title: Five-year survivors of brain metastases: a single-institution report of 32 patients.
abstract: 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.
authors.affiliation: Department of Radiation Oncology, Brain Tumor Institute, Taussig Cancer Center, The Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
authors.forename: Samuel T
authors.initials: ST
authors.lastname: Chao
authors.forename: Gene H
authors.initials: GH
authors.lastname: Barnett
authors.forename: Stephanie W
authors.initials: SW
authors.lastname: Liu
authors.forename: Alwyn M
authors.initials: AM
authors.lastname: Reuther
authors.forename: Steven A
authors.initials: SA
authors.lastname: Toms
authors.forename: Michael A
authors.initials: MA
authors.lastname: Vogelbaum
authors.forename: Gregory M M
authors.initials: GM
authors.lastname: Videtic
authors.forename: John H
authors.initials: JH
authors.lastname: Suh
mesh_terms: 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