Preoperative Prognostic Index for Patients with Brain Metastases—A Population-Based Multi-Centre Study
Background: Brain metastases (BM) are common in cancer patients and are associated with high morbidity and mortality. Surgery is an option, but the optimal selection of patients for surgery is challenging and controversial. Current prognostication tools are not ideal for preoperative prognostication...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-06-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/12/3174 |
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| author | Rebecca Rootwelt Winther Eva Skovlund Joakim Stray Andreassen Lisa Arvidsson Jonathan Halvardson Ole Solheim Jiri Bartek Stein Kaasa Marianne Jensen Hjermstad Einar Osland Vik-Mo |
| author_facet | Rebecca Rootwelt Winther Eva Skovlund Joakim Stray Andreassen Lisa Arvidsson Jonathan Halvardson Ole Solheim Jiri Bartek Stein Kaasa Marianne Jensen Hjermstad Einar Osland Vik-Mo |
| author_sort | Rebecca Rootwelt Winther |
| collection | DOAJ |
| description | Background: Brain metastases (BM) are common in cancer patients and are associated with high morbidity and mortality. Surgery is an option, but the optimal selection of patients for surgery is challenging and controversial. Current prognostication tools are not ideal for preoperative prognostication. By using a reference population (derivation data set) and two external populations (validation data set) of patients who underwent surgery for BM, we aimed to create and validate a preoperative prognostic index. Methods: The derivation data set consists of 590 patients who underwent surgery for BM (2011–2018) at Oslo University Hospital. We identified variables associated with survival and created a preoperative prognostic index with four prognostic groups, which was validated on patients who underwent surgery for BM at Karolinska University Hospital and St. Olavs University Hospital during the same time period. To reduce over-fitting, we adjusted the index in accordance with our findings. Results: 438 patients were included in the validation data set. The preoperative prognostic index correctly divided patients into four true prognostic groups. The two prognostic groups with the poorest survival outcomes overlapped, and these were merged to create the adjusted preoperative prognostic index. Conclusion: We created a prognostic index for patients with BM that predicts overall survival preoperatively. This index might be valuable in supporting informed choice when considering surgery for BM. |
| first_indexed | 2024-03-09T10:57:43Z |
| format | Article |
| id | doaj.art-e61caabc7bcb42498ffc543166b44524 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T10:57:43Z |
| publishDate | 2023-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-e61caabc7bcb42498ffc543166b445242023-12-01T01:32:30ZengMDPI AGCancers2072-66942023-06-011512317410.3390/cancers15123174Preoperative Prognostic Index for Patients with Brain Metastases—A Population-Based Multi-Centre StudyRebecca Rootwelt Winther0Eva Skovlund1Joakim Stray Andreassen2Lisa Arvidsson3Jonathan Halvardson4Ole Solheim5Jiri Bartek6Stein Kaasa7Marianne Jensen Hjermstad8Einar Osland Vik-Mo9European Palliative Care Research Centre (PRC), Department of Oncology, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, 4956 Oslo, NorwayDepartment of Public Health and Nursing, Norwegian University of Science and Technology, 7034 Trondheim, NorwayDepartment of Neurosurgery, St. Olavs University Hospital, 7030 Trondheim, NorwayDepartment of Neurosurgery, Karolinska University Hospital, 17164 Stockholm, SwedenDepartment of Neurosurgery, Karolinska University Hospital, 17164 Stockholm, SwedenDepartment of Neurosurgery, St. Olavs University Hospital, 7030 Trondheim, NorwayDepartment of Neurosurgery, Karolinska University Hospital, 17164 Stockholm, SwedenEuropean Palliative Care Research Centre (PRC), Department of Oncology, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, 4956 Oslo, NorwayEuropean Palliative Care Research Centre (PRC), Department of Oncology, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, 4956 Oslo, NorwayInstitute of Clinical Medicine, University of Oslo, 0318 Oslo, NorwayBackground: Brain metastases (BM) are common in cancer patients and are associated with high morbidity and mortality. Surgery is an option, but the optimal selection of patients for surgery is challenging and controversial. Current prognostication tools are not ideal for preoperative prognostication. By using a reference population (derivation data set) and two external populations (validation data set) of patients who underwent surgery for BM, we aimed to create and validate a preoperative prognostic index. Methods: The derivation data set consists of 590 patients who underwent surgery for BM (2011–2018) at Oslo University Hospital. We identified variables associated with survival and created a preoperative prognostic index with four prognostic groups, which was validated on patients who underwent surgery for BM at Karolinska University Hospital and St. Olavs University Hospital during the same time period. To reduce over-fitting, we adjusted the index in accordance with our findings. Results: 438 patients were included in the validation data set. The preoperative prognostic index correctly divided patients into four true prognostic groups. The two prognostic groups with the poorest survival outcomes overlapped, and these were merged to create the adjusted preoperative prognostic index. Conclusion: We created a prognostic index for patients with BM that predicts overall survival preoperatively. This index might be valuable in supporting informed choice when considering surgery for BM.https://www.mdpi.com/2072-6694/15/12/3174brain metastasessurgeryprognosticationsurvivalindex |
| spellingShingle | Rebecca Rootwelt Winther Eva Skovlund Joakim Stray Andreassen Lisa Arvidsson Jonathan Halvardson Ole Solheim Jiri Bartek Stein Kaasa Marianne Jensen Hjermstad Einar Osland Vik-Mo Preoperative Prognostic Index for Patients with Brain Metastases—A Population-Based Multi-Centre Study Cancers brain metastases surgery prognostication survival index |
| title | Preoperative Prognostic Index for Patients with Brain Metastases—A Population-Based Multi-Centre Study |
| title_full | Preoperative Prognostic Index for Patients with Brain Metastases—A Population-Based Multi-Centre Study |
| title_fullStr | Preoperative Prognostic Index for Patients with Brain Metastases—A Population-Based Multi-Centre Study |
| title_full_unstemmed | Preoperative Prognostic Index for Patients with Brain Metastases—A Population-Based Multi-Centre Study |
| title_short | Preoperative Prognostic Index for Patients with Brain Metastases—A Population-Based Multi-Centre Study |
| title_sort | preoperative prognostic index for patients with brain metastases a population based multi centre study |
| topic | brain metastases surgery prognostication survival index |
| url | https://www.mdpi.com/2072-6694/15/12/3174 |
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