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Войти в исследования Prognostic Stratification of Brain Metastases from Nonanaplastic Follicular Cell-Derived Thyroid Carcinoma: Results of an International Multicenter Retrospective Study.
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Prinzi Antonio, van Velsen Evert F S, Krajewska Jolanta, Kolton Magdalena, Finkel Inbar, Kampel Liyona, Kiesewetter Barbara, Wolff Ladislaia, Habra Mouhammed Amir, Balderrama-Brondani Vania, Kim Won Gu, Kim Chae A, Spitzweg Christine, Koehler Viktoria Florentine, Stegenga Merel Tessa, Zandee Wouter T, Links Thera P, Maia Ana Luiza, Scheffel Rafael Selbach, Sheehan Jason, Gild Matti L, Pitoia Fabian, Jiskra Jan, Parameswaran Rajeev, Paschke Ralf, Liscak Roman, Alzahrani Ali S, Wadsley Jonathan, Visser W Edward, Frasca Francesco, Malandrino Pasqualino
Аннотация
METHODS: This retrospective international multicenter study included adults with histologically confirmed non-ATC and radiologically documented BMs treated at 19 tertiary referral centers. Clinical, radiological, treatment, and outcome data were collected. Independent predictors of progression-free survival (PFS) and overall survival (OS) were analyzed using Cox regression, and variables identified were used to develop a disease-specific Graded Prognostic Assessment (non-ATC GPA), exploratorily assessed in an independent SEER cohort.
RESULTS: A total of 189 patients were included; median age at BM diagnosis was 59 years (interquartile range [IQR] 48-67). First-line BM treatments included stereotactic radiosurgery (27.0%), neurosurgery (23.8%), whole-brain radiotherapy (18.5%), and best supportive care (10.6%). Median PFS was 7.0 months (IQR: 2.9-22.4), and median OS was 15.0 months (IQR: 4.0-38.4). Independent predictors of shorter OS were age >75 years, Eastern Cooperative Oncology Group performance status ≥2, papillary histology, extracranial metastases, and ≥4 BM. The GPA stratified patients into four prognostic groups with median OS ranging from 72.6 months in the highest-score group to 3.7 months in the lowest. An exploratory SEER-based assessment showed survival differences across adapted prognostic groups (p = 0.036), although this analysis was limited by the absence of all key GPA variables.
CONCLUSIONS: BMs from non-ATC are associated with poor survival and marked prognostic heterogeneity. The proposed GPA may provide a useful framework for prognostic stratification, pending further validation in independent datasets to support individualized management.