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Karnofsky Performance Status (KPS) ≤60 Is Strongly Associated With Shorter Brain-Specific Progression-Free Survival
Mark Freeman1, Marguerite Ennis2, Katarzyna J Jerzak1,3,4
1Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Frontiers in Oncology
|August 15, 2022
Summary
Patients with breast cancer brain metastases and Karnofsky Performance Status (KPS) of 60 or less have significantly shorter brain-specific progression-free survival and overall survival. Routine KPS documentation can improve prognostication for these patients.
Area of Science:
- Neuro-oncology
- Medical oncology
- Radiotherapy
Background:
- Breast cancer brain metastases (BCBrM) significantly impact patient prognosis.
- Karnofsky Performance Status (KPS) is a measure of functional status.
- The prognostic value of KPS for outcomes in BCBrM requires further elucidation.
Purpose of the Study:
- To investigate the association between KPS and brain-specific progression-free survival (bsPFS) in patients with BCBrM.
- To determine if KPS is a significant predictor of overall survival (OS) in this patient population.
Main Methods:
- Retrospective cohort study of 683 patients with BCBrM treated between 2008-2018.
- KPS scores were imputed at diagnosis; patients were grouped into KPS ≤60 and KPS >60 cohorts.
- Univariable and multivariable Cox proportional hazards models were used to analyze prognostic factors for bsPFS and OS.
Main Results:
- A KPS ≤60 score was significantly associated with shorter bsPFS (HR 1.86) and OS (HR 2.95) in multivariable analyses.
- Factors such as leptomeningeal disease and neurological symptoms also correlated with poorer bsPFS.
- The median bsPFS was 9 months; median OS was not reached.
Conclusions:
- A KPS ≤60 is a significant independent predictor of worse outcomes in patients with BCBrM.
- Routine documentation of KPS at diagnosis is recommended for improved prognostication.
- KPS assessment can aid in clinical decision-making and patient management for BCBrM.
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