Article
Prediction of survival in patients with breast cancer brain metastases (BCBM)
Überlebensprognose für Patientinnen mit cerebral metastasiertem Mammakarzinom
Search Medline for
Authors
Published: | June 4, 2021 |
---|
Outline
Text
Objective: Breast cancer (BC) brain metastases (BM/BCBM) requiring surgical treatment determine the prognosis in patients with BC. The graded prognostic assessment (GPA) score was described and established as an estimation of the prognosis in BCBM patients, regardless the need for BM surgery. We aimed to develop the scores for the prediction of short (<6 months, STS) and long-term survival (>3 years, LTS) after BCBM surgery.
Methods: All female patients with BCBM who underwent BM surgery in our institution between 2008 and 2019 were included. Various preoperative demographic, clinical and histopathological characteristics of the patients were evaluated as potential STS/LTS score components.
Results: Of 95 BCBM patients in the final analysis (median age: 60.0 years), STS and LTS after BM surgery was observed in 77 (79.4%) and 22 (22.7%) cases respectively. Breast-preserving surgery (1 points), presence of multiple BM (1 point) and age ≥ 65 years at BC diagnosis (1 point) were included in the STS score (0-3 points). In turn, LTS score (0-3 points) consisted of positive HER2 receptor status in BM (1 point), time interval ≥3 years between BC and BM diagnosis (1 point) and KPS≥90% (1 point). The new scores showed higher diagnostic accuracy for STS/LTS prediction (STS-score: AUC: 0.773/ LTS-Score: AUC: 0.775) than the GPA (AUC: 0.498/ AUC: 0.615) and modified-GPA (AUC: 0.642/ AUC: 0.654) scores.
Conclusion: Different factors play the crucial role in the prediction of STS and LTS in BCBM patients selected for microsurgery. These new scores could support the interdisciplinary decision for the selection of proper candidate for the surgical treatment of BCBM.