The Experts below are selected from a list of 45036 Experts worldwide ranked by ideXlab platform
Ryan Shanley - One of the best experts on this subject based on the ideXlab platform.
-
Development of a disease-specific graded Prognostic Assessment index for the management of sarcoma patients with brain metastases (Sarcoma-GPA)
BMC cancer, 2020Co-Authors: Anna Patrikidou, Ryan Shanley, Loic Chaigneau, Nicolas Isambert, Kyriaki Kitikidou, Isabelle Ray-coquard, Thibaud Valentin, Bettina Malivoir, Maryline Laigre, Jacques Olivier BayAbstract:Brain metastases from sarcomatous lesions pose a management challenge owing to their rarity and the histopathological heterogeneity. Prognostic indices such as the Graded Prognostic Assessment (GPA) index have been developed for several primary tumour types presenting with brain metastases (e.g. lung, breast, melanoma), tailored to the specifics of different primary histologies and molecular profiles. Thus far, a Prognostic index to direct treatment decisions is lacking for adult sarcoma patients with brain metastases. We performed a multicentre analysis of a national group of expert sarcoma tertiary centres (French Sarcoma Group, GSF-GETO) with the participation of one Canadian and one Swiss centre. The study cohort included adult patients with a diagnosis of a bone or soft tissue sarcoma presenting parenchymal or meningeal brain metastases, managed between January 1992 and March 2012. We assessed the validity of the original GPA index in this patient population and developed a disease-specific Sarcoma-GPA index. The original GPA index is not Prognostic for sarcoma brain metastasis patients. We have developed a dedicated Sarcoma-GPA index that identifies a sub-group of patients with particularly favourable prognosis based on histology, number of brain lesions and performance status. The Sarcoma-GPA index provides a novel tool for sarcoma oncologists to guide clinical decision-making and outcomes research.
-
Development of a disease-specific graded Prognostic Assessment index for the management of sarcoma patients with brain metastases (Sarcoma-GPA)
BMC Cancer, 2020Co-Authors: Anna Patrikidou, Ryan Shanley, Loic Chaigneau, Nicolas Isambert, Kyriaki Kitikidou, Thibaud Valentin, Bettina Malivoir, Maryline Laigre, Isabelle Ray-coquard, Laurence Moureau-zabottoAbstract:Background Brain metastases from sarcomatous lesions pose a management challenge owing to their rarity and the histopathological heterogeneity. Prognostic indices such as the Graded Prognostic Assessment (GPA) index have been developed for several primary tumour types presenting with brain metastases (e.g. lung, breast, melanoma), tailored to the specifics of different primary histologies and molecular profiles. Thus far, a Prognostic index to direct treatment decisions is lacking for adult sarcoma patients with brain metastases. Methods We performed a multicentre analysis of a national group of expert sarcoma tertiary centres (French Sarcoma Group, GSF-GETO) with the participation of one Canadian and one Swiss centre. The study cohort included adult patients with a diagnosis of a bone or soft tissue sarcoma presenting parenchymal or meningeal brain metastases, managed between January 1992 and March 2012. We assessed the validity of the original GPA index in this patient population and developed a disease-specific Sarcoma-GPA index. Results The original GPA index is not Prognostic for sarcoma brain metastasis patients. We have developed a dedicated Sarcoma-GPA index that identifies a sub-group of patients with particularly favourable prognosis based on histology, number of brain lesions and performance status. Conclusions The Sarcoma-GPA index provides a novel tool for sarcoma oncologists to guide clinical decision-making and outcomes research.
