External Validation of a Prognostic Score for Patients with Brain Metastases: Extended Diagnosis-Specific Graded Prognostic Assessment
Purpose: The aim of our study was the external validation of an extended variant of the four-tiered diagnosis-specific graded prognostic assessment (DS-GPA) that includes more information about extracranial disease burden and blood test results, and predicts survival of patients with brain metastase...
Published in: | Oncology Research and Treatment |
---|---|
Main Authors: | , , |
Format: | Article in Journal/Newspaper |
Language: | English |
Published: |
S. Karger AG
2020
|
Subjects: | |
Online Access: | http://dx.doi.org/10.1159/000506954 https://www.karger.com/Article/Pdf/506954 |
id |
crskarger:10.1159/000506954 |
---|---|
record_format |
openpolar |
spelling |
crskarger:10.1159/000506954 2024-06-09T07:48:26+00:00 External Validation of a Prognostic Score for Patients with Brain Metastases: Extended Diagnosis-Specific Graded Prognostic Assessment Nieder, Carsten Hess, Sebastian Lewitzki, Victor 2020 http://dx.doi.org/10.1159/000506954 https://www.karger.com/Article/Pdf/506954 en eng S. Karger AG https://www.karger.com/Services/SiteLicenses https://www.karger.com/Services/SiteLicenses Oncology Research and Treatment volume 43, issue 5, page 221-227 ISSN 2296-5270 2296-5262 journal-article 2020 crskarger https://doi.org/10.1159/000506954 2024-05-15T13:31:32Z Purpose: The aim of our study was the external validation of an extended variant of the four-tiered diagnosis-specific graded prognostic assessment (DS-GPA) that includes more information about extracranial disease burden and blood test results, and predicts survival of patients with brain metastases. The extracranial DS-GPA (EC-GPA) includes serum albumin, lactate dehydrogenase, and number of extracranial organs involved. Originally, the score was developed in Germany. Patients and Methods: A retrospective analysis of 236 patients with brain metastases treated with primary whole-brain radiotherapy in North-Norway was performed (independent external validation cohort). Results: The four-tiered EC-GPA score showed good discrimination between all prognostic groups (log-rank test p < 0.05 for all pairwise comparisons). One-year survival was 0, 11, 30, and 100%, respectively. Median survival was 0.7 months (95% CI, 0.5–0.9) in the worst prognostic group, with a hazard ratio for death of 44.31 (95% CI, 5.78–339.50) compared to the best group. In the German database, the corresponding HR was 31.64 (median survival 0.4 months). The remaining hazard ratios in this validation study were 7.13 and 12.10, compared with 4.84 and 9.26 in the score development study. Conclusions: This study provides an independent validation of the EC-GPA, which was the best prognostic model for defining patients who did not benefit from radiation therapy of brain metastases in terms of overall survival in the original German study. The proposed modification of the established DS-GPA should undergo further validation in multi-institutional databases. Article in Journal/Newspaper North Norway Karger Norway Oncology Research and Treatment 43 5 221 227 |
institution |
Open Polar |
collection |
Karger |
op_collection_id |
crskarger |
language |
English |
description |
Purpose: The aim of our study was the external validation of an extended variant of the four-tiered diagnosis-specific graded prognostic assessment (DS-GPA) that includes more information about extracranial disease burden and blood test results, and predicts survival of patients with brain metastases. The extracranial DS-GPA (EC-GPA) includes serum albumin, lactate dehydrogenase, and number of extracranial organs involved. Originally, the score was developed in Germany. Patients and Methods: A retrospective analysis of 236 patients with brain metastases treated with primary whole-brain radiotherapy in North-Norway was performed (independent external validation cohort). Results: The four-tiered EC-GPA score showed good discrimination between all prognostic groups (log-rank test p < 0.05 for all pairwise comparisons). One-year survival was 0, 11, 30, and 100%, respectively. Median survival was 0.7 months (95% CI, 0.5–0.9) in the worst prognostic group, with a hazard ratio for death of 44.31 (95% CI, 5.78–339.50) compared to the best group. In the German database, the corresponding HR was 31.64 (median survival 0.4 months). The remaining hazard ratios in this validation study were 7.13 and 12.10, compared with 4.84 and 9.26 in the score development study. Conclusions: This study provides an independent validation of the EC-GPA, which was the best prognostic model for defining patients who did not benefit from radiation therapy of brain metastases in terms of overall survival in the original German study. The proposed modification of the established DS-GPA should undergo further validation in multi-institutional databases. |
format |
Article in Journal/Newspaper |
author |
Nieder, Carsten Hess, Sebastian Lewitzki, Victor |
spellingShingle |
Nieder, Carsten Hess, Sebastian Lewitzki, Victor External Validation of a Prognostic Score for Patients with Brain Metastases: Extended Diagnosis-Specific Graded Prognostic Assessment |
author_facet |
Nieder, Carsten Hess, Sebastian Lewitzki, Victor |
author_sort |
Nieder, Carsten |
title |
External Validation of a Prognostic Score for Patients with Brain Metastases: Extended Diagnosis-Specific Graded Prognostic Assessment |
title_short |
External Validation of a Prognostic Score for Patients with Brain Metastases: Extended Diagnosis-Specific Graded Prognostic Assessment |
title_full |
External Validation of a Prognostic Score for Patients with Brain Metastases: Extended Diagnosis-Specific Graded Prognostic Assessment |
title_fullStr |
External Validation of a Prognostic Score for Patients with Brain Metastases: Extended Diagnosis-Specific Graded Prognostic Assessment |
title_full_unstemmed |
External Validation of a Prognostic Score for Patients with Brain Metastases: Extended Diagnosis-Specific Graded Prognostic Assessment |
title_sort |
external validation of a prognostic score for patients with brain metastases: extended diagnosis-specific graded prognostic assessment |
publisher |
S. Karger AG |
publishDate |
2020 |
url |
http://dx.doi.org/10.1159/000506954 https://www.karger.com/Article/Pdf/506954 |
geographic |
Norway |
geographic_facet |
Norway |
genre |
North Norway |
genre_facet |
North Norway |
op_source |
Oncology Research and Treatment volume 43, issue 5, page 221-227 ISSN 2296-5270 2296-5262 |
op_rights |
https://www.karger.com/Services/SiteLicenses https://www.karger.com/Services/SiteLicenses |
op_doi |
https://doi.org/10.1159/000506954 |
container_title |
Oncology Research and Treatment |
container_volume |
43 |
container_issue |
5 |
container_start_page |
221 |
op_container_end_page |
227 |
_version_ |
1801380145222647808 |