Evidence map›Paper›PMID 28735121›Full record

ArticleWorld neurosurgery2017

Survival Patterns of 5750 Stereotactic Radiosurgery-Treated Patients with Brain Metastasis as a Function of the Number of Lesions.

Mir Amaan Ali, Brian R Hirshman, Bayard Wilson, Kate T Carroll, James A Proudfoot, Steven J Goetsch, John F Alksne, Kenneth Ott, Hitoshi Aiyama, Osamu Nagano and 6 more

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PubMed Full text at PMC Publisher
In one paragraph

Article in World neurosurgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

25 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Mir Amaan AliCenter for Translational and Applied Neuro-Oncology, Department of Neurosurgery, University of California, San Diego, La Jolla, California, USA.
Brian R HirshmanCenter for Translational and Applied Neuro-Oncology, Department of Neurosurgery, University of California, San Diego, La Jolla, California, USA.
Bayard WilsonCenter for Translational and Applied Neuro-Oncology, Department of Neurosurgery, University of California, San Diego, La Jolla, California, USA.
Kate T CarrollCenter for Translational and Applied Neuro-Oncology, Department of Neurosurgery, University of California, San Diego, La Jolla, California, USA.
James A ProudfootClinical and Translational Research Institute, University of California, San Diego, San Diego, California, USA.
Steven J GoetschSan Diego Gamma Knife Center, La Jolla, California, USA.
John F AlksneCenter for Translational and Applied Neuro-Oncology, Department of Neurosurgery, University of California, San Diego, La Jolla, California, USA.
Kenneth OttSan Diego Gamma Knife Center, La Jolla, California, USA.
Hitoshi AiyamaKatsuta Hospital Mito GammaHouse, Hitachi-Naka, Japan.
Osamu NaganoGamma Knife House, Chiba Cerebral and Cardiovascular Center, Ichihara, Japan.
Bob S CarterCenter for Translational and Applied Neuro-Oncology, Department of Neurosurgery, University of California, San Diego, La Jolla, California, USA.
Gerald FogartyMelanoma Institute of Australia, Sydney, Australia.
Angela HongMelanoma Institute of Australia, Sydney, Australia.
Toru SerizawaTsukiji Neurological Clinic, Tokyo Gamma Unit Center, Tokyo, Japan.
Masaaki YamamotoKatsuta Hospital Mito GammaHouse, Hitachi-Naka, Japan.
Clark C ChenCenter for Translational and Applied Neuro-Oncology, Department of Neurosurgery, University of California, San Diego, La Jolla, California, USA; Department of Neurosurgery, University of Minnesota, Minneapolis, Minnesota, USA. Electronic address: ccchen@umn.edu.

Funding

UC San Diego Clinical and Translational Research InstituteTL1TR001443 · NCATS · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI DEPP, COLIN A. · 2015 to 2019
$3.4M
NCATS NIH HHS TL1 TR001443
6 · The paper itself

Abstract

backgroundThe number of brain metastases (BMs) plays an important role in the decision between stereotactic radiosurgery (SRS) and whole-brain radiation therapy.

methodsWe analyzed the survival of 5750 SRS-treated patients with BM as a function of BM number. Survival analyses were performed with Kaplan-Meier analysis as well as univariate and multivariate Cox proportional hazards models.

resultsPatients with BMs were first categorized as those with 1, 2-4, and 5-10 BMs based on the scheme proposed by Yamamoto et al. (Lancet Oncology 2014). Median overall survival for patients with 1 BM was superior to those with 2-4 BMs (7.1 months vs. 6.4 months, P = 0.009), and survival of patients with 2-4 BMs did not differ from those with 5-10 BMs (6.4 months vs. 6.3 months, P = 0.170). The median survival of patients with >10 BMs was lower than those with 2-10 BMs (6.3 months vs. 5.5 months, P = 0.025). In a multivariate model that accounted for age, Karnofsky Performance Score, systemic disease status, tumor histology, and cumulative intracranial tumor volume, we observed a ∼10% increase in hazard of death when comparing patients with 1 versus 2-10 BMs (P < 0.001) or 10 versus >10 BMs (P < 0.001). When BM number was modeled as a continuous variable rather than using the classification by Yamamoto et al., we observed a step-wise 4% increase in the hazard of death for every increment of 6-7 BM (P < 0.001).

conclusionsThe contribution of BM number to overall survival is modest and should be considered as one of the many variables considered in the decision between SRS and whole-brain radiation therapy.

Indexed as

Tumor BurdenAdultAgedBrain NeoplasmsCohort StudiesFemaleFollow-Up StudiesHumansMaleMiddle AgedRadiosurgeryRetrospective StudiesSurvival RateTreatment OutcomeBrain metastasisPrognosticationRadiationStereotactic radiosurgerySurvival

Identifiers

PMID28735121
PMCPMC5654648

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.