Utility of a prognostic assessment tool to predict survival following surgery for brain metastases.

IF 2.4 Q2 CLINICAL NEUROLOGY
Neuro-oncology practice Pub Date : 2023-08-07 eCollection Date: 2023-12-01 DOI:10.1093/nop/npad047
Hadleigh Cuthbert, Max Riley, Shreya Bhatt, Claudia Kate Au-Yeung, Ayesha Arshad, Sondos Eladawi, Athanasios Zisakis, Georgios Tsermoulas, Colin Watts, Victoria Wykes
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引用次数: 0

Abstract

Background: Brain metastases account for more than 50% of all intracranial tumors and are associated with poor outcomes. Treatment decisions in this highly heterogenous cohort remain controversial due to the myriad of treatment options available, and there is no clearly defined standard of care. The prognosis in brain metastasis patients varies widely with tumor type, extracranial disease burden and patient performance status. Decision-making regarding treatment is, therefore, tailored to each patient and their disease.

Methods: This is a retrospective cohort study assessing survival outcomes following surgery for brain metastases over a 50-month period (April 1, 2014-June 30, 2018). We compared predicted survival using the diagnosis-specific Graded Prognostic Assessment (ds-GPA) with actual survival.

Results: A total of 186 patients were included in our cohort. Regression analysis demonstrated no significant correlation between actual and predicted outcome. The most common reason for exclusion was insufficient information being available to the neuro-oncology multidisciplinary team (MDT) meeting to allow GPA calculation.

Conclusions: In this study, we demonstrate that "predicted survival" using the ds-GPA does not correlate with "actual survival" in our operated patient cohort. We also identify a shortcoming in the amount of information available at MDT in order to implement the GPA appropriately. Patient selection for aggressive therapies is crucial, and this study emphasizes the need for treatment decisions to be individualized based on patient and cancer clinical characteristics.

预测脑转移手术后生存的预后评估工具的应用
脑转移占所有颅内肿瘤的50%以上,并且与不良预后有关。由于有无数的治疗选择,而且没有明确定义的护理标准,在这个高度异质的队列中的治疗决定仍然存在争议。脑转移患者的预后因肿瘤类型、颅外疾病负担和患者表现状况而异。因此,关于治疗的决策是针对每个患者及其疾病量身定制的。这是一项回顾性队列研究,评估了50个月内(2014年4月1日至2018年6月30日)脑转移手术后的生存结果。我们将使用诊断特异性分级预后评估(GPA)的预测生存率与实际生存率进行了比较。共有186名患者被纳入我们的队列。回归分析表明,实际结果和预测结果之间没有显著相关性。排除的最常见原因是神经肿瘤学多学科团队(MDT)会议提供的信息不足,无法计算GPA。在这项研究中,我们证明,在我们的手术患者队列中,使用诊断特异性GPA的“预测生存率”与“实际生存率”无关。我们还发现了MDT可用信息量的不足,以便适当实施GPA。积极治疗的患者选择至关重要,本研究强调需要根据患者和癌症的临床特征做出个性化的治疗决定。
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来源期刊
Neuro-oncology practice
Neuro-oncology practice CLINICAL NEUROLOGY-
CiteScore
5.30
自引率
11.10%
发文量
92
期刊介绍: Neuro-Oncology Practice focuses on the clinical aspects of the subspecialty for practicing clinicians and healthcare specialists from a variety of disciplines including physicians, nurses, physical/occupational therapists, neuropsychologists, and palliative care specialists, who have focused their careers on clinical patient care and who want to apply the latest treatment advances to their practice. These include: Applying new trial results to improve standards of patient care Translating scientific advances such as tumor molecular profiling and advanced imaging into clinical treatment decision making and personalized brain tumor therapies Raising awareness of basic, translational and clinical research in areas of symptom management, survivorship, neurocognitive function, end of life issues and caregiving
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