• Media type: E-Article
  • Title: Correlation of large brain edema with favorable prognosis in patients with single brain metastases
  • Contributor: Preusser, Matthias; Berghoff, Anna Sophie; Dinhof, Carina; Hutterer, Markus; Woehrer, Adelheid; Hackl, Monika; Bartsch, Rupert; Birner, Peter; Zielinski, Christoph; Widhalm, Georg; Marosi, Christine; Prayer, Daniela; Spannberger, Thomas
  • imprint: American Society of Clinical Oncology (ASCO), 2012
  • Published in: Journal of Clinical Oncology
  • Language: English
  • DOI: 10.1200/jco.2012.30.15_suppl.2053
  • ISSN: 0732-183X; 1527-7755
  • Keywords: Cancer Research ; Oncology
  • Origination:
  • Footnote:
  • Description: <jats:p> 2053 </jats:p><jats:p> Background: The sub-cohort of brain metastases (BM) patients (pts) with single BM has relatively favorable survival times, but novel prognostic factors are needed to individualize patient management. Methods: We retrospectively evaluated pre-operative magnetic resonance images in patients, who underwent neurosurgical resection of a single BM. The localization and largest diameter of the BM was recorded. The extent of brain edema (BE) was graded on contrast-enhanced T1, T2 and fluid-attenuated inversion recovery (FLAIR) images as follows: BE &lt;1cm, BE &gt;1 cm without affection of the contralateral hemisphere, BE &gt;1cm with affection of the contralateral hemisphere. Further, immunohistochemically assessed expression of hypoxia-induced factor 1 alpha (HIF1a) was analyzed in each BM tissue specimen. Results: 159 pts were studied (81 male, 78 female; age range 24 to 80 years, median 58). The primary tumors were lung carcinoma in 74, breast cancer in 26, kidney cancer in 13, colorectal cancer in 11, melanoma in 9 and other tumor types in 26 cases. At univariate analysis, we found a significant positive correlation of overall survival time (OS) with young age, Karnofsky index &gt;80, non-melanoma histology, and, surprisingly, large BE (p&lt;0.05, log-rank test). At multivariate analysis, pts age, histological diagnosis and extent of BE remained independent prognostic parameters (Cox regression model, p&lt;0.05). We found a significant positive correlation of extent of BE with expression of HIF1a (Mann-Whitney-U test, p=0.003). Conclusions: Large BE positively and independently correlates with favorable prognosis in pts operated for single BM. Peritumoral BE correlates with HIF1a expression, indicating a possible role of tumor hypoxia in its formation. [Table: see text] </jats:p>
  • Access State: Open Access