Stereotactic radiotherapy for stage I renal cell carcinoma: Overall survival and treatment trends compared to thermal ablation and surgical resection.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e16111-e16111
Author(s):  
Annemarie Uhlig ◽  
Johannes Uhlig ◽  
Lutz Trojan ◽  
Hyun S. Kim
Keyword(s):  
Overall Survival ◽  
Propensity Score ◽  
Stereotactic Radiotherapy ◽  
Renal Cell ◽  
Thermal Ablation ◽  
Proportional Hazards ◽  
Cell Cancer ◽  
Cox Proportional Hazards ◽  
Stage I ◽  
Invasive Treatment

e16111 Background: Stereotactic radiotherapy (SRT) is a non-invasive treatment modality that is currently evaluated for use in renal cell cancer (RCC). We aimed to evaluate current utilization of SRT for stage I RCC and compare associated overall survival with thermal ablation (TA) and partial nephrectomy (PN). Methods: The 2004-2015 United States National Cancer Database was searched for histopathologically approved stage I RCC treated with PN, cryoablation (CRA), radiofrequency- or microwave-ablation (RFA/MWA) or SRT. Patients were propensity score matched to account for potential confounders. Overall survival (OS) was evaluated with Kaplan-Meier plots, log-rank tests and Cox proportional hazards models. Results: A total of 91,965 patients were included (SRT n = 174; PN n = 82,913; CRA n = 5,446; RFA/MWA n = 3,432).Stage I SRT patients tended to be older females with fewer comorbidities and treated at non-academic centers in New England states. After propensity score matching, a cohort of n = 660 patients was obtained with well-balanced distribution of confounders between the different treatment strategies. In the matched cohort, OS following SRT was inferior to PN and thermal ablation (PN vs. SRT HR = 0.33, 95% CI: 0.22-0.50, p < 0.001; CRA vs. SRT HR = 0.44, 95% CI: 0.30 – 0.66, p < 0.001; RFA/MWA vs. SRT HR = 0.53, 95% CI: 0.36-0.77, p < 0.001). OS following CRA was comparable to PN (HR = 1.35, 95% CI: 0.84-2.18, p = 0.216), while OS following RFA/MWA was inferior to PN (HR = 1.61, 95% CI: 1.01-2.56, p = 0.046). OS rates are summarized in table 1. Conclusions: Only a minority of RCC patients receive SRT. In stage I RCC, current renal SRT protocols yield lower overall survival compared to thermal ablation and resection, while CRA and PN show comparable outcomes. Based on the current body of evidence, SRT for RCC should be reserved for clinical trials or exceptional clinical circumstances.[Table: see text]

scholarly journals Survival rates and prognostic factors in right- and left-sided colon cancer stage I–IV: an unselected retrospective single-center trial

2021 ◽  
Author(s):  
Claudius E. Degro ◽  
Richard Strozynski ◽  
Florian N. Loch ◽  
Christian Schineis ◽  
Fiona Speichinger ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Overall Survival ◽  
Blood Level ◽  
Proportional Hazards ◽  
Survival Rates ◽  
Cox Proportional Hazards ◽  
Stage I ◽  
Cancer Stage ◽  
Single Center ◽  
Significant Difference

Abstract Purpose Colorectal cancer revealed over the last decades a remarkable shift with an increasing proportion of a right- compared to a left-sided tumor location. In the current study, we aimed to disclose clinicopathological differences between right- and left-sided colon cancer (rCC and lCC) with respect to mortality and outcome predictors. Methods In total, 417 patients with colon cancer stage I–IV were analyzed in the present retrospective single-center study. Survival rates were assessed using the Kaplan–Meier method and uni/multivariate analyses were performed with a Cox proportional hazards regression model. Results Our study showed no significant difference of the overall survival between rCC and lCC stage I–IV (p = 0.354). Multivariate analysis revealed in the rCC cohort the worst outcome for ASA (American Society of Anesthesiologists) score IV patients (hazard ratio [HR]: 16.0; CI 95%: 2.1–123.5), CEA (carcinoembryonic antigen) blood level > 100 µg/l (HR: 3.3; CI 95%: 1.2–9.0), increased lymph node ratio of 0.6–1.0 (HR: 5.3; CI 95%: 1.7–16.1), and grade 4 tumors (G4) (HR: 120.6; CI 95%: 6.7–2179.6) whereas in the lCC population, ASA score IV (HR: 8.9; CI 95%: 0.9–91.9), CEA blood level 20.1–100 µg/l (HR: 5.4; CI 95%: 2.4–12.4), conversion to laparotomy (HR: 14.1; CI 95%: 4.0–49.0), and severe surgical complications (Clavien-Dindo III–IV) (HR: 2.9; CI 95%: 1.5–5.5) were identified as predictors of a diminished overall survival. Conclusion Laterality disclosed no significant effect on the overall prognosis of colon cancer patients. However, group differences and distinct survival predictors could be identified in rCC and lCC patients.

