Abstract
Purpose
Postoperative careful radiological observation could be a therapeutic option in patients with brain metastases after complete resection. However, there are no clear criteria to determine this indication. We investigated risk factors for local recurrence after complete resection and developed a scoring system to predict it.
Methods
We included 53 patients with 54 brain metastases, who underwent complete resection between January 2016 and December 2021. We identified risk factors for local recurrence and developed a scoring system to predict it using the extracted risk factors by assigning one point to each risk factor and calculating the total scores for each patient. We evaluated the correlation between the prognostic score and time to local recurrence.
Results
Local recurrence occurred in 37 of 54 tumors (68.5%), with a median follow-up duration of 21.0 months. The median time to local recurrence was 5.1 months, with a 6-month recurrence rate of 55.6%. Univariate and multivariate analyses revealed that non-lung adenocarcinoma, infratentorial tumors, and no postoperative systemic therapy were identified as significant risk factors for local recurrence (non-lung adenocarcinoma: odds ratio 2.59, p = 0.035; infratentorial tumors: odds ratio 2.27, p = 0.044; and no postoperative systemic therapy: odds ratio 2.62, p = 0.0069). A score ≥ 2 showed a median time to local recurrence of 2.1 months, contrasting starkly with 30.8 months for a score ≤ 1 (p = 0.0002).
Conclusions
Non-lung adenocarcinoma, infratentorial tumors, and no postoperative systemic therapy were risk factors for local recurrence. Our scoring system using the factors can predict local recurrence, potentially aiding treatment decisions.