(HealthDay News) – The updated Graded Prognostic Assessment (GPA), a diagnosis-specific, predictive index for cancer patients with brain metastases, helps clinicians estimate survival, select appropriate treatment, and stratify patients for clinical trials, according to a study published online December 27 in the Journal of Clinical Oncology.
Paul W. Sperduto, MD, of the University of Minnesota in Minneapolis, and colleagues conducted a multi-institutional retrospective study (1985 to 2007) of 3,940 patients with newly diagnosed brain metastases to assess updated diagnosis-specific GPA indices (score range, 0.0 [worst prognosis] to 4.0 [best prognosis]). Patient outcomes were analyzed by primary tumor site, treatment, and associated prognostic factors.
The researchers found that significant prognostic factors for brain metastases varied by diagnosis for the primary tumor. Prognostic factors for patients with lung cancer included Karnofsky performance score, age, presence of extracranial metastases, and number of brain metastases. For patients with melanoma and renal cell cancer, prognostic factors included Karnofsky performance score and the number of brain metastases. For patients with breast cancer, the prognostic factors were tumor subtype, Karnofsky performance score, and age, while Karnofsky performance score was the only prognostic factor for patients with gastrointestinal cancer. Overall median survival time was 7.16 months but varied (2.79 to 25.30 months) depending on diagnosis and GPA.
“Prognostic factors for patients with brain metastases vary by diagnosis, and for each diagnosis, a robust separation into different GPA scores was discerned, implying considerable heterogeneity in outcome, even within a single tumor type,” the authors write.