scholarly journals Radical Versus Non-Radical Resection for Early-Stage Retroperitoneal Sarcoma: A Propensity Score-Matched Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Chengxin Weng ◽  
Jiarong Wang ◽  
Jichun Zhao ◽  
Ding Yuan ◽  
Bin Huang ◽  
...  
Keyword(s):  
Propensity Score ◽  
Proportional Hazards ◽  
Early Stage ◽  
Radical Resection ◽  
Cox Proportional Hazards ◽  
Retroperitoneal Sarcoma ◽  
Stage I ◽  
National Database ◽  
Cox Proportional Hazards Models ◽  
Overall Mortality

BackgroundThe appropriate surgical procedure for early-stage retroperitoneal sarcoma (RPS) is unclear. Thus, we used a national database to compare the outcomes of radical and non-radical resection in patients with early stage RPS.MethodsThis retrospective study included 886 stage I RPS patients from 2004 to 2015 in the SEER database. Outcomes were compared using the multivariate Cox proportional hazards models and the results were presented as adjusted hazards ratio (AHR) with corresponding 95% confidence intervals (95%CIs). Propensity score-matched analyses were also performed for sensitive analyses.ResultsFor the 886 stage I RPS patients, 316 underwent radical resection, and 570 underwent non-radical resection, with a median follow-up of 4.58 (2.73-8.35) years. No difference was observed in overall mortality (AHR 0.84, 95%CI 0.62-1.15; P = 0.28) or RPS-specific mortality (AHR 0.88, 95%CI 0.57-1.36; P = 0.56) between groups. The results were similar in propensity score-matching analyses. However, subgroup analysis revealed that radical resection was associated with significantly decreased risks of overall mortality in male (AHR 0.61, 95%CI 0.38-0.98; P = 0.04) and in patients with radiotherapy (AHR 0.56, 95%CI 0.32-0.98; P = 0.04).ConclusionRadical resection did not improve midterm survival outcomes compared with non-radical resection in overall patients with early stage RPS. However, male patients or patients who received radiotherapy might benefit from radical resection with improved overall survival.

Comparison of adjuvant chemotherapy, chemoradiation, and chemotherapy followed by chemoradiation for resected stage I-II pancreatic cancer.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 372-372
Author(s):  
Sung Jun Ma ◽  
Gregory Hermann ◽  
Kavitha M Prezzano ◽  
Lucas M Serra ◽  
Austin J Iovoli ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Overall Survival ◽  
Adjuvant Chemotherapy ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Multivariable Analysis ◽  
Cox Proportional Hazards ◽  
Stage I ◽  
Concurrent Chemoradiation ◽  
Forest Plot

