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

10.1093/noajnl/vdae090.108
vdae090.108
Final Category: Research Methods and Trial Design Considerations
AcademicSubjects/MED00300
AcademicSubjects/MED00310
RMTD-01 PROGNOSTIC SIGNIFICANCE OF STABLE EXTRACRANIAL DISEASE IN PATIENTS WITH INTRACRANIAL METASTATIC DISEASE: INSIGHTS FROM A RETROSPECTIVE POPULATION-BASED STUDY
Sherman Madison University of Toronto, Toronto, Canada

Li Alyssa Y University of Toronto, Toronto, Canada

Das Sunit University of Toronto, Toronto, Canada
St. Michael’s Hospital, Toronto, Canada

8 2024
02 8 2024
02 8 2024
6 Suppl 1 2024 SNO/ASCO CNS Metastases Conference i33i33
© 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

BACKGROUND

Intracranial metastatic disease (IMD) is a life-limiting complication of lung cancer, breast cancer, and melanoma. Prior research suggests prolonged survival in patients with stable extracranial disease and IMD (IMD-SE), compared to patients with progressive extracranial disease (IMD-PE). A comprehensive clinical characterization of patients with IMD-SE is lacking. This study aims to investigate clinical characteristics, outcomes, and the impact of patient and treatment factors on survival in patients with IMD-SE vs. IMD-PE.

METHODS

This retrospective cohort study included patients diagnosed with primary lung cancer, breast cancer, or melanoma, and IMD in Ontario, Canada between April 1, 2010, and August 31, 2019. IMD-SE criteria included no extracranial metastases within 2 months of primary cancer diagnosis and ≥2 rounds of systemic therapy, documented in provincial records. Analyses, including Cox regression, Kaplan-Meier, and logistic regression, assessed overall survival (OS) and associations with IMD-SE. Data analysis occurred between September and December 2023.

RESULTS

In our analysis of 15,577 patients, 16.0% had IMD-SE, comprising 50.6% lung cancer, 40.0% breast cancer, and 9.3% melanoma. IMD-SE patients showed longer median OS from primary cancer diagnosis (27.72 months vs. 6.54 months in IMD-PE; p<0.0001) and from IMD diagnosis (4.60 months vs. 1.91 months in IMD-PE; p<0.0001). Receipt of systemic therapy and brain surgery decreased the risk of death in IMD-SE patients (HR <0.8), while lung cancer and cranial radiotherapy increased the risk. IMD-SE status was least associated with lung cancer and most associated with age <65 years, systemic therapy, primary radiation, and ≥2 rounds of cranial radiotherapy.

CONCLUSION AND RELEVANCE

This study provides insights into IMD prognosis, emphasizing the importance of considering extracranial disease progression for survival predictions. Our findings enhance understanding of IMD-SE, guiding refined prognostic assessments and innovative treatments. Future studies should explore additional variables for a comprehensive understanding of factors influencing IMD-SE.
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