Christina Wolfert1, Veit Rohde1, Abdelhalim Hussein1, Ingo Fiss1, Silvia Hernández-Durán1, Dörthe Malzahn2, Annalen Bleckmann3,4, Dorothee Mielke1, Bawarjan Schatlo5. 1. Department of Neurosurgery, University Hospital Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany. 2. mzBiostatistics, Statistical Consultancy, 37075, Göttingen, Germany. 3. Clinic for Hematology/ Medical Oncology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany. 4. Medical Clinic A, Haematology, Haemostasiology, Oncology and Pulmonology, University Hospital Münster, 48149, Münster, Germany. 5. Department of Neurosurgery, University Hospital Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany. bawarjan.schatlo@med.uni-goettingen.de.
Abstract
BACKGROUND: Radiooncological scores are used to stratify patients for radiation therapy. We assessed their ability to predict overall survival (OS) in patients undergoing surgery for metastatic brain disease. METHODS: We performed a post-hoc single-center analysis of 175 patients, prospectively enrolled in the MetastaSys study data. Score index of radiosurgery (SIR), graded prognostic assessment (GPA), and recursive partitioning analysis (RPA) were assessed. All scores consider age, systemic disease, and performance status prior to surgery. Furthermore, GPA and SIR include the number of intracranial lesions while SIR additionally requires metastatic lesion volume. Predictive values for case fatality at 1 year after surgery were compared among scoring systems. RESULTS: All scores produced accurate reflections on OS after surgery (p ≤ 0.003). Median survival was 21-24 weeks in patients scored in the unfavorable cohorts, respectively. In cohorts with favorable scores, median survival ranged from 42 to 60 weeks. Favorable SIR was associated with a hazard ratio (HR) of 0.44 [0.29, 0.66] for death within 1 year. For GPA, the HR amounted to 0.44 [0.25, 0.75], while RPA had a HR of 0.30 [0.14, 0.63]. Overall test performance was highest for the SIR. CONCLUSIONS: All scores proved useful in predicting OS. Considering our data, we recommend using the SIR for preoperative prognostic evaluation and counseling.
BACKGROUND: Radiooncological scores are used to stratify patients for radiation therapy. We assessed their ability to predict overall survival (OS) in patients undergoing surgery for metastatic brain disease. METHODS: We performed a post-hoc single-center analysis of 175 patients, prospectively enrolled in the MetastaSys study data. Score index of radiosurgery (SIR), graded prognostic assessment (GPA), and recursive partitioning analysis (RPA) were assessed. All scores consider age, systemic disease, and performance status prior to surgery. Furthermore, GPA and SIR include the number of intracranial lesions while SIR additionally requires metastatic lesion volume. Predictive values for case fatality at 1 year after surgery were compared among scoring systems. RESULTS: All scores produced accurate reflections on OS after surgery (p ≤ 0.003). Median survival was 21-24 weeks in patients scored in the unfavorable cohorts, respectively. In cohorts with favorable scores, median survival ranged from 42 to 60 weeks. Favorable SIR was associated with a hazard ratio (HR) of 0.44 [0.29, 0.66] for death within 1 year. For GPA, the HR amounted to 0.44 [0.25, 0.75], while RPA had a HR of 0.30 [0.14, 0.63]. Overall test performance was highest for the SIR. CONCLUSIONS: All scores proved useful in predicting OS. Considering our data, we recommend using the SIR for preoperative prognostic evaluation and counseling.
Authors: Daniel W Golden; Kathleen R Lamborn; Michael W McDermott; Sandeep Kunwar; William M Wara; Jean L Nakamura; Penny K Sneed Journal: J Neurosurg Date: 2008-12 Impact factor: 5.115
Authors: M Martínez-Garcia; J Álvarez-Linera; C Carrato; L Ley; R Luque; X Maldonado; M Martínez-Aguillo; L M Navarro; M A Vaz-Salgado; M Gil-Gil Journal: Clin Transl Oncol Date: 2017-10-30 Impact factor: 3.405
Authors: Steven N Kalkanis; Douglas Kondziolka; Laurie E Gaspar; Stuart H Burri; Anthony L Asher; Charles S Cobbs; Mario Ammirati; Paula D Robinson; David W Andrews; Jay S Loeffler; Michael McDermott; Minesh P Mehta; Tom Mikkelsen; Jeffrey J Olson; Nina A Paleologos; Roy A Patchell; Timothy C Ryken; Mark E Linskey Journal: J Neurooncol Date: 2009-12-04 Impact factor: 4.130