372 Background: Prior National Cancer Database (NCDB) studies have demonstrated an overall survival (OS) benefit for adjuvant concurrent chemoradiation (CRT) compared to chemotherapy alone. Given the more recent adoption of postoperative chemotherapy followed by concurrent chemoradiation (C+CRT), this NCDB analysis evaluates the clinical outcomes of C+CRT compared to CRT alone or adjuvant chemotherapy alone (C) for resected pancreatic cancer. Methods: The NCDB was queried for primary stage I-II, cT1-3N0-1M0, resected pancreatic adenocarcinoma treated with adjuvant C, CRT, or C+CRT (2004-2015). Patients treated with C+CRT were compared with those treated with C (cohort C) or with CRT (cohort CRT). The primary endpoint was overall survival (OS). Baseline patient, tumor, and treatment characteristics were examined. Kaplan-Meier analysis, multivariable Cox proportional hazards method, forest plot, and propensity score matching were used. Results: Among 5667 patients (n = 3031 for C, n = 1307 for CRT, n = 1329 for C+CRT), median follow-up was 34.7 months, 45.2 months, and 39.7 months for the C, CRT, and C+CRT cohorts, respectively. In the multivariable analysis for all patients, C (HR 1.31, p < 0.001) and CRT (HR 1.24, p < 0.001) were associated with worse mortality compared to C+CRT. Treatment interactions were seen among pathologically node positive disease. C+CRT was favored in 1-3 (HR 0.74, p < 0.001) and 4+ (HR 0.75, p < 0.001) positive lymph node disease when compared to C or CRT alone, but none of the treatment options were significantly favored in node negative disease (HR 0.96, p = 0.67). Using 1:1 propensity score matching, 2152 patients for cohort C and 1774 patients for cohort CRT were matched. C+CRT remained significant for improved OS for both cohort C (median OS 23.3 vs 20.0 months, p < 0.001) and cohort CRT (median OS 23.4 vs 20.8 months, p < 0.001). Conclusions: This NCDB study using propensity score matched analysis demonstrates an OS benefit for C+CRT compared to C or CRT alone following surgical resection of pancreatic cancer. Most of this benefit is in patients with positive lymph nodes.

scholarly journals Interstitial lung abnormalities in patients with stage I non-small cell lung cancer are associated with shorter overall survival: the Boston lung cancer study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tomoyuki Hida ◽  
Akinori Hata ◽  
Junwei Lu ◽  
Vladimir I. Valtchinov ◽  
Takuya Hino ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Small Cell ◽  
Stage I ◽  
Small Cell Lung ◽  
Lung Abnormalities

Abstract Background Interstitial lung abnormalities (ILA) can be detected on computed tomography (CT) in lung cancer patients and have an association with mortality in advanced non-small cell lung cancer (NSCLC) patients. The aim of this study is to demonstrate the significance of ILA for mortality in patients with stage I NSCLC using Boston Lung Cancer Study cohort. Methods Two hundred and thirty-one patients with stage I NSCLC from 2000 to 2011 were investigated in this retrospective study (median age, 69 years; 93 males, 138 females). ILA was scored on baseline CT scans prior to treatment using a 3-point scale (0 = no evidence of ILA, 1 = equivocal for ILA, 2 = ILA) by a sequential reading method. ILA score 2 was considered the presence of ILA. The difference of overall survival (OS) for patients with different ILA scores were tested via log-rank test and multivariate Cox proportional hazards models were used to estimate hazard ratios (HRs) including ILA score, age, sex, smoking status, and treatment as the confounding variables. Results ILA was present in 22 out of 231 patients (9.5%) with stage I NSCLC. The presence of ILA was associated with shorter OS (patients with ILA score 2, median 3.85 years [95% confidence interval (CI): 3.36 – not reached (NR)]; patients with ILA score 0 or 1, median 10.16 years [95%CI: 8.65 - NR]; P <  0.0001). In a Cox proportional hazards model, the presence of ILA remained significant for increased risk for death (HR = 2.88, P = 0.005) after adjusting for age, sex, smoking and treatment. Conclusions ILA was detected on CT in 9.5% of patients with stage I NSCLC. The presence of ILA was significantly associated with a shorter OS and could be an imaging marker of shorter survival in stage I NSCLC.

Prognostic effect of inflammatory genes on stage I-III colorectal cancer – integrative analysis of TCGA data

2020 ◽  
Author(s):  
Eun Kyung Choe ◽  
Sangwoo Lee ◽  
So Yeon Kim ◽  
Manu Shivakumar ◽  
Kyu Joo Park ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Clinical Features ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Integrative Analysis ◽  
Stage I ◽  
The Cancer Genome Atlas ◽  
Integrative Model ◽  
Inflammatory Status

