A validation study of graded prognostic assessment index for lung cancer patients with brain metastases.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 2070-2070 ◽  
Author(s):  
Lingling Du ◽  
Vyshak Alva Venur ◽  
Saurabh Dahiya ◽  
Rohan Garje ◽  
Kwabena Osei-Boateng ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Cancer Patients ◽  
Squamous Cell ◽  
Tertiary Care ◽  
Cleveland Clinic ◽  
Lung Cancer Patients ◽  
Prognostic Assessment ◽  
Graded Prognostic Assessment ◽  
Extracranial Metastases

2070 Background: The Graded Prognostic Assessment (GPA) is a commonly used index based on 5 prior randomized trials performed by the RTOG (Protocols 7916, 8528, 8905, 9104, and 9508). The purpose of this study was to validate GPA index in a recent cohort of lung cancer patients with brain metastases (LBM) at a larger tertiary care center. Methods: Cleveland Clinic Brain Tumor and Neuro-Oncology Center's database was used to identify LBM treated in the recent era (2000-12). A proportional hazards model was used to assess overall survival (OS), measured from the date of diagnosis of brain metastases to death or last follow-up. Results: 490 LBM (250 males) median age 61 years (range 35-86) were included. Histology included small cell (64, 13%) adenocarcinoma (289, 59%), squamous (53, 11%), large cell (26, 5%) and unknown (55, 11%). The median number of brain metastases was 1 (range, 1-47). Karnofsky Performance Scale (KPS) was 90-100 in 187 (41%), 70-80 in 238 (52%) and <70 in 33 (7%). Extracranial Metastases was present in 327 patients (67%). OS was 14.1 months (95% C.I. 12.3-15.7). GPA for lung cancer is derived from KPS, the number of brain mets, the presence/absence of extracranial metastases, and age. GPA was 0-1.0 in 83 patients, 1.5-2 in 211, 2.5-3 in 135 and 3.5-4 in 18 patients. Although overall GPA was prognostic for survival (p<.0001), not all of the factors used to derive it were significant (Table). Factors noted to be prognostic for survival included primary controlled (p=<.0001), squamous cell histology (p=.0001), age (p=.0002), KPS (p=.0002). The new index divided the patients into unfavorable, intermediate, favorable that was prognostic for survival in this cohort (p<.0001). Conclusions: New index developed based on a revised set of independent prognostic factors (primary controlled, squamous cell histology, age and performance status) is proposed. [Table: see text]

Graded prognostic assessment index for breast cancer patients with brain metastases (BCBM).

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 2096-2096
Author(s):  
Vyshak Alva Venur ◽  
Saurabh Dahiya ◽  
Lingling Du ◽  
Rohan Garje ◽  
Kwabena Osei-Boateng ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Brain Metastases ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Tertiary Care ◽  
Prognostic Assessment ◽  
Hazards Model ◽  
Graded Prognostic Assessment ◽  
Extracranial Metastases

2096 Background: The Graded Prognostic Assessment (GPA) is a commonly used prognostic index based on RTOG protocols in patients with brain metastases (BM). The purpose of this study was to evaluate prognostic factors to predict for overall survival (OS) in breast cancer BM (BCBM) treated at a single tertiary care center. Methods: After obtaining IRB approval, the Cleveland Clinic Brain Tumor and Neuro-Oncology Center’s database was used to identify BCBM who were treated in the recent years (2000-12). A proportional hazards model was used to assess OS, which was measured from the date of diagnosis of brain metastases to death or last follow-up. Results: 161 BCBM (160 females) median age 52 years (range 27-84) were included for analysis. 48% of patients were ER positive, 31% were PR positive, 50% were HER2 positive while 31% of patients were triple negative. The median number of BM was 2 (range, 1-15). Karnofsky Performance Scale (KPS) of the patient was 90-100 in 50%, 70-80 in 47%) and <70 in 43%. Extracranial Metastases was present in 85% of patients. Overall 85% of patients had died at the time of analysis; median OS was 19.0 months (95% C.I. 15.7-23.2). Breast GPA that includes age, KPS and subtype was 0-1.0 in 5%, 1.5-2 in 31%, 2.5-3 in 35% and 3.5-4 in 29% of patients. Although GPA was statistically significant (p=0.002), some but not all of the factors used to derive it were significant (KPS [p=0.05],subtype [p=0.003] age [p=0.50]). Factors noted to be independently prognostic for OS (multivariable Cox proportional hazards model) included location of BM, number of extracranial metastases and uncontrolled primary tumor (Table). Conclusions: New GPA based on a set of independent prognostic factors is proposed. [Table: see text]

