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Descriptive statistical analysis of a real life cohort of 2419 patients with brain metastases of solid cancers
  1. Anna S Berghoff1,2,
  2. Sophie Schur1,2,
  3. Lisa M Füreder1,2,
  4. Brigitte Gatterbauer2,3,
  5. Karin Dieckmann2,4,
  6. Georg Widhalm2,3,
  7. Johannes Hainfellner2,5,
  8. Christoph C Zielinski1,2,
  9. Peter Birner2,6,
  10. Rupert Bartsch1,2,
  11. Matthias Preusser1,2
  1. 1Department of Medicine I, Medical University of Vienna, Vienna, Austria
  2. 2Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
  3. 3Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
  4. 4Department of Radiotherapy, Medical University of Vienna, Vienna, Austria
  5. 5Institute of Neurology, Medical University of Vienna, Vienna, Austria
  6. 6Department of Pathology, Medical University of Vienna, Vienna, Austria
  1. Correspondence to Professor Matthias Preusser; Matthias.preusser{at}meduniwien.ac.at

Abstract

Aim We provide a descriptive statistical analysis of baseline characteristics and the clinical course of a large real-life cohort of brain metastases (BM) patients.

Methods We performed a retrospective chart review for patients treated for BM of solid cancers at the Medical University of Vienna between 1990 and 2011.

Results We identified a total of 2419 BM patients (50.5% male, 49.5% female, median age 59 years). The primary tumour was lung cancer in 43.2%, breast cancer in 15.7%, melanoma in 16.4%, renal cell carcinoma in 9.1%, colorectal cancer in 9.3% and unknown in 1.4% of cases. Rare tumour types associated with BM included genitourinary cancers (4.1%), sarcomas (0.7%). gastro-oesophageal cancer (0.6%) and head and neck cancers (0.2%). 48.7% of patients presented with a singular BM, 27.7% with 2–3 and 23.5% with >3 BM. Time from primary tumour to BM diagnosis was shortest in lung cancer (median 11 months; range 1–162) and longest in breast cancer (median 44 months; 1–443; p<0.001). Multiple BM were most frequent in breast cancer (30.6%) and least frequent in colorectal cancer (8.5%; p<0.001). Patients with breast cancer had the longest median overall survival times (8 months), followed by patients with lung cancer (7 months), renal cell carcinoma (7 months), melanoma (5 months) and colorectal cancer (4 months; p<0.001; log rank test). Recursive partitioning analysis and graded prognostic assessment scores showed significant correlation with overall survival (both p<0.001, log rank test). Evaluation of the disease status in the past 2 months prior to patient death showed intracranial progression in 35.9%, extracranial progression in 27.5% and combined extracranial and intracranial progression in 36.6% of patients.

Conclusions Our data highlight the heterogeneity in presentation and clinical course of BM patients in the everyday clinical setting and may be useful for rational planning of clinical studies.

  • brain metastases
  • prognosis
  • disease status in end of life period
  • descriptive analysis

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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