Abstract Background Inflammatory status indicators have been reported as a prognostic biomarker of colorectal cancer (CRC). However, since the inflammatory interactions with colon involve various modes of action, the biological mechanism to link inflammation and CRC prognosis is not fully elucidated. We comprehensively evaluated the predictive role of the expression and methylation level of inflammation-related genes for CRC prognosis and their pathophysiological associations. Method An integrative analysis was conducted on 247 patients of stage I-III CRC from The Cancer Genome Atlas. Lasso-penalized Cox proportional hazards regression (Lasso-Cox) and statistical Cox proportional hazard regression (CPH) were used for analysis. Result Models to predict overall survival were designed with respective combinations of clinical variables, including age, sex, stage, gene expression, and methylation. An integrative model combining expression, methylation, and clinical features had the highest performance (median C-index=0.756), compared to the model with clinical features alone (median C-index=0.726). By multivariate CPH with features from the best model, methylation levels of CEP250, RAB21 and TNPO3 were significantly associated with overall survival. They did not share any biological process in functional networks. The 5-year survival rate was 29.8% in a low methylation group of CEP250 and 79.1% in a high (P <0.001). Conclusion Our study result implicates the importance of integrating the expression and methylation information along with clinical information in prediction of survival. CEP250, RAB21 and TNPO3, in the prediction model might have a crucial role in CRC prognosis and further improve our understanding of potential mechanisms linking inflammatory reaction and CRC progression.

The outcome of patients with stage I endometrial cancer involving the lower uterine segment

2008 ◽  
Vol 18 (5) ◽  
pp. 1079-1083 ◽  
Author(s):  
O. Lavie ◽  
L. Uriev ◽  
M. Gdalevich ◽  
F. Barak ◽  
G. Peer ◽  
...  
Keyword(s):  
Overall Survival ◽  
Endometrial Carcinoma ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Myometrial Invasion ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Stage I ◽  
Rank Test ◽  
Log Rank Test

The objective of this study was to evaluate whether lower uterine segment involvement (LUSI) correlates with recurrence and survival in women with stage I endometrial adenocarcinoma and whether it is associated with poor prognostic histopathologic features. Three hundred seventy-five consecutive patients with endometrial carcinoma stage I compromised the study population. The patients were divided into two groups according to the presence of LUSI with endometrial carcinoma. The two groups were compared with regard to prognostic factors and outcome measures by using the Pearson χ2 test, log-rank test, and Cox proportional hazards model. LUSI was present in 89 (24%) patients with stage I endometrial carcinoma. LUSI was significantly associated with grade 3 tumor (P= 0.022), deep myometrial invasion (P< 0.0001), and the presence of capillary space-like involvement (CSLI) (P= 0.003). Kaplan–Meier survival curves demonstrated that patients with LUSI had a lower recurrence-free survival (log-rank test; P= 0.009) and a worse overall survival (log-rank test; P= 0.0008). In the Cox proportional hazards model, only a trend toward higher recurrence rate (HR = 2.4, 95% CI 0.7, 8.2; P= 0.16) and a trend toward poorer overall survival (HR = 1.54, 95% CI 0.82, 2.91; P= 0.18) were noted when LUSI was present. In patients with stage I endometrial cancer, the presence of LUSI is associated with grade 3 tumor, deep myometrial invasion, and the presence of CSLI. A larger group of patients is necessary to conclude whether higher recurrence rate and poorer overall survival are associated with the presence of LUSI.

Sarcomatoid renal cell carcinoma: Does stage impact survival?

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 693-693
Author(s):  
Kyle A Blum ◽  
Renzo DiNatale ◽  
Alejandro Sanchez ◽  
Nirmal T John ◽  
Eden Axler ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Overall Survival ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Oncologic Outcomes ◽  
Lower Stage ◽  
The Impact ◽  
Sarcomatoid Differentiation