-
effect of tumor subtype on survival and the graded Prognostic Assessment for patients with breast cancer and brain metastases
International Journal of Radiation Oncology Biology Physics, 2012Co-Authors: Paul W. Sperduto, Penny K. Sneed, Samuel T Chao, David Roberge, Norbert Kased, Ryan Shanley, Robert J Weil, John H. Suh, Xianghua Luo, Amit BhattAbstract:Purpose The diagnosis-specific Graded Prognostic Assessment (GPA) was published to clarify prognosis for patients with brain metastases. This study refines the existing Breast-GPA by analyzing a larger cohort and tumor subtype. Methods and Materials A multi-institutional retrospective database of 400 breast cancer patients treated for newly diagnosed brain metastases was generated. Prognostic factors significant for survival were analyzed by multivariate Cox regression and recursive partitioning analysis (RPA). Factors were weighted by the magnitude of their regression coefficients to define the GPA index. Results Significant Prognostic factors by multivariate Cox regression and RPA were Karnofsky performance status (KPS), HER2, ER/PR status, and the interaction between ER/PR and HER2. RPA showed age was significant for patients with KPS 60 to 80. The median survival time (MST) overall was 13.8 months, and for GPA scores of 0 to 1.0, 1.5 to 2.0, 2.5 to 3.0, and 3.5 to 4.0 were 3.4 ( n = 23), 7.7 ( n = 104), 15.1 ( n = 140), and 25.3 ( n = 133) months, respectively ( p Conclusions The Breast-GPA documents wide variation in prognosis and shows clear separation between subgroups of patients with breast cancer and brain metastases. This tool will aid clinical decision making and stratification in clinical trials. These data confirm the effect of tumor subtype on survival and show the Breast-GPA offers significantly more predictive power than the tumor subtype alone.
-
summary report on the graded Prognostic Assessment an accurate and facile diagnosis specific tool to estimate survival for patients with brain metastases
Journal of Clinical Oncology, 2012Co-Authors: Paul W. Sperduto, Penny K. Sneed, Samuel T Chao, Amit Bhatt, David Roberge, Norbert Kased, Zhiyuan Xu, Ryan Shanley, Robert J Weil, Ashley W. JensenAbstract:Purpose Our group has previously published the Graded Prognostic Assessment (GPA), a Prognostic index for patients with brain metastases. Updates have been published with refinements to create diagnosis-specific Graded Prognostic Assessment indices. The purpose of this report is to present the updated diagnosis-specific GPA indices in a single, unified, user-friendly report to allow ease of access and use by treating physicians. Methods A multi-institutional retrospective (1985 to 2007) database of 3,940 patients with newly diagnosed brain metastases underwent univariate and multivariate analyses of Prognostic factors associated with outcomes by primary site and treatment. Significant Prognostic factors were used to define the diagnosis-specific GPA Prognostic indices. A GPA of 4.0 correlates with the best prognosis, whereas a GPA of 0.0 corresponds with the worst prognosis. Results Significant Prognostic factors varied by diagnosis. For lung cancer, Prognostic factors were Karnofsky performance score, ag...
-
The effect of tumor subtype on survival and the graded Prognostic Assessment (GPA) for patients with breast cancer and brain metastases.
Journal of Clinical Oncology, 2011Co-Authors: Paul W. Sperduto, Samuel T Chao, Amit Bhatt, David Roberge, Norbert Kased, Ryan Shanley, Helen A. Shih, John P. Kirkpatrick, Paul D. Brown, Laurie E. GasparAbstract:238 Background: The Diagnosis-Specific Graded Prognostic Assessment (DS-GPA) was published to clarify prognosis for patients with brain metastases. This study refines the existing Breast GPA by analyzing a larger cohort and tumor subtype. Methods: A multi-institutional retrospective database of 400 breast cancer patients treated for newly-diagnosed brain metastases was generated. Prognostic factors significant for survival were analyzed by multivariate Cox regression (MCR) and recursive partitioning analysis (RPA). Factors were weighted by magnitude of their regression coefficients to define the GPA index. A GPA score of 4.0 represents the best prognosis, 0.0, the worst. Results: Significant Prognostic factors by MCR and RPA were Karnofsky Performance Status (KPS), HER2, ER/PR status, and the interaction between ER/PR and HER2. RPA showed age was significant for patients with KPS 60-80. The median survival time (MST) overall was 13.8 months, and for GPA scores of 0-1.0, 1.5-2.0, 2.5-3.0 and 3.5-4.0 was 3....
Paul W. Sperduto - One of the best experts on this subject based on the ideXlab platform.
