Impact of preoperative clinical patient parameters on surgically obtained brain metastasis samples for translational...

Human tissue samples are a crucial resource for cancer research, offering key insights into physiological and pathological processes while enabling comprehensive characterization of molecular signatures across cancer subtypes. Recent advances in genetic analysis techniques lead to a substantiall expansion of specific molecular pathways knowledge. The application of these technologies to fresh tissue samples from patients undergoing surgical resection for metastatic disease represents a promising approach to gain a deeper understanding of the biology of brain metastasis. Brain metastases remain particularly challenging due to their poor prognosis and the complex mechanisms underlying central nervous system invasion. This study sought to identify preoperative factors influencing the research utility of fresh brain metastasis tissue samples. A pipeline was established to transfer fresh, surplus tissue from surgical resections to research laboratories with histological quality assessment. Of the fifty-five fresh specimens collected, thirty-eight (69 %) were classified as suitable for further research applications. Statistical analysis revealed that only two factors significantly affected sample quality. First, the extent of MRI-derived necrosis was significantly higher in unsuitable samples (mean 18.0 %) than in suitable samples (mean 8.3 %) (p = 0.0273). Second, prior treatment with target-specific therapeutics (TST) was associated with a lower proportion of suitable samples (47 %) compared to no prior TST (79 %) (p = 0.018). Logistic regression confirmed these variables as significant predictors, with MRI-derived necrosis (odds ratio 1.049) and target-specific therapy exposure (odds ratio 4.486) independently increasing the likelihood of obtaining suboptimal samples. Other parameters, including age, gender, metastasis volume, localization, primary cancer site, and other therapeutic interventions, showed no significant impact on sample quality. Based on these findings, the collection pipeline was modified to include evaluation by board-certified neuropathologists before samples are used for research purposes, improving the efficiency of translational research utilizing brain metastasis tissue.