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Towards the definition of progressive disease in brain metastasis treated with laser ablation: an evidence-based study

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Abstract

Purpose

The postoperative period after laser interstitial thermal therapy (LITT) is marked by a temporary increase in volume, which can impact the accuracy of radiographic assessment. The current criteria for progressive disease (PD) suggest that a 20% increase in size of brain metastasis (BM) assessed in 6–12 weeks intervals should be considered as local progression (LP). However, there is no agreement on how LP should be defined in this context. In this study, we aimed to statistically analyze which tumor volume variations were associated with LP.

Methods

We analyzed 40 BM that underwent LITT between 2013 and 2022. For this study, LP was defined following radiographic features. A ROC curve was generated to evaluate volume change as a predictor of LP and find the optimal cutoff point. A logistic regression analysis and Kaplan Meier curves were performed to assess the impact of various clinical variables on LP.

Results

Out of 40 lesions, 12 (30%) had LP. An increase in volume of 25.6% from baseline within 120–180 days after LITT presented a 70% sensitivity and 88.9% specificity for predicting LP (AUC: 0.78, p = 0.041). The multivariate analysis showed a 25% increase in volume between 120 and 180 days as a negative predictive factor (p = 0.02). Volumetric changes within 60–90 days after LITT did not predict LP (AUC: 0.57; p = 0.61).

Conclusion

Volume changes within the first 120 days after the procedure are not independent indicators of LP of metastatic brain lesions treated with LITT.

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Data Availability

Data will be made available upon reasonable request.

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Funding

This study did not receive any funding or financial support.

Author information

Author notes

  1. Alexa Semonche

    Present address: Department of Neurosurgery, University of California, San Francisco, School of Medicine, 533 Parnassus Ave, San Francisco, CA, 94143, USA

Authors and Affiliations

  1. Department of Neurological Surgery, University of Miami Miller School of Medicine, Lois Pope Life Center, 1095 NW 14th Terrace 2nd Floor, (D4-6), Miami, FL, 33136, USA

    Martin A. Merenzon, Adam S. Levy, Shovan Bhatia, Cameron Rivera, Alexis A. Morell, Alexa Semonche, Lekhaj C. Daggubati, Evan Luther, Ricardo J. Komotar, Ashish H. Shah & Michael E. Ivan

  2. Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, 1475 NW 12th Ave, Miami, FL, 33136, USA

    Ricardo J. Komotar, Ashish H. Shah & Michael E. Ivan

Authors
  1. Martin A. Merenzon
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  2. Adam S. Levy
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  3. Shovan Bhatia
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  4. Cameron Rivera
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  5. Alexis A. Morell
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  6. Alexa Semonche
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  7. Lekhaj C. Daggubati
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  8. Evan Luther
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  9. Ricardo J. Komotar
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Contributions

Substantial contributions to the conception or design of the work: A.H.S., M.E.I., M.A.M., R.J.K. Acquisition, analysis, or interpretation of data for the work: M.A.M., A. S., A.S.L., S.B., C.R., A.S., A.A.M., L.C.D., E.L. Drafting the work: M.A.M., A. S., A.S.L., S.B., C.R. Revising it critically for important intellectual content: M.A.M., A.S.L., S.B., C.R., A.A.M., L.C.D., E.L., R.J.K., A.H.S., M.E.I. Final approval of the version to be published: M.A.M., A.S.L., S.B., C.R., A.A.M., A.S., L.C.D., E.L., R.J.K., A.H.S., M.E.I. Agreement to be accountable for all aspects of the work: M.A.M., A.S.L., S.B., C.R., A.A.M., A.S., L.C.D., E.L., R.J.K., A.H.S., M.E.I.

Corresponding author

Correspondence to Martin A. Merenzon.

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Competing interests

M Ivan is a consultant and grant recipient from Medtronic. The other authors have no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article.

Financial interests

M Ivan is a consultant and grant recipient from Medtronic. The other authors have no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article.

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Merenzon, M.A., Levy, A.S., Bhatia, S. et al. Towards the definition of progressive disease in brain metastasis treated with laser ablation: an evidence-based study. J Neurooncol 163, 463–471 (2023). https://doi.org/10.1007/s11060-023-04360-0

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  • DOI: https://doi.org/10.1007/s11060-023-04360-0

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