Dataset Information

Estimating survival in patients with gastrointestinal cancers and brain metastases: An update of the graded prognostic assessment for gastrointestinal cancers (GI-GPA).

ABSTRACT:

Background

Patients with gastrointestinal cancers and brain metastases (BM) represent a unique and heterogeneous population. Our group previously published the Diagnosis-Specific Graded Prognostic Assessment (DS-GPA) for patients with GI cancers (GI-GPA) (1985-2007, n?=?209). The purpose of this study is to update the GI-GPA based on a larger contemporary database.

Methods

An IRB-approved consortium database analysis was performed using a multi-institutional (18), multi-national (3) cohort of 792 patients with gastrointestinal (GI) cancers, with newly-diagnosed BM diagnosed between 1/1/2006 and 12/31/2017. Survival was measured from date of first treatment for BM. Multiple Cox regression was used to select and weight prognostic factors in proportion to their hazard ratios. These factors were incorporated into the updated GI-GPA.

Results

Median survival (MS) varied widely by primary site and other prognostic factors. Four significant factors (KPS, age, extracranial metastases and number of BM) were used to formulate the updated GI-GPA. Overall MS for this cohort remains poor; 8?months. MS by GPA was 3, 7, 11 and 17?months for GPA 0-1, 1.5-2, 2.5-3.0 and 3.5-4.0, respectively. >30% present in the worst prognostic group (GI-GPA of ?1.0).

Conclusions

Brain metastases are not uncommon in GI cancer patients and MS varies widely among them. This updated GI-GPA index improves our ability to estimate survival for these patients and will be useful for therapy selection, end-of-life decision-making and stratification for future clinical trials. A user-friendly, free, on-line app to calculate the GPA score and estimate survival for an individual patient is available at brainmetgpa.com.

SUBMITTER: Sperduto PW

PROVIDER: S-EPMC6612649 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

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Publications

Estimating survival in patients with gastrointestinal cancers and brain metastases: An update of the graded prognostic assessment for gastrointestinal cancers (GI-GPA).

Sperduto Paul W PW Fang Penny P Li Jing J Breen William W Brown Paul D PD Cagney Daniel D Aizer Ayal A Yu James B JB Chiang Veronica V Jain Supriya S Gaspar Laurie E LE Myrehaug Sten S Sahgal Arjun A Braunstein Steve S Sneed Penny P Cameron Brent B Attia Albert A Molitoris Jason J Wu Cheng-Chia CC Wang Tony J C TJC Lockney Natalie A NA Beal Kathryn K Parkhurst Jessica J Buatti John M JM Shanley Ryan R Lou Emil E Tandberg Daniel D DD Kirkpatrick John P JP Shi Diana D Shih Helen A HA Chuong Michael M Saito Hirotake H Aoyama Hidefumi H Masucci Laura L Roberge David D Mehta Minesh P MP

Clinical and translational radiation oncology 20190627

<h4>Background</h4>Patients with gastrointestinal cancers and brain metastases (BM) represent a unique and heterogeneous population. Our group previously published the Diagnosis-Specific Graded Prognostic Assessment (DS-GPA) for patients with GI cancers (GI-GPA) (1985-2007, n = 209). The purpose of this study is to update the GI-GPA based on a larger contemporary database.<h4>Methods</h4>An IRB-approved consortium database analysis was performed using a multi-institutional (18), multi-national ( ...[more]

PMID: 31341974

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Dataset Information

Estimating survival in patients with gastrointestinal cancers and brain metastases: An update of the graded prognostic assessment for gastrointestinal cancers (GI-GPA).

Background

Methods

Results

Conclusions

Publications

Estimating survival in patients with gastrointestinal cancers and brain metastases: An update of the graded prognostic assessment for gastrointestinal cancers (GI-GPA).

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