-
Estimating survival for renal cell carcinoma patients with brain metastases: an update of the Renal Graded Prognostic Assessment tool
Neuro-oncology, 2018Co-Authors: Paul W. Sperduto, Paul D. Brown, Brian J. Deegan, Krishan R. Jethwa, Natalie A. Lockney, Kathryn Beal, Nitesh Rana, Albert Attia, Chia-lin TsengAbstract:Background Brain metastases are a common complication of renal cell carcinoma (RCC). Our group previously published the Renal Graded Prognostic Assessment (GPA) tool. In our prior RCC study (n = 286, 1985-2005), we found marked heterogeneity and variation in outcomes. In our recent update in a larger, more contemporary cohort, we identified additional significant Prognostic factors. The purpose of this study is to update the original Renal-GPA based on the newly identified Prognostic factors. Methods A multi-institutional retrospective institutional review board-approved database of 711 RCC patients with new brain metastases diagnosed from January 1, 2006 to December 31, 2015 was created. Clinical parameters and treatment were correlated with survival. A revised Renal GPA index was designed by weighting the most significant factors in proportion to their hazard ratios and assigning scores such that the patients with the best and worst prognoses would have a GPA of 4.0 and 0.0, respectively. Results The 4 most significant factors were Karnofsky performance status, number of brain metastases, extracranial metastases, and hemoglobin. The overall median survival was 12 months. Median survival for GPA groups 0-1.0, 1.5-2.0, 2.5-3, and 3.5-4.0 (% n = 25, 27, 30 and 17) was 4, 12, 17, and 35 months, respectively. Conclusion The updated Renal GPA is a user-friendly tool that will help clinicians and patients better understand prognosis, individualize clinical decision making and treatment selection, provide a means to compare retrospective literature, and provide more robust stratification of future clinical trials in this heterogeneous population. To simplify use of this tool in daily practice, a free online application is available at brainmetgpa.com.
-
effect of tumor subtype on survival and the graded Prognostic Assessment for patients with breast cancer and brain metastases
International Journal of Radiation Oncology Biology Physics, 2012Co-Authors: Paul W. Sperduto, Penny K. Sneed, Samuel T Chao, David Roberge, Norbert Kased, Ryan Shanley, Robert J Weil, John H. Suh, Xianghua Luo, Amit BhattAbstract:Purpose The diagnosis-specific Graded Prognostic Assessment (GPA) was published to clarify prognosis for patients with brain metastases. This study refines the existing Breast-GPA by analyzing a larger cohort and tumor subtype. Methods and Materials A multi-institutional retrospective database of 400 breast cancer patients treated for newly diagnosed brain metastases was generated. Prognostic factors significant for survival were analyzed by multivariate Cox regression and recursive partitioning analysis (RPA). Factors were weighted by the magnitude of their regression coefficients to define the GPA index. Results Significant Prognostic factors by multivariate Cox regression and RPA were Karnofsky performance status (KPS), HER2, ER/PR status, and the interaction between ER/PR and HER2. RPA showed age was significant for patients with KPS 60 to 80. The median survival time (MST) overall was 13.8 months, and for GPA scores of 0 to 1.0, 1.5 to 2.0, 2.5 to 3.0, and 3.5 to 4.0 were 3.4 ( n = 23), 7.7 ( n = 104), 15.1 ( n = 140), and 25.3 ( n = 133) months, respectively ( p Conclusions The Breast-GPA documents wide variation in prognosis and shows clear separation between subgroups of patients with breast cancer and brain metastases. This tool will aid clinical decision making and stratification in clinical trials. These data confirm the effect of tumor subtype on survival and show the Breast-GPA offers significantly more predictive power than the tumor subtype alone.
