Abstract
Background and purpose
This study aimed to determine factors allowing the prediction of extracranial metastases in patients presenting with brain metastases at the first diagnosis of cancer.
Materials and methods
Data from 659 patients with brain metastases upon first diagnosis of cancer were retrospectively analyzed. The parameters age, gender, Karnofsky performance score (KPS), primary tumor type and number of brain metastases were compared between 359 patients with extracranial metastases and 300 patients without extracranial metastases. Additional analyses were performed for patients with the most unfavorable and those with the most favorable characteristics.
Results
The comparison of patients with versus without extracranial metastases revealed significant differences between the groups in terms of KPS (p < 0.001) and number of brain metastases (p < 0.001). Of the study patients, 113 had both most unfavorable characteristics, i.e. KPS ≤ 50 and ≥ 4 brain metastases. The sensitivity for identifying patients with extracranial metastases was 82 %; specificity was 51 %. A total of 50 patients had KPS ≥ 90 and only one brain metastasis. The sensitivity for identifying patients without extracranial metastases was 86 %; specificity was 58 %.
Conclusion
The combination of KPS and the number of brain metastases can help to predict the presence or absence of extracranial metastases.
Zusammenfassung
Hintergrund und Ziel
Diese Studie soll zur Abschätzung des Vorliegens extrakranieller Metastasen bei Patienten mit primär zerebral metastasierter Tumorerkrankung beitragen.
Material und Methoden
Daten von 659 Patienten mit primär zerebral metastasierter Tumorerkrankung wurden retrospektiv analysiert. Insgesamt 359 Patienten mit extrakraniellen Metastasen wurden mit 300 Patienten ohne extrakranielle Metastasierung hinsichtlich Alter, Geschlecht, Karnofsky-Performance-Score (KPS), Art des Primärtumors und der Anzahl der Hirnmetastasen miteinander verglichen. Weitere Analysen erfolgten bei Patienten mit den ungünstigsten und bei Patienten mit den günstigsten Charakteristika.
Ergebnisse
Der Vergleich der Patienten mit versus ohne extrakranielle Metastasierung ergab signifikante Unterschiede beider Gruppen hinsichtlich KPS (p < 0,001) und Anzahl der Hirnmetastasen (p < 0,001). Die beiden ungünstigsten Charakteristika, KPS ≤ 50 und ≥ 4 Hirnmetastasen, wiesen 113 Patienten auf. Die Sensitivität für die Identifikation von Patienten mit extrakraniellen Metastasen betrug 82 %. Die Spezifität lag bei 51 %. Einen KPS ≥ 90 und nur eine Hirnmetastase hatten 50 Patienten. Die Sensitivität für die Identifikation von Patienten ohne extrakranielle Metastasen betrug 86 %. Die Spezifität lag bei 58 %.
Schlussfolgerung
Die Kombination von KPS und Anzahl der Hirnmetastasen kann zur Abschätzung des Vorliegens extrakranieller Metastasen beitragen.
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Compliance with ethical guidelines
Conflict of interest. D. Rades, B. Segedin, V. Nagy, S.E. Schild, N.T. Trang and M.T. Khoa state that there are no conflicts of interest.
The accompanying manuscript does not include studies on humans or animals.
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Rades, D., Segedin, B., Nagy, V. et al. Predicting the presence of extracranial metastases in patients with brain metastases upon first diagnosis of cancer. Strahlenther Onkol 190, 405–407 (2014). https://doi.org/10.1007/s00066-013-0516-x
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DOI: https://doi.org/10.1007/s00066-013-0516-x