693 Background: Sarcomatoid differentiation is associated with poor clinical outcomes and is present in approximately 4% of patients with renal cell carcinoma (sRCC). However, limited studies have evaluated the impact of sarcomatoid differentiation among patients, especially with lower stage pT1−2 disease. Methods: This study evaluated 3,850 patients with RCC who underwent partial or radical nephrectomy between 2000−2017. Patients were divided into four groups for analysis: pT1−2NxMx RCC without sarcomatoid features, pT1−2NxMx sRCC, pT3−4 RCC without sarcomatoid features and pT3−4 sRCC. Clinicopathological outcomes including sex, race, age, primary histology, lymph node involvement and margin status were compared between groups using Chi−squared and T-tests. Overall survival rates were analyzed by constructing Kaplan−Meier curves, p−values were calculated using log−rank tests and fitting Cox proportional hazards models for adjusted analyses. Results: Among 3,850 cases, 168 (4.4%) sRCC patients were identified. Of these, 33 (19.6%) were pT1−2. The mean overall follow up time was 59.9 months. When comparing CSS between groups, survival was poorer in patients with sarcomatoid features regardless of pT stage (p < 0.0001). Of note, CSS was worse in sRCC pT1−2 patients compared to non−sarcomatoid pT3−4 patients. Overall survival (OS) results were similar, with sarcomatoid tumors having worse estimates on survival analysis (p < 0.0001). Conclusions: Patients with pT1−2 sRCC demonstrated worse CSS when compared to pT1-2 and pT3−T4 RCC without sarcomatoid features, regardless of primary histology. Sarcomatoid differentiation in low−stage disease may be a marker of poor oncologic outcomes requiring more vigilant surveillance and possible inclusion in adjuvant therapy trials. Our next step, which is currently ongoing, is to pursue a multi−institutional collaborative effort and establish a larger cohort of sRCC for analysis.

Real-world overall survival of patients diagnosed with recurrent versus de novo metastatic pancreatic ductal adenocarcinoma (PDAC).

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e16250-e16250
Author(s):  
Eileen Mary O'Reilly ◽  
Kenneth H. Yu ◽  
Neil Lamarre ◽  
Andy Surinach ◽  
Paul Cockrum
Keyword(s):  
Overall Survival ◽  
Real World ◽  
Proportional Hazards ◽  
De Novo ◽  
Relative Survival ◽  
Cox Proportional Hazards ◽  
Stage I ◽  
Ductal Adenocarcinoma ◽  
Similar Proportion ◽  
Metastatic Setting

e16250 Background: PDAC is a lethal malignancy which accounted for the third most cancer related deaths in 2020. Patients (pts) who are initially diagnosed with stage I-III PDAC have a 5-year relative survival of 13.3 – 39.4%; those with metastatic disease at diagnosis have a 5-year relative survival of 2.9%. Limited data are published comparing the outcomes of pts with stage I-III who develop metastases (recurrent) compared to pts with de novo mPDAC (de novo). This analysis seeks to compare demographic, clinical characteristics, and survival outcomes of pts with recurrent versus de novo mPDAC in a community oncology setting. Methods: Using the Flatiron Health database, a retrospective observational study was conducted abstracting deidentified data from ≥280 US cancer clinics. Pts with mPDAC diagnosed from 01/2016 to 08/2020 with a known stage at initial diagnosis were included. Pts were stratified based on initial stage at diagnosis. Median overall survival (OS) from time of metastasis was derived using Kaplan-Meier analysis. Unadjusted and multivariable Cox proportional hazards models were used to compare survival between recurrent and de novo cohorts. Results: N = 6,543 pts analyzed; 70.1% (n = 4,586) had de novo mPDAC and 29.9% (n = 1,957) had recurrent mPDAC. Median age at time of metastasis was similar for both cohorts: 69 years (IQR: 62 – 76). The most common site of primary tumor location was head for both cohorts (recurrent mPDAC: 69.8%; de novo mPDAC: 40.3%). Approximately 45% of pts with recurrent mPDAC underwent a Whipple procedure (pre diagnosis of metastasis). A similar proportion of pts in both cohorts received treatment in the metastatic setting (recurrent mPDAC: 74.3%; de novo mPDAC: 77.3%). Pts with recurrent mPDAC had a longer median OS compared to the de novo cohort: 8.0 months (95% CI: 7.5 – 8.6) versus 6.1 (95% CI: 5.7 – 6.4) [unadjusted hazard ratio (HR): 0.79 (95% CI: 0.74 – 0.84); adjusted HR: 0.73 (0.68 – 0.78), p < 0.0001]. Conclusions: The results of this real-world study indicate that pts with recurrent mPDAC are more likely to have a head primary and to experience longer OS from time of metastasis than those with de novo mPDAC. These data suggest stratification for clinical trial enrollment for recurrent vs de novo is necessitated.

scholarly journals Prognostic Significance of Preoperative Fibrinogen-to-Prealbumin Ratio in Patients with Stage I–III Colorectal Cancer Undergoing Surgical Resection: A Retrospective Cohort Study