-
summary report on the graded Prognostic Assessment an accurate and facile diagnosis specific tool to estimate survival for patients with brain metastases
Journal of Clinical Oncology, 2012Co-Authors: Paul W. Sperduto, Penny K. Sneed, Samuel T Chao, Amit Bhatt, David Roberge, Norbert Kased, Zhiyuan Xu, Ryan Shanley, Robert J Weil, Ashley W. JensenAbstract:Purpose Our group has previously published the Graded Prognostic Assessment (GPA), a Prognostic index for patients with brain metastases. Updates have been published with refinements to create diagnosis-specific Graded Prognostic Assessment indices. The purpose of this report is to present the updated diagnosis-specific GPA indices in a single, unified, user-friendly report to allow ease of access and use by treating physicians. Methods A multi-institutional retrospective (1985 to 2007) database of 3,940 patients with newly diagnosed brain metastases underwent univariate and multivariate analyses of Prognostic factors associated with outcomes by primary site and treatment. Significant Prognostic factors were used to define the diagnosis-specific GPA Prognostic indices. A GPA of 4.0 correlates with the best prognosis, whereas a GPA of 0.0 corresponds with the worst prognosis. Results Significant Prognostic factors varied by diagnosis. For lung cancer, Prognostic factors were Karnofsky performance score, ag...
-
The effect of tumor subtype on survival and the graded Prognostic Assessment (GPA) for patients with breast cancer and brain metastases.
Journal of Clinical Oncology, 2011Co-Authors: Paul W. Sperduto, Samuel T Chao, Amit Bhatt, David Roberge, Norbert Kased, Ryan Shanley, Helen A. Shih, John P. Kirkpatrick, Paul D. Brown, Laurie E. GasparAbstract:238 Background: The Diagnosis-Specific Graded Prognostic Assessment (DS-GPA) was published to clarify prognosis for patients with brain metastases. This study refines the existing Breast GPA by analyzing a larger cohort and tumor subtype. Methods: A multi-institutional retrospective database of 400 breast cancer patients treated for newly-diagnosed brain metastases was generated. Prognostic factors significant for survival were analyzed by multivariate Cox regression (MCR) and recursive partitioning analysis (RPA). Factors were weighted by magnitude of their regression coefficients to define the GPA index. A GPA score of 4.0 represents the best prognosis, 0.0, the worst. Results: Significant Prognostic factors by MCR and RPA were Karnofsky Performance Status (KPS), HER2, ER/PR status, and the interaction between ER/PR and HER2. RPA showed age was significant for patients with KPS 60-80. The median survival time (MST) overall was 13.8 months, and for GPA scores of 0-1.0, 1.5-2.0, 2.5-3.0 and 3.5-4.0 was 3....
-
A graded Prognostic Assessment (GPA) for women with breast cancer and brain metastases.
Journal of Clinical Oncology, 2010Co-Authors: Paul W. Sperduto, Ashley W. Jensen, Amit Bhatt, David Roberge, P.k. Sneed, Xianghua Luo, Helen A. Shih, John P. Kirkpatrick, Laurie E. GasparAbstract:1028 Background: The graded Prognostic Assessment (GPA) has been previously published by our group to clarify diagnosis- specific prognosis for brain metastases (BM) patients. The purpose of this s...
Samuel T Chao - One of the best experts on this subject based on the ideXlab platform.
-
Graded Prognostic Assessment index for colorectal cancer with brain metastases.
Journal of Clinical Oncology, 2015Co-Authors: Vidhya Karivedu, Samuel T Chao, Vyshak Alva Venur, Iullia Kim, John H. Suh, Davendra Sohal, Alok A. Khorana, Xuefei Jia, Manmeet AhluwaliaAbstract:2049 Background: Brain metastasis (BM) is a rare but serious neurologic complication of colorectal cancer (CRC). The Disease Specific Graded Prognostic Assessment (DS-GPA) which is based solely on ...
-
BM-03REVISED GRADED Prognostic Assessment FOR MELANOMA PATIENTS WITH BRAIN METASTASIS (MBM).
