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. WangNatalie Lockney, Kathryn Beal, Jessica Parkhurst, John M. Buatti, Ryan M 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

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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.

Original languageEnglish (US)
Pages (from-to)63-72
Number of pages10
JournalTranslational Research
Volume208
DOIs
StatePublished - Jun 1 2019

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Gastrointestinal Neoplasms
Brain Neoplasms
Brain
Neoplasm Metastasis
Survival
Karnofsky Performance Status
Research Ethics Committees
Tumors
Rectum
Esophagus
Decision making
Demography
Clinical Trials
Databases
Therapeutics

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural

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Survival and prognostic factors in patients with gastrointestinal cancers and brain metastases : have we made progress? / Sperduto, Paul W.; Fang, Penny; Li, Jing; Breen, William; Brown, Paul D.; Cagney, Daniel; Aizer, Ayal; Yu, James; Chiang, Veronica; Jain, Supriya; Gaspar, Laurie E.; Myrehaug, Sten; Sahgal, Arjun; Braunstein, Steve; Sneed, Penny; Cameron, Brent; Attia, Albert; Molitoris, Jason; Wu, Cheng Chia; Wang, Tony J.C.; Lockney, Natalie; Beal, Kathryn; Parkhurst, Jessica; Buatti, John M.; Shanley, Ryan M; Lou, Emil; Tandberg, Daniel D.; Kirkpatrick, John P.; Shi, Diana; Shih, Helen A.; Chuong, Michael; Saito, Hirotake; Aoyama, Hidefumi; Masucci, Laura; Roberge, David; Mehta, Minesh P.

In: Translational Research, Vol. 208, 01.06.2019, p. 63-72.

Research output: Contribution to journalArticle

Sperduto, PW, Fang, P, Li, J, Breen, W, Brown, PD, Cagney, D, Aizer, A, Yu, J, Chiang, V, Jain, S, Gaspar, LE, Myrehaug, S, Sahgal, A, Braunstein, S, Sneed, P, Cameron, B, Attia, A, Molitoris, J, Wu, CC, Wang, TJC, Lockney, N, Beal, K, Parkhurst, J, Buatti, JM, Shanley, RM, Lou, E, Tandberg, DD, Kirkpatrick, JP, Shi, D, Shih, HA, Chuong, M, Saito, H, Aoyama, H, Masucci, L, Roberge, D & Mehta, MP 2019, 'Survival and prognostic factors in patients with gastrointestinal cancers and brain metastases: have we made progress?', Translational Research, vol. 208, pp. 63-72. https://doi.org/10.1016/j.trsl.2019.02.011
Sperduto, Paul W. ; Fang, Penny ; Li, Jing ; Breen, William ; Brown, Paul D. ; Cagney, Daniel ; Aizer, Ayal ; Yu, James ; Chiang, Veronica ; Jain, Supriya ; Gaspar, Laurie E. ; Myrehaug, Sten ; Sahgal, Arjun ; Braunstein, Steve ; Sneed, Penny ; Cameron, Brent ; Attia, Albert ; Molitoris, Jason ; Wu, Cheng Chia ; Wang, Tony J.C. ; Lockney, Natalie ; Beal, Kathryn ; Parkhurst, Jessica ; Buatti, John M. ; Shanley, Ryan M ; Lou, Emil ; Tandberg, Daniel D. ; Kirkpatrick, John P. ; Shi, Diana ; Shih, Helen A. ; Chuong, Michael ; Saito, Hirotake ; Aoyama, Hidefumi ; Masucci, Laura ; Roberge, David ; Mehta, Minesh P. / Survival and prognostic factors in patients with gastrointestinal cancers and brain metastases : have we made progress?. In: Translational Research. 2019 ; Vol. 208. pp. 63-72.
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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.",
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AU - Sperduto, Paul W.

AU - Fang, Penny

AU - Li, Jing

AU - Breen, William

AU - Brown, Paul D.

AU - Cagney, Daniel

AU - Aizer, Ayal

AU - Yu, James

AU - Chiang, Veronica

AU - Jain, Supriya

AU - Gaspar, Laurie E.

AU - Myrehaug, Sten

AU - Sahgal, Arjun

AU - Braunstein, Steve

AU - Sneed, Penny

AU - Cameron, Brent

AU - Attia, Albert

AU - Molitoris, Jason

AU - Wu, Cheng Chia

AU - Wang, Tony J.C.

AU - Lockney, Natalie

AU - Beal, Kathryn

AU - Parkhurst, Jessica

AU - Buatti, John M.

AU - Shanley, Ryan M

AU - Lou, Emil

AU - Tandberg, Daniel D.

AU - Kirkpatrick, John P.

AU - Shi, Diana

AU - Shih, Helen A.

AU - Chuong, Michael

AU - Saito, Hirotake

AU - Aoyama, Hidefumi

AU - Masucci, Laura

AU - Roberge, David

AU - Mehta, Minesh P.

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