scholarly journals Circulating Exosomal Integrin β3 Is Associated with Intracranial Failure and Survival in Lung Cancer Patients Receiving Cranial Irradiation for Brain Metastases: A Prospective Observational Study

Cancers ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 380
Author(s):  
Guann-Yiing Chen ◽  
Jason Chia-Hsien Cheng ◽  
Ya-Fang Chen ◽  
James Chih-Hsin Yang ◽  
Feng-Ming Hsu
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Hazard Ratio ◽  
Subdistribution Hazard ◽  
Assessment Score ◽  
Lung Cancer Patients ◽  
Failure Patterns ◽  
Integrin Β3 ◽  
Prognostic Assessment ◽  
Graded Prognostic Assessment

Brain metastasis (BM) is a major problem in patients with cancer. Exosomes or extracellular vesicles (EV) and integrins contribute to the development of BM, and exosomal integrins have been shown to determine organotropic metastasis. We hypothesized that circulating EV integrins are able to influence the failure patterns and outcomes in patients treated for BM. We prospectively enrolled 75 lung cancer patients with BM who received whole brain radiotherapy (WBRT). We isolated and quantified their circulating EV integrins, and analyzed the association of EV integrins with clinical factors, survival, and intracranial/extracranial failure. Circulating EV integrin levels were independent of age, sex, histology, number of BM, or graded prognostic assessment score. Age, histology, and graded prognostic assessment score correlated with survival. Patients with higher levels of circulating EV integrin β3 had worse overall survival (hazard ratio: 1.15 per 1 ng/mL increase; p = 0.04) following WBRT. Multivariate regression analysis also showed a higher cumulative incidence of intracranial failure (subdistribution hazard ratio: 1.216 per 1 ng/mL increase; p = 0.037). In conclusion, circulating EV integrin β3 levels correlated with survival and intracranial control of patients with lung cancer after WBRT for BM. This supports that EV integrin β3 mediates a brain-tropic metastasis pattern, and may serve as a novel prognostic biomarker for BM.

scholarly journals Clinicopathological Profile of Patients with Lung Carcinoma in a Tertiary Care Center

2020 ◽  
Author(s):  
M.T. Chandramouli ◽  
Giridhar Belur Hosmane
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Lung Carcinoma ◽  
Care Center ◽  
Tertiary Care ◽  
Smoking History ◽  
Tertiary Care Center ◽  
Cell Type ◽  
Lung Cancer Patients ◽  
Incidence And Mortality

Abstract Introduction Among malignant diseases, lung carcinoma is the most common cancer in men worldwide in terms of both incidence and mortality. Its increasing incidence in developing countries like India is an important public health problem. This work aimed to study the demographic, clinical, radiological, and histological features of patients with confirmed lung cancer. Materials and Methods A total of 50 patients with histologically confirmed lung cancer at a tertiary care center in India from August 2016 to September 2018 were studied and analyzed. Results Out of 50 diagnosed lung cancer patients, 86% were men and 14% women; 31 (62%) patients were aged more than 60 years. Majority were smokers (84%) and all were men. Cough (94%) was the most common presenting symptom followed by dyspnea (68%), chest pain (48%), and hemoptysis (38%). Of the 50 patients, 29 (58%) had soft tissue density mass lesion on radiograph. Squamous cell carcinoma (SCC) was the diagnosed histological cell type in 24 (48%) patients and adenocarcinoma in 21 (42%) patients. Distant metastasis was observed in 20 (40%) patients. Conclusion In this study, the most common histopathological cell type is SCC. Patients aged more than 50 years and smokers are at high risk of lung cancer. Patients with a smoking history and persistent respiratory symptoms should be promptly evaluated for lung malignancy.

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