2021 ◽  
Vol 2021 ◽  
pp. 1-13
Author(s):  
Hailun Xie ◽  
Shizhen Huang ◽  
Guanghui Yuan ◽  
Shuangyi Tang ◽  
Jialiang Gan
Keyword(s):  
Overall Survival ◽  
Surgical Resection ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Disease Free Survival ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Stage I ◽  
Free Survival ◽  
Disease Free

Background. The objective of this study was to explore the role of preoperative fibrinogen-to-prealbumin ratio (FPR) in evaluating the prognosis of patients with stage I–III colorectal cancer (CRC). Methods. This retrospective study enrolled 584 stage I–III CRC patients undergoing surgical resection. Logistic regression analysis was used to explore the correlation between FPR and postoperative complications. The Kaplan-Meier curve and Cox proportional hazards model were used to identify the prognostic factors. The nomograms were constructed based on the prognostic factors. The concordance index and calibration curve were used to determine the accuracy of the nomograms. Time-dependent receiver operating characteristic was used to compare the predictive prognostic efficacy of nomograms and TNM stage. Results. FPR was determined to be an independent factor affecting postoperative complications. Patients with a low-FPR had a significantly better prognosis than those with a high-FPR (disease-free survival, p = 0.028 ; overall survival, p = 0.027 ), especially patients with stage I CRC (disease-free survival, p = 0.015 ; overall survival, p = 0.017 ). The Cox proportional hazards model identified FPR as an independent poor prognostic factor of disease-free survival (hazard ratio HR = 1.459 , 95% confidence interval CI = 1.074 –1.954, p = 0.011 ) and overall survival ( HR = 1.405 , 95% CI = 1.034 –1.909, p = 0.030 ). The prognostic nomograms had good accuracy and were superior to the traditional TNM stage. Conclusions. FPR is a potential indicator for predicting short- and long-term prognosis of stage I–III CRC patients undergoing surgical resection.

Multicenter study on prognostic factors in 692 patients with brain metastases of malignant melanoma

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 9081-9081
Author(s):  
T. K. Eigentler ◽  
A. Figl ◽  
D. Krex ◽  
P. Mohr ◽  
P. Kurschat ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Malignant Melanoma ◽  
Stereotactic Radiotherapy ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Proportional Hazards Models ◽  
Kaplan Meier ◽  
Cox Proportional Hazards Models ◽  
Pre Treatment

9081 Background: This multicenter study aimed to identify prognostic factors in patients with brain metastases from malignant melanoma (BM-MM). Methods: In a retrospective survey in nine cancer centres of the German Cancer Society 692 patients were identified with BM-MM during the period 1986–2007. Overall survival was analysed using Kaplan-Meier estimator and compared by log-rank analysis. Cox proportional hazards models were used to identify prognostic factors significant for survival. Results: The median overall survival of the entire cohort was 5.0 months (95%CI: 4–5). Prognostic factors in the univariate Kaplan- Meier analysis were: Karnofsky Performance Status (≥ 70 vs. <70; p<0.001), number of BM-MM (single vs. multiple; p<0.001), pre-treatment levels of serum LDH (normal vs. elevated; p<0.001), pre-treatment levels of S100 (normal vs. elevated; p<0.001), Prognostic groups according to Radiation Therapy Oncology Group (Class I vs. Class II vs. Class III; p=0.0485), kind of applied treatment (for the cohort with single BM-MM, only) (stereotactic radiotherapy or neurosurgical metastasectomy vs. others; p=0.036). Cox proportional hazards models revealed pre-treatment elevated level of serum LDH (HR: 1.6, 95%CI: 1.3–2.0; p=0.00013) and number of BM-MM (HR: 1.6, 95%CI: 1.3–2.0; p=0.00011) in the whole cohort of patients as independent prognostic variables, whereas in patients with single BM-MM the kind of applied treatment (stereotactic radiotherapy or neurosurgical metastasectomy vs. others; HR: 1.5, 95%CI: 1.1–1.9; p=0.0061) was identified as unique prognostic factor. Conclusions: Overall survival of patients with BM-MM mainly depends on the number of metastases and pre-treatment levels of LDH. In case of a single brain metastasis the application of stereotactic radiotherapy or neurosurgical metastasectomy is by far the most important factor for improving survival. No significant financial relationships to disclose.

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