ArticleFrontiers in oncology2025
Validation of a prognostic scoring system for brain metastases with synchronous detection of primary cancers at initial consultation.
Article in Frontiers in oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To develop and validate a simple 0-7 point prognostic score for patients with synchronous brain metastases (s-BM) at initial consultation and to provide an exploratory comparison with metachronous BM (m-BM). Methods: We retrospectively analyzed 297 patients with BM (2014-2022): s-BM n=64 and m-BM n=233. The score uses five pre-treatment factors available at time-zero: age <70 y (1 point), KPS ≥70 (2 points), absence of extracranial metastases (ECM) (2 points), presence of a lung mass on imaging (1 point), and absence of a digestive-tract mass (1 point). Patients were stratified as Score A (0), B (1-4), and C (5-7). Discrimination and parsimony were assessed by Harrell's C-index and AIC; proportional-hazards (PH) assumptions by global Schoenfeld test; time-dependent AUCs at 6/12 months were calculated; bootstrap (B = 500) provided optimism-corrected C-indices. (Synchronous was defined as ≤30 days between first ascertainment of primary tumor and BM; m-BM >30 days). Results: Median OS appeared similar for s-BM and m-BM in this cohort (5.2 Conclusions: A five-factor, 1-2 point score usable at initial consultation provides superior discrimination and parsimony in s-BM compared with established systems. External, multicenter validation is warranted.
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