Prognostic Importance of Cumulative Intracranial Tumor Volume in Patients with Gastrointestinal Brain Metastasis Treated with Stereotactic Radiosurgery
| Autor: | Hitoshi Aiyama, Mir Amaan Ali, Osamu Nagano, Ali Al-Attar, Kate T. Carroll, Brian R. Hirshman, Rushikesh S. Joshi, Clark C. Chen, Masaaki Yamamoto, Toru Serizawa |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Oncology medicine.medical_specialty Prognostic variable Intracranial tumor medicine.medical_treatment Radiosurgery Logistic regression Cohort Studies 03 medical and health sciences 0302 clinical medicine Internal medicine Image Processing Computer-Assisted Humans Medicine Karnofsky Performance Status Aged Gastrointestinal Neoplasms Brain Neoplasms Proportional hazards model business.industry Cancer Middle Aged medicine.disease Magnetic Resonance Imaging Confidence interval Logistic Models 030220 oncology & carcinogenesis Female Surgery Neurology (clinical) business 030217 neurology & neurosurgery Brain metastasis |
| Zdroj: | World Neurosurgery. 121:e747-e754 |
| ISSN: | 1878-8750 |
| DOI: | 10.1016/j.wneu.2018.09.209 |
| Popis: | Background The disease-specific Graded Prognostic Assessment (ds-GPA) for patients with gastrointestinal (GI) tract cancer brain metastases (BM) suggests Karnofsky Performance Status (KPS) as the only pertinent prognostic factor. We evaluated the prognostic importance of cumulative intracranial tumor volume (CITV). Methods KPS, CITV, and overall survival were collected from consecutive patients with stereotactic radiosurgery–treated GI BM. Patients were grouped into 2 independent cohorts for development and validation of the model (termed “exploratory” and “validation” cohorts). Analyses were performed using logistic regression, Cox proportional hazards models, Net Reclassification Index (NRI >0), integrated discrimination improvement (IDI >0), and Akaike information criterion. Results In univariable logistic regression models, both CITV and KPS were independently associated with patient survival. The association between CITV and overall survival remained robust after controlling for KPS (P 0 of 0.397 (95% confidence interval [CI], 0.165–0.630; P 0 of 0.478 (95% CI, 0.257–0.699; P Conclusions CITV is an important prognostic variable in patients with stereotactic radiosurgery–treated GI BM and augments the prognostic accuracy of the GI-ds-GPA index. |
| Databáze: | OpenAIRE |
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