Neuro-Oncology, 2014Co-Authors: Vyshak Alva Venur, Samuel T Chao, Paul Elson, Manmeet AhluwaliaAbstract:BACKGROUND: Melanoma is third most common cause of brain metastasis (MBM). We evaluated Prognostic factors that predict overall survival (OS) in MBM treated at a single tertiary care institution in contemporary cohort. METHODS: With IRB approval, the Cleveland Clinic's database was used to identify MBM patients treated between 2000 and 2013. OS from the diagnosis of MBM was the primary end point. Cox proportional hazards models with stepwise variable selection were used for data analysis. RESULTS: 256 patients with median age of 55 (20-85) years were included for analysis. Karnofsky performance scale (KPS) was 100 in 17, 90 in 88, 80 in 64, ≤ 70 in 58 patients. Seventy four patients (30%) were treated with stereotactic radiosurgery (SRS), 60 (24%) with whole brain radiation therapy (WBRT), 37 (15%) with WBRT and SRS, 35 (14%) underwent surgery and WBRT, 21 (8%) surgery and SRS. Median OS was 5.7 months (95% C.I. 4.9-6.6 months). Genomic data was available for 73 patients; 34 had BRAF mutation and 39 were BRAF negative. Disease specific graded Prognostic Assessment (GPA) for MBM is based on KPS and age at diagnosis. Overall it was Prognostic for OS (p
-
Graded Prognostic Assessment index for melanoma with brain metastases (MBM).
Journal of Clinical Oncology, 2013Co-Authors: Kwabena Osei-boateng, Samuel T Chao, Vyshak Alva Venur, Saurabh Dahiya, Rohan Garje, Paul Elson, Manmeet AhluwaliaAbstract:9086 Background: The Graded Prognostic Assessment (GPA) is a commonly used Prognostic index in patients with brain metastases (BM). GPA for melanoma consists of Karnofsky Performance Scale (KPS) an...
-
Graded Prognostic Assessment index for breast cancer patients with brain metastases (BCBM).
Journal of Clinical Oncology, 2013Co-Authors: Vyshak Alva Venur, Samuel T Chao, Kwabena Osei-boateng, Saurabh Dahiya, Rohan Garje, Paul Elson, John H. Suh, Manmeet AhluwaliaAbstract:2096 Background: The Graded Prognostic Assessment (GPA) is a commonly used Prognostic index based on RTOG protocols in patients with brain metastases (BM). The purpose of this study was to evaluate Prognostic factors to predict for overall survival (OS) in breast cancer BM (BCBM) treated at a single tertiary care center. Methods: After obtaining IRB approval, the Cleveland Clinic Brain Tumor and Neuro-Oncology Center’s database was used to identify BCBM who were treated in the recent years (2000-12). A proportional hazards model was used to assess OS, which was measured from the date of diagnosis of brain metastases to death or last follow-up. Results: 161 BCBM (160 females) median age 52 years (range 27-84) were included for analysis. 48% of patients were ER positive, 31% were PR positive, 50% were HER2 positive while 31% of patients were triple negative. The median number of BM was 2 (range, 1-15). Karnofsky Performance Scale (KPS) of the patient was 90-100 in 50%, 70-80 in 47%) and
-
A validation study of graded Prognostic Assessment index for lung cancer patients with brain metastases.
Journal of Clinical Oncology, 2013Co-Authors: Vyshak Alva Venur, Samuel T Chao, Kwabena Osei-boateng, Saurabh Dahiya, Rohan Garje, Paul Elson, John H. Suh, Manmeet AhluwaliaAbstract:2070 Background: The Graded Prognostic Assessment (GPA) is a commonly used index based on 5 prior randomized trials performed by the RTOG (Protocols 7916, 8528, 8905, 9104, and 9508). The purpose of this study was to validate GPA index in a recent cohort of lung cancer patients with brain metastases (LBM) at a larger tertiary care center. Methods: Cleveland Clinic Brain Tumor and Neuro-Oncology Center's database was used to identify LBM treated in the recent era (2000-12). A proportional hazards model was used to assess overall survival (OS), measured from the date of diagnosis of brain metastases to death or last follow-up. Results: 490 LBM (250 males) median age 61 years (range 35-86) were included. Histology included small cell (64, 13%) adenocarcinoma (289, 59%), squamous (53, 11%), large cell (26, 5%) and unknown (55, 11%). The median number of brain metastases was 1 (range, 1-47). Karnofsky Performance Scale (KPS) was 90-100 in 187 (41%), 70-80 in 238 (52%) and
Amit Bhatt - One of the best experts on this subject based on the ideXlab platform.
-
effect of tumor subtype on survival and the graded Prognostic Assessment for patients with breast cancer and brain metastases
International Journal of Radiation Oncology Biology Physics, 2012Co-Authors: Paul W. Sperduto, Penny K. Sneