Survival and prognostic factors in patients with gastrointestinal cancers and brain metastases: have we made progress?

Paul W Sperduto; Penny Fang; Jing Li; William Breen; Paul D Brown; Daniel Cagney; Ayal Aizer; James Yu; Veronica Chiang; Supriya Jain; Laurie E Gaspar; Sten Myrehaug; Arjun Sahgal; Steve Braunstein; Penny Sneed; Brent Cameron; Albert Attia; Jason Molitoris; Cheng-Chia Wu; Tony J C Wang; Natalie Lockney; Kathryn Beal; Jessica Parkhurst; John M Buatti; Ryan Shanley; Emil Lou; Daniel D Tandberg; John P Kirkpatrick; Diana Shi; Helen A Shih; Michael Chuong; Hirotake Saito; Hidefumi Aoyama; Laura Masucci; David Roberge; Minesh P Mehta

doi:10.1016/j.trsl.2019.02.011

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Survival and prognostic factors in patients with gastrointestinal cancers and brain metastases: have we made progress?

Journal article

Open access

Peer reviewed

Survival and prognostic factors in patients with gastrointestinal cancers and brain metastases: have we made progress?

Paul W Sperduto, Penny Fang, Jing Li, William Breen, Paul D Brown, Daniel Cagney, Ayal Aizer, James Yu, Veronica Chiang, Supriya Jain, …

Translational research : the journal of laboratory and clinical medicine, Vol.208, pp.63-72

06/2019

DOI: 10.1016/j.trsl.2019.02.011

PMCID: PMC6527460

PMID: 30885538

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https://www.ncbi.nlm.nih.gov/pmc/articles/6527460View

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Abstract

The literature describing the prognosis of patients with gastrointestinal (GI) cancers and brain metastases (BM) is sparse. Our group previously published a prognostic index, the Graded Prognostic Assessment (GPA) for GI cancer patients with BM, based on 209 patients diagnosed from 1985-2005. The purpose of this analysis is to identify prognostic factors for GI cancer patients with newly diagnosed BM in a larger contemporary cohort. A multi-institutional retrospective IRB-approved database of 792 GI cancer patients with new BM diagnosed from 1/1/2006 to 12/31/2016 was created. Demographic data, clinical parameters, and treatment were correlated with survival and time from primary diagnosis to BM (TPDBM). Kaplan-Meier median survival (MS) estimates were calculated and compared with log-rank tests. The MS from time of first treatment for BM for the prior and current cohorts were 5 and 8 months, respectively (P < 0.001). Eight prognostic factors (age, stage, primary site, resection of primary tumor, Karnofsky Performance Status (KPS), extracranial metastases, number of BM and Hgb were found to be significant for survival, in contrast to only one (KPS) in the prior cohort. In this cohort, the most common primary sites were rectum (24%) and esophagus (23%). Median TPDBM was 22 months. Notably, 37% (267/716) presented with poor prognosis (GPA 0-1.0). Although little improvement in overall survival in this cohort has been achieved in recent decades, survival varies widely and multiple new prognostic factors were identified. Future work will translate these factors into a prognostic index to facilitate clinical decision-making and stratification of future clinical trials.

Adult

Aged

Aged, 80 and over

Brain Neoplasms - pathology

Brain Neoplasms - secondary

Cohort Studies

Female

Gastrointestinal Neoplasms - pathology

Gastrointestinal Neoplasms - secondary

Humans

Kaplan-Meier Estimate

Male

Middle Aged

Prognosis

Details

Title: Subtitle: Survival and prognostic factors in patients with gastrointestinal cancers and brain metastases: have we made progress?
Creators: Paul W Sperduto - University of Minnesota‐Twin Cities
Penny Fang - The University of Texas MD Anderson Cancer Center
Jing Li - The University of Texas MD Anderson Cancer Center
William Breen - Mayo Clinic
Paul D Brown - Mayo Clinic
Daniel Cagney - Dana-Farber Cancer Institute
Ayal Aizer - Dana-Farber Cancer Institute
James Yu - Yale University
Veronica Chiang - Yale University
Supriya Jain - University of Colorado Anschutz Medical Campus
Laurie E Gaspar - University of Colorado System
Sten Myrehaug - Sunnybrook Hospital
Arjun Sahgal - Sunnybrook Hospital
Steve Braunstein - UCSF.
Penny Sneed - UCSF.
Brent Cameron - Vanderbilt University
Albert Attia - Vanderbilt University
Jason Molitoris - University of Maryland, College Park
Cheng-Chia Wu - Columbia University Medical Center
Tony J C Wang - Columbia University Medical Center
Natalie Lockney - Memorial Sloan Kettering Cancer Center
Kathryn Beal - Memorial Sloan Kettering Cancer Center
Jessica Parkhurst - University of Iowa
John M Buatti - University of Iowa
Ryan Shanley - University of Minnesota
Emil Lou - University of Minnesota
Daniel D Tandberg - Duke University
John P Kirkpatrick - Duke University
Diana Shi - Massachusetts General Hospital
Helen A Shih - Massachusetts General Hospital
Michael Chuong - Miami Cancer Institute
Hirotake Saito - Niigata University
Hidefumi Aoyama - Niigata University
Laura Masucci - Centre Hospitalier de l’Université de Montréal
David Roberge - Centre Hospitalier de l’Université de Montréal
Minesh P Mehta - Miami Cancer Institute
Resource Type: Journal article
Publication Details: Translational research : the journal of laboratory and clinical medicine, Vol.208, pp.63-72
DOI: 10.1016/j.trsl.2019.02.011
PMID: 30885538
PMCID: PMC6527460
NLM abbreviation: Transl Res
ISSN: 1931-5244
eISSN: 1878-1810
Grant note: P30 CA077598 / NCI NIH HHS UL1 TR002494 / NCATS NIH HHS UL1 TR001863 / NCATS NIH HHS
Language: English
Date published: 06/2019
Academic Unit: Radiation Oncology; Neurosurgery; Otolaryngology
Record Identifier: 9984303898902771

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