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Preoperative Prognostic Index for Patients with Brain Metastases-A Population-Based Multi-Centre Study.

Rebecca Rootwelt Winther1, Eva Skovlund2, Joakim Stray Andreassen3

  • 1European Palliative Care Research Centre (PRC), Department of Oncology, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, 4956 Oslo, Norway.

Cancers
|June 28, 2023
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Summary

A new prognostic index helps predict survival for patients with brain metastases (BM) undergoing surgery. This tool aids in making informed decisions about surgical interventions for BM.

Keywords:
brain metastasesindexprognosticationsurgerysurvival

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Area of Science:

  • Oncology
  • Neurosurgery
  • Biostatistics

Background:

  • Brain metastases (BM) are a frequent complication in cancer patients, leading to significant morbidity and mortality.
  • Current preoperative prognostication tools for surgical intervention in BM are suboptimal.
  • Patient selection for surgery remains challenging and controversial.

Purpose of the Study:

  • To develop and validate a preoperative prognostic index for patients undergoing surgery for brain metastases.
  • To improve preoperative prognostication and support informed decision-making.

Main Methods:

  • A derivation dataset of 590 patients who underwent surgery for BM was used to identify survival-associated variables.
  • A preoperative prognostic index was created and subsequently validated on two external datasets comprising 438 patients.
  • The index was adjusted to minimize over-fitting and enhance its predictive accuracy.

Main Results:

  • The developed prognostic index successfully stratified patients into four distinct prognostic groups.
  • Two groups with similar poor survival outcomes were merged following validation.
  • An adjusted preoperative prognostic index was established based on these findings.

Conclusions:

  • A validated preoperative prognostic index for brain metastases (BM) has been developed.
  • This index accurately predicts overall survival, aiding in surgical decision-making for BM patients.
  • The tool offers valuable support for informed choices regarding surgical treatment of BM.