
==== Front
Neurooncol Adv
Neurooncol Adv
noa
Neuro-Oncology Advances
2632-2498
Oxford University Press US

10.1093/noajnl/vdae090.047
vdae090.047
Final Category: Multimodality Approaches
AcademicSubjects/MED00300
AcademicSubjects/MED00310
MMOD-03 CRANIOTOMY RATES FOR BRAIN METASTASES AFTER INTRODUCTION OF IMMUNOTHERAPY
Pelcher Isabelle Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, USA

Begley Sabrina Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, USA

Sreenivasan Sanjeev Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, USA

Ziemba Yonah Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, USA

Travaglia Isabella Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, USA

Ratra Avi Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, USA

Schulder Michael Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, USA

8 2024
02 8 2024
02 8 2024
6 Suppl 1 2024 SNO/ASCO CNS Metastases Conference i15i16
© The Author(s) 2024. Published by Oxford University Press, the Society for Neuro-Oncology and the European Association of Neuro-Oncology.
2024
https://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

Abstract

Immunotherapy has been found effective for many patients with solid tissue cancers, with long-term remission of systemic disease and even of brain metastases from these treatments alone. We sought to determine whether the rates of craniotomies have changed since the introduction of immunotherapy. Institutional data of brain metastases incidence was gathered from 2011-2022 and included demographics and primary cancer information. A total of 885 samples from 789 unique patients were analyzed. National data were queried from the NSQIP database from 2011-2022 to include patients surgically treated for brain metastases for a total sample of 14,494 cases. A Craniotomy for Metastasis Index (CMI) was calculated and plotted over time. The most common institutional primary cancers were lung (46.1%), breast (17.4%), and gastrointestinal (10.1%) cancer. The most common lung cancer subtype was adenocarcinoma (57.11%) followed by non-small cell lung cancer (NSCLC) (11.52%). Institutionally, the CMI showed a non-significant decrease in craniotomies (R2=0.0545, p=0.46). When comparing the institutional CMI between 2011-2016 and 2017-2022, there was no significant change (p=0.37). Nationally, the CMI had a significantly positive slope of 0.03 (R2=0.544, p=0.006). When comparing the national CMI between 2011-2016 and 2017-2022, there was a significant increase in craniotomies (p=0.005). Despite the increasing efficacy of immunotherapy in the treatment of patients with brain metastases, the number of craniotomies remained constant institutionally and increased nationally. Possible explanations for these findings include improved surgical techniques that have made resection safer, along with longer survival of patients with systemic cancer who then develop metastatic brain tumors.
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pmc
