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

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.