Metastatic Brain Cancer Prognosis

Prognostic groups for outcome after palliative treatment of brain metastases by recursive partitioning analysis

Class Prognostic factors Median survival, months
I KPS ≥70 percent 7.1
Age <65 years
Controlled primary site
No extracranial metastases
II All others 4.2
III KPS <70 2.3

Karnofsky performance status scale

Value Level of functional capacity Definition
100 Normal, no complaints, no evidence of disease Able to carry on normal activity and to work; no special care needed
90 Able to carry on normal activity, minor signs or symptoms of disease
80 Normal activity with effort, some signs or symptoms of disease
70 Cares for self, unable to carry on normal activity or to do active work Unable to work; able to live at home and care for most personal needs; various degrees of assistance needed
60 Requires occasional assistance, but is able to care for most needs
50 Requires considerable assistance and frequent medical care
40 Disabled, requires special care and assistance Unable to care for self; requires equivalent of institutional or hospital care; disease may be progressing rapidly
30 Severely disabled, hospitalization is indicated although death is not imminent
20 Hospitalization is necessary, very sick, active supportive treatment necessary
10 Moribund, fatal processes progressing rapidly
0 Dead

Graded prognostic assessment for brain metastases by diagnosis

Non-small-cell and small-cell lung cancer
Prognostic factor Scoring criteria Patient score
0 0.5 1.0
Age in years >60 50-60 <50
KPS <70 70-80 90-100
Extracranial metastases Present Absent
Number of brain mets (BM) >3 2-3 1
Total:
Median survival (months) by score: 0-1.0 = 3.0; 1.5-2.0 = 5.5; 2.5-3.0 = 9.4; 3.5-4.0 = 14.8
Melanoma
Prognostic factor Scoring criteria Patient score
0 1.0 2.0
KPS <70 70-80 90-100
Number of BM >3 2-3 1
Total:
Median survival (months) by score: 0-1.0 = 3.4; 1.5-2.0 = 4.7; 2.5-3.0 = 8.8; 3.5-4.0 = 13.2
Breast cancer
Prognostic factor Scoring criteria Patient score
0 0.5 1.0 1.5 2.0
KPS ≤50 60 70-80 90-100 n/a
Subtype* Basal n/a Luminal A HER2 Luminal B
Age in years ≥60 <60 n/a n/a n/a
Total:
Median survival (months) by score: 0-1.0 = 3.4; 1.5-2.0 = 7.7; 2.5-3.0 = 15.1; 3.5-4.0 = 25.3
Renal cell carcinoma
Prognostic factor Scoring criteria Patient score
0 1.0 2.0
KPS <70 70-80 90-100
Number of BM >3 2-3 1
Total:
Median survival (months) by score: 0-1.0 = 3.3; 1.5-2.0 = 7.3; 2.5-3.0 = 11.3; 3.5-4.0 = 14.8
Gastrointestinal cancers
Prognostic factor Scoring criteria Patient score
0 1 2 3 4
KPS <70 70 80 90 100
Total:
Median survival (months) by score: 0-1.0 = 3.1; 2.0 = 4.4; 3.0 = 6.9; 4.0 = 13.5

* Basal: triple negative; Luminal A: ER/PR positive, HER2 negative; Luminal B: triple positive; HER2: ER/PR negative, HER2 positive.

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