and prognosis of patients with brain metastases at diagnosis of systemic malignancy: A population-based study. Neuro-Oncology, 19(11), 1511–1521.
15. Wong, J., Hird, A., Kirou-Mauro, A., Napolskikh, J., & Chow, E. (2008). Quality of life in brain metastases radiation trials: A literature review. Current Oncology, 15(5), 25–45.
16. Niedermeyer, S., Schmutzer-Sondergeld, M., Weller, J., Katzendobler, S., Kirchleitner, S., Forbrig, R., et al. (2024). Neurosurgical resection of multiple brain metastases: Outcomes, complications, and survival rates in a retrospective analysis. Journal of Neuro-Oncology, 169(2), 349–358.
17. Enders, F., Geisenberger, C., Jungk, C., Bermejo, J. L., Warta, R., von Deimling, A., et al. (2016). Prognostic factors and long-term survival in surgically treated brain metastases from non-small cell lung cancer. Clinical Neurology and Neurosurgery, 142, 72–80.
18. Kim, S. Y., Hong, C. K., Kim, T. H., Hong, J. B., Park, C. H., Chang, Y. S., et al. (2015). Efficacy of surgical treatment for brain metastasis in patients with non-small cell lung cancer. Yonsei Medical Journal, 56(1), 103–111.
19. Singh, K., Saxena, S., Khosla, A. A., McDermott, M. W., Kotecha, R. R., & Ahluwalia, M. S. (2022). Update on the management of brain metastasis. Neurotherapeutics, 19(6), 1772–1781.
