Evidence map›Paper›PMID 35474015›Full record

ArticleNeuro-oncology2022

Factors correlating with survival following adjuvant or definitive radiosurgery for large brain metastases.

Enrique Gutiérrez-Valencia, Aristotelis Kalyvas, Conrad J Villafuerte, Barbara-Ann Millar, Normand Laperriere, Tatiana Conrad, Alejandro Berlin, Jessica Weiss, Gelareh Zadeh, Mark Bernstein and 2 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neuro-oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.4field-weighted citation impact, top 19% of its field
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

7 citing papers in PubMed, 9 citations in OpenAlex.

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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

12 authors at 3 institutions in 1 country.

Enrique Gutiérrez-ValenciaDepartment of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada.
Aristotelis KalyvasDivision of Neurosurgery, Toronto Western Hospital - University of Toronto, Toronto, ON, Canada.
Conrad J VillafuerteDepartment of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada.
Barbara-Ann MillarDepartment of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada.
Normand LaperriereDepartment of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada.ORCID 0000-0001-8930-9650
Tatiana ConradDepartment of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada.
Alejandro BerlinDepartment of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada.
Jessica WeissDepartment of Biostatistics, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
Gelareh ZadehDivision of Neurosurgery, Toronto Western Hospital - University of Toronto, Toronto, ON, Canada.ORCID 0000-0002-6637-4502
Mark BernsteinDivision of Neurosurgery, Toronto Western Hospital - University of Toronto, Toronto, ON, Canada.
Paul KongkhamDivision of Neurosurgery, Toronto Western Hospital - University of Toronto, Toronto, ON, Canada.
David B ShultzDepartment of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada.
University Health Network · CAUniversity of Toronto · CAPrincess Margaret Cancer Centre · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWe sought to identify variates correlating with overall survival (OS) in patients treated with surgery (S) plus adjuvant stereotactic radiosurgery (SRS) versus definitive SRS for large (>4 cc) brain metastases (BrM).

methodsWe used univariate (UVA) and multivariate analyses (MVA) to identify survival correlates among eligible patients identified from a prospective registry and compared definitive SRS to S+ adjuvant SRS cohorts using propensity score-matched analysis (PSMA). Secondary outcomes were measured using the cumulative incidence (CI) method.

resultsWe identified 364 patients; 127 and 237 were treated with S+SRS and definitive SRS, respectively. On UVA, SRS alone [HR1.73 (1.35,2.22) P < .001), BrM quantity [HR 1.13 (1.06-1.22) (P < .001)]; performance status (PS) [HR 2.78 (1.73-4.46) (P < .001)]; extracranial disease (ECD) [HR 1.82 (1.37,2.40) (P < .001)]; and receipt of systemic treatment after BrM therapy, [HR 0.58 (0.46-073) (P < .001)] correlated with OS. On MVA, SRS alone [HR 1.81 (1.19,2.74) (P < .0054)], SRS target volume [HR 1.03 (1.01,1.06) (P < .0042)], and receipt of systemic treatment [HR 0.68 (0.50,0.93) (P < .015)] correlated with OS. When PSMA was used to balance ECD, BrM quantity, PS, and SRS target volume, SRS alone remained correlated with worsened OS [HR 1.62 (1.20-2.19) (P = 0.0015)]. CI of local failure requiring resection at 12 months was 3% versus 7% for S+SRS and SRS cohorts, respectively [(HR 2.04 (0.89-4.69) (P = .091)]. CI of pachymeningeal failure at 12 months was 16% versus 0% for S+SRS and SRS.

conclusionSRS target volume, receipt of systemic therapies, and treatment with S+SRS instead of definitive SRS correlated with improved survival in patients with large BrM.

Indexed as

Brain NeoplasmsRadiosurgeryHumansIncidenceMultivariate AnalysisRetrospective Studieslarge brain metastasespachymeningeal failureSRS target volumeSurgery

Identifiers

PMID35474015
PMCPMC9629433
OpenAlexW4224981127

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.