MLTI-03 - David Reinecke.mp4
The relevance of the count of brain metastases for treatment and outcome in NSCLC
Contact Presenter
David Reinecke1, Stephanie T. Jünger1, Martin Kocher2, Maximilian Ruge2, Daniel Ruess2, Roland Goldbrunner1, Stefan J. Grau1
1Center for Neurosurgery, Department of General Neurosurgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne/NRW, Germany. 2Center for Neurosurgery, Department of Stereotaxy and Functional Neurosurgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne/NRW, Germany
Background and Purpose: While data reporting the number of brain metastasis as a prognostic factor for patients with NSCLC, we analyzed whether the prognostic importance of the mere count of brain metastasis in a modern, multimodal treatment setting.
Patients and Methods: We retrospectively analyzed patients treated for BM from non-small lung cancer between 2010 and 2020. Demographics, baseline characteristics, and tumor-associated parameters were retrieved from an electronic database. Prognostic factors for local cerebral control and survival were identified using the log-rank test and Cox regression analysis.
Results: We included 343 consecutive patients (male n=187, female n=156; median age 61 years). Histological subtypes were adenocarcinoma (n=283), squamous-cell carcinoma (n=42) and neuroendocrine carcinoma (n=18). The median number of BM was one (range 1-20). Single (n = 189), oligo (n=110) and multiple BM (n=44) showed in total a median follow up of 10 months (minimum 1, maximum 142). Treatment comprised surgical resection (n=218) with radiotherapy, stereotactic radiosurgery (n=125) and adjuvant systemic therapy (n=203). The median local cerebral control was 11 months (95%CI 8.5 – 13.5) and the median overall survival was 16 months (95%CI 12.8 – 19.2). The number of BM did not influence local control and overall survival rates (p = 0.234 and p = 0.210, respectively). Controlled systemic disease (HR 0.42; 95% CI 0.2284-0.633; p<0.0001), clinical status (Karnofsky Performance Score > 70; HR 0.41; 95% CI 0.265-0.661; p<0.0001) and adjuvant systemic therapy (HR 0.38; 95% CI 0.279-0.530; p<0.0001) were independent prognostic factors for survival.
Conclusions: The mere number of brain metastases is not a prognostic factor for survival and local cerebral control in a multimodal treatment setting.
Contact Presenter
David Reinecke1, Stephanie T. Jünger1, Martin Kocher2, Maximilian Ruge2, Daniel Ruess2, Roland Goldbrunner1, Stefan J. Grau1
1Center for Neurosurgery, Department of General Neurosurgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne/NRW, Germany. 2Center for Neurosurgery, Department of Stereotaxy and Functional Neurosurgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne/NRW, Germany
Background and Purpose: While data reporting the number of brain metastasis as a prognostic factor for patients with NSCLC, we analyzed whether the prognostic importance of the mere count of brain metastasis in a modern, multimodal treatment setting.
Patients and Methods: We retrospectively analyzed patients treated for BM from non-small lung cancer between 2010 and 2020. Demographics, baseline characteristics, and tumor-associated parameters were retrieved from an electronic database. Prognostic factors for local cerebral control and survival were identified using the log-rank test and Cox regression analysis.
Results: We included 343 consecutive patients (male n=187, female n=156; median age 61 years). Histological subtypes were adenocarcinoma (n=283), squamous-cell carcinoma (n=42) and neuroendocrine carcinoma (n=18). The median number of BM was one (range 1-20). Single (n = 189), oligo (n=110) and multiple BM (n=44) showed in total a median follow up of 10 months (minimum 1, maximum 142). Treatment comprised surgical resection (n=218) with radiotherapy, stereotactic radiosurgery (n=125) and adjuvant systemic therapy (n=203). The median local cerebral control was 11 months (95%CI 8.5 – 13.5) and the median overall survival was 16 months (95%CI 12.8 – 19.2). The number of BM did not influence local control and overall survival rates (p = 0.234 and p = 0.210, respectively). Controlled systemic disease (HR 0.42; 95% CI 0.2284-0.633; p<0.0001), clinical status (Karnofsky Performance Score > 70; HR 0.41; 95% CI 0.265-0.661; p<0.0001) and adjuvant systemic therapy (HR 0.38; 95% CI 0.279-0.530; p<0.0001) were independent prognostic factors for survival.
Conclusions: The mere number of brain metastases is not a prognostic factor for survival and local cerebral control in a multimodal treatment setting.