Lagerwaard et al evaluated patients with metastatic tumors to the brain. They identified clinical factors which may predict survival in these patients. The authors are from Daniel den Hoed Cancer Center at the University Hospital Rotterdam.
Parameter
Better Prognosis
Worse Prognosis
ECOG performance status
0 or 1
2 or 3
systemic tumor activity
none
limited or extensive
neurological improvement after steroid therapy
substantial
none or limited
where:
• Patients with ECOG 4 were not included but would have a poor prognosis.
Additional favorable prognostic factors:
(1) management with neurosurgical resection followed by radiation therapy
(2) normal serum LDH concentration
Additional favorable prognositc factors with lesser importance:
(3) female gender if lung cancer
(4) younger age (< 70 years)
(5) 1 or 2 brain metastases
(6) breast cancer and interval to brain metastases >= 2 years
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