Introduction
Methods
Study design
Treatment work-flow
Inclusion and exclusion criteria
Clinical data
Imaging data
Statistical analysis
Results
Study cohort
Characteristic | Frequency |
---|---|
Total number of patients, N (%) | 229 (100) |
Age: | |
• Diagnosis primary tumor, years, mean ± SD | 58.0 ± 11.6 |
• Diagnosis secondary tumor, years, mean ± SD | 61.5 ± 11.1 |
Female sex, N (%) | 115 (50.2) |
Tumor diagnosis: | |
• SCLC/NSCLC, N (%) | 113 (49.3) |
• Melanoma, N (%) | 24 (10.5) |
• Breast cancer, N (%) | 24 (10.5) |
• GIT cancer, N (%) | 17 (7.4) |
• Urogenital cancer, N (%) | 17 (7.4) |
• CUP syndrome, N (%) | 15 (6.6) |
• Miscellaneous#, N (%) | 8 (3.5) |
• Renal cancer, N (%) | 7 (3.1) |
• Head/Neck cancer, N (%) | 4 (1.7) |
Clinical performance: | |
• KPS, median (IQR) | 90 (80– 90) |
• RPA score, median (IQR) | 2 (2– 2) |
• dsGPA score, median (IQR) | 2 (1.75– 3.00) |
• CCI, median (IQR) | 8 (5– 10) |
BM multiplicity: | |
• 1 BM, N (%) | 133 (58.1) |
• 2 BM, N (%) | 76 (33.2) |
• 3 BM, N (%) | 20 (8.7) |
BM features: | |
• Volume, cm3, mean ± SD | 17.3 ± 19.0 |
• Depth, mm, mean ± SD | 18.6 ± 9.9 |
• Localization: | |
- Frontal lobe, N (%) | 97 (42.4) |
- Parietal lobe, N (%) | 24 (10.5) |
- Temporal lobe, N (%) | 27 (11.8) |
- Occipital lobe, N (%) | 21 (9.2) |
- Cerebellum, N (%) | 60 (26.2) |
Prior treatment: | |
• Systemic treatment, N (%) | 144 (62.9) |
• BM irradiation, N (%) | 47 (20.5) |
• Steroid treatment, N (%) | 187 (81.7) |
• Anticoagulation, N (%) | 54 (23.6) |
Predictors of preoperative BM-associated hemorrhage
Parameter | BM with hemorrhage (N = 54) | BM w/o hemorrhage (N = 175) | p-value | OR | 95%CI |
---|---|---|---|---|---|
Age in years, mean ± SD | 61.5 ± 13.6 | 61.5 ± 10.3 | 0.984 a | N/A | N/A |
Female sex, N (%) | 27 (50.0) | 88 (50.3) | 0.999 b | 0.99 | 0.54– 1.82 |
Tumor diagnosis: | |||||
• SCLC/NSCLC, N (%) | 23 (42.6) | 90 (51.4) | 0.279 b | 0.7 | 0.38– 1.30 |
• Melanoma, N (%) | 14 (25.9) | 10 (5.71) | 0.001b | 5.78 | 2.39– 13.95 |
• Breast cancer, N (%) | 1 (1.9) | 22 (12.6) | 0.034b | 0.13 | 0.02– 1.00 |
• GIT cancer, N (%) | 5 (9.3) | 12 (6.9) | 0.768 b | 1.39 | 0.47– 4.13 |
Clinical performance: | |||||
• KPS < 70, N (%) | 8 (14.8) | 1 (0.6) | 0.001b | 30.26 | 3.69– 248.13 |
• RPA > 2, N (%) | 8 (14.8) | 1 (0.6) | 0.001b | 30.26 | 3.69– 248.13 |
• dsGPA > 2, N (%) | 19 (35.2) | 59 (33.7) | 0.870 b | 1.07 | 0.56– 2.03 |
Comorbidity: | |||||
• CCI > 10, N (%) | 11 (20.4) | 33 (37.7) | 0.844 b | 1.1 | 0.51– 2.36 |
BM multiplicity, N (%) | 23 (42.6) | 73 (41.7) | 0.999 b | 1.04 | 0.56– 1.92 |
BM features: | |||||
• Volume, cm3, mean ± SD | 21.7 ± 26.2 | 15.7 ± 15.9 | 0.044a | N/A | N/A |
• Depth, mm, mean ± SD | 19.7 ± 8.5 | 18.3 ± 10.3 | 0.349 a | N/A | N/A |
• Localization: | |||||
- Frontal lobe, N (%) | 26 (48.1) | 71 (40.6) | 0.347 b | 1.36 | 0.74– 2.51 |
- Parietal lobe, N (%) | 6 (14.8) | 18 (10.3) | 0.999 b | 1.01 | 0.41– 2.90 |
- Temporal lobe, N (%) | 7 (13.0) | 21 (12.0) | 0.999 b | 1.09 | 0.44– 2.73 |
- Occipital lobe, N (%) | 3 (5.6) | 17 (9.7) | 0.421 b | 1.75 | 0.53– 5.74 |
- Cerebellum, N (%) | 12 (22.2) | 48 (27.4) | 0.485 b | 1.23 | 0.71– 2.15 |
Prior treatment: | |||||
• Systemic treatment, N (%) | 29 (53.7) | 115 (65.7) | 0.147 b | 0.61 | 0.33– 1.12 |
• BM irradiation, N (%) | 8 (14.8) | 39 (22.3) | 0.256 b | 0.61 | 0.26– 1.39 |
• Steroid treatment, N (%) | 44 (81.4) | 143 (81.7) | 0.999 b | 0.99 | 0.45– 2.16 |
• Anticoagulation, N (%) | 15 (27.8) | 42 (24.0) | 0.592 b | 1.22 | 0.61– 2.43 |
Parameter | p-value | aOR | 95%CI |
---|---|---|---|
Tumor diagnosis: melanoma | 0.001 | 5.52 | 2.19–13.95 |
Clinical performance: KPS score < 70 | 0.001 | 60.07 | 5.41–666.62 |
Tumor feature: volume > 5cm3 | 0.020 | 3.17 | 1.20–8.41 |