Five-year survivors of brain metastases: a single-institution report of 32 patients.
OBJECTIVE
To report on 32 patients who survived > or = 5 years from brain metastases treated at a single institution.


METHODS
The records of 1288 patients diagnosed with brain metastases between 1973 and 1999 were reviewed. Patients were treated with whole-brain radiation therapy (WBRT), surgery, and/or stereotactic radiosurgery (SRS). Thirty-two (2.5%) > or = 5-year survivors were identified. Factors contributing to long-term survival were identified.


RESULTS
Median survival was 9.3 years for > or = 5-year survivors. Seven of these patients lived > or = 10 years. Female gender was the only patient characteristic that correlated with better survival (p = 0.0369). When these patients were compared with < 5-year survivors, age < 65 years (p = 0.0044), control of the primary at diagnosis (p = 0.0052), no systemic disease (p = 0.0012), recursive partitioning analysis (RPA) Class 1 (p = 0.0002 with Class 2; p = 0.0022 with Class 3), and single brain metastasis (p = 0.0018) were associated with long-term survival in the univariate logistic regression model. In the multivariate model, RPA Class 1 compared with Class 2 (OR = 0.39, p = 0.0196), surgery (OR = 0.16, p < 0.0001), and SRS (OR = 0.41, p = 0.0188) were associated with long-term survival.


CONCLUSIONS
For patients with good prognostic factors such as young age, good RPA characteristics and single metastasis, treatment with surgery or SRS offers the best chance for long-term survival.
Chao
Samuel T
ST
Department of Radiation Oncology, Brain Tumor Institute, Taussig Cancer Center, The Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
Barnett
Gene H
GH
Liu
Stephanie W
SW
Reuther
Alwyn M
AM
Toms
Steven A
SA
Vogelbaum
Michael A
MA
Videtic
Gregory M M
GM
Suh
John H
JH
D000368:Aged; D001932:Brain Neoplasms / Q000401:mortality* / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery; D016371:Cranial Irradiation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016634:Radiosurgery; D012737:Sex Factors; D016019:Survival Analysis; D017741:Survivors; D013997:Time Factors