Bernardo Cacho-Díaz1, Nydia A Lorenzana-Mendoza2, J Danaé Chávez-Hernandez2, Alberto González-Aguilar3, Gervith Reyes-Soto2, Ángel Herrera-Gómez4. 1. Unidad de Neurociencias, Instituto Nacional de Cancerología, Mexico City, Mexico. Electronic address: bernardocacho@doctor.com. 2. Unidad de Neurociencias, Instituto Nacional de Cancerología, Mexico City, Mexico. 3. Neuro-oncología, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, Mexico. 4. Instituto Nacional de Cancerología, Mexico City, Mexico.
Abstract
BACKGROUND: Brain metastases (BM) are a frequent complication of cancer and are regularly seen in clinical practice. New treatment modalities are improving survival after diagnosis of BM. However, symptoms are rarely reported and their significance is not well established. The aim of the present study was to investigate neurologic indicators as prognostic markers in patients with brain metastases. PATIENTS AND METHODS: A prospectively acquired database from 2 referral centers was analyzed. All patients had had at least 2 neuro-oncologic consultations and magnetic resonance imaging to confirm the diagnosis. Patients were classified according to universally used prognostic scores, gender, primary tumor, localization of BM, and clinical complaints. Univariate and multivariate analysis was used to evaluate associations. RESULTS: A total of 570 patients were included; 71% were female, and 91% had solid tumors. Median survival was 11 months (95% confidence interval 9.4-12.6). Of 1322 parenchymal lesions, 78% were supratentorial, and were most commonly in the frontal lobe. The most common symptoms were headache, vision changes, and weakness. Brain metastases in the brainstem were associated with a worse prognosis (P = 0.04). Visual complaints (P = 0.005), altered mental status, (P < 0.0001) and cranial neuropathy (P 0.001) were also associated with a poor outcome, as were poor performance status, more than 1 brain metastases, meningeal carcinomatosis, and uncontrolled primary cancer. CONCLUSIONS: Both presenting symptoms and the location of brain metastases have prognostic significance and should be further studied, both as independent prognostic predictors and in conjunction with other factors used in prognostic scores.
BACKGROUND:Brain metastases (BM) are a frequent complication of cancer and are regularly seen in clinical practice. New treatment modalities are improving survival after diagnosis of BM. However, symptoms are rarely reported and their significance is not well established. The aim of the present study was to investigate neurologic indicators as prognostic markers in patients with brain metastases. PATIENTS AND METHODS: A prospectively acquired database from 2 referral centers was analyzed. All patients had had at least 2 neuro-oncologic consultations and magnetic resonance imaging to confirm the diagnosis. Patients were classified according to universally used prognostic scores, gender, primary tumor, localization of BM, and clinical complaints. Univariate and multivariate analysis was used to evaluate associations. RESULTS: A total of 570 patients were included; 71% were female, and 91% had solid tumors. Median survival was 11 months (95% confidence interval 9.4-12.6). Of 1322 parenchymal lesions, 78% were supratentorial, and were most commonly in the frontal lobe. The most common symptoms were headache, vision changes, and weakness. Brain metastases in the brainstem were associated with a worse prognosis (P = 0.04). Visual complaints (P = 0.005), altered mental status, (P < 0.0001) and cranial neuropathy (P 0.001) were also associated with a poor outcome, as were poor performance status, more than 1 brain metastases, meningeal carcinomatosis, and uncontrolled primary cancer. CONCLUSIONS: Both presenting symptoms and the location of brain metastases have prognostic significance and should be further studied, both as independent prognostic predictors and in conjunction with other factors used in prognostic scores.
Authors: Martin A Proescholdt; Petra Schödel; Christian Doenitz; Tobias Pukrop; Julius Höhne; Nils Ole Schmidt; Karl-Michael Schebesch Journal: Cancers (Basel) Date: 2021-03-31 Impact factor: 6.639
Authors: Stephanie T Jünger; Lenhard Pennig; Petra Schödel; Roland Goldbrunner; Lea Friker; Martin Kocher; Martin Proescholdt; Stefan Grau Journal: Cancers (Basel) Date: 2021-03-21 Impact factor: 6.639