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- W1977501524 abstract "The diagnosis-specific Graded Prognostic Assessment (GPA) has been previously published by our group to clarify prognosis for patients with brain metastases (BM). This study refines the existing breast cancer-specific GPA index by analyzing additional variables, including Her2Neu and ER/PR status. A retrospective database of 837 women with breast cancer treated for BM between 1985 and 2010 was generated from 11 institutions. of these, 673 women with breast cancer and newly diagnosed BMs were eligible for analysis and 375 patients had complete data on survival, Her2Neu status, and ER/PR status. ER/PR status was considered positive if either were positive. Prognostic factors (PF) significant for survival were analyzed by two methods for patients with complete data: multivariate Cox regression (MCR) and recursive partitioning analysis (RPA). PF found to be significant by either method were weighted relative to their significance to define the GPA index such that a GPA score of 4.0 correlates with the best prognosis and 0.0, the worst. In turn, GPA scores were calculated for each patient and correlated with survival. Overall median survival time (MST) for women with complete data was 14.4 months. Among those with complete data, significant PF by MCR, in order of significance, were KPS, Her2Neu, ER/PR status, and age. Significant PF by RPA were KPS, Her2Neu status, ER/PR status, age and number of BM. Values of 0.0, 0.5 and 1.0 were assigned to each of the five PF as follows: 0.0 for KPS <70, Her2Neu negative, ER/PR negative, age ≥ 70, >1 BM; 0.5 for KPS 70-80, age < 70, single BM; 1.0 for KPS 90-100, Her2Neu positive, ER/PR positive. The sum of those values defined the total Breast-GPA score. The MST (months) of women with total GPA scores of 0-1.0, 1.5-2.0, 2.5-3.0 and 3.5-4.0 was 2.1 (n = 14), 6.4 (n = 93), 16.7 (n = 161) and 25.5 (n = 105) months, respectively (p < 0.0001). This updated Breast-GPA shows highly significant correlation with MST for women with breast cancer and brain metastases. This index should replace existing prognostic indices for stratification of future clinical trials and as a guide for clinical decision-making." @default.
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- W1977501524 date "2010-11-01" @default.
- W1977501524 modified "2023-09-27" @default.
- W1977501524 title "The Graded Prognostic Assessment for Women with Brain Metastases from Breast Cancer (GPA-Breast): A Diagnosis-specific Prognostic Index" @default.
- W1977501524 doi "https://doi.org/10.1016/j.ijrobp.2010.07.057" @default.
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