Neurosurgeons Chetan Bettegowda and Jordina Rincon-Torroella discuss results from their retrospective study about the incidence and survival outcomes of brain metastases over the past decade. Using data from the TriNetX Diamond Network and diagnoses and therapies identified with ICD-10 and CPT codes, they found (1) a substantial rate of brain metastases present within 2-6 months of primary cancer, which may guide future recommendations on intracranial staging, and (2) antineoplastic and radiation therapy prior to the development of brain metastases may prolong time before metastasis and improve survival.
I'm Doctor Gina. Hello. My name is and it's our pleasure to describe our study entitled Epidemiology and Survival Outcomes of Synchronous and Metachronous Brain Metastasis. A retrospective population based study, brain metastasis are the most common central nervous system tumors and one of the most frequent neurological complications in patients with malignancy. Unlike primary brain tumors, there's no systematic nationwide reporting of secondary brain Malign disease understanding the epidemiology of brain metastasis is of tremendous importance to inform screening recommendations, preventative measures and treatment decisions. We aim to report the incident and survival outcomes of brain metastasis over the past decade using a large nationwide multi institutional database to do this. We queried the trine Diamond network, a health network of deidentified electronic medical records and administrative claims data. This platform encompasses over 200 million patients in the United States. We identified a total of 11,497,000 patients. The diagnosis of one of the 15 most common primary cancers that metastasized to the brain. 2.6% of these patients develop brain metastases. The average age of patients at the diagnosis of a brain metastasis was around 64 years of age brain metastases most commonly came from lung and bronchus primary cancers followed by breast cancer and melanoma. We also evaluated the time between the diagnosis of a primary cancer and the diagnosis of a brain metastasis. 37.8% of patients had synchronous brain metastasis, which is defined as a diagnosis of primary cancer and brain metastasis within two months. Due to limitations in data. Most published epidemiological studies only include this population. However, 62.2% of patients had metachronous brain metastasis, which is defined as a diagnosis of brain metastasis. More than two months after the diagnosis of primary cancer, except for lung and bronchos cancer, all primary cancers were more likely to present metachronous. The current body of literature may be missing. Most patients with brain metastasis which we included in this study for patients with metachronous brain metastasis. The average time between the diagnosis of primary cancer. The diagnosis of a brain metastasis was 1.8 years, but a substantial portion present much earlier. 19% of those who developed brain metastasis were diagnosed within 2 to 6 months of their primary cancer diagnosis. This high rate of brain metastases presenting close to the diagnosis of primary cancer may indicate a role for increased early intracranial screening. The shortest average time to brain metastasis of 1.3 years was seen in lung and bronchus cancers compared to extracranial metastasis. Brain metastases are associated with 30.4 months decreased median survival. However, whether brain metastasis were diagnosed in chronically had little effect on survival outcomes. Once the brain metastasis was present, metachronous, diagnosed metastasis were associated with 1.4 months increased survival. Patients with primary cancer who receive chemotherapy experienced 13.3 months of additional brain metastasis for survival and an additional 17.1 month of overall survival. Similarly, we examine the effects of radiation therapy directed at the primary cancer patients with primary cancer who receive radiation therapy, experience 6.1 months of additional brain metastasis, free survival and 2.7 months of additional overall survival. In conclusion, most brain metastases present metachronous and within two years of primary cancer diagnosis. The substantial rate of brain metastases presenting within 2 to 6 months of primary cancer may guide future recommendations for intracranial staging, anti neoplastic and radiation therapy. Prior to the development of brain metastases may prolong time before metastasis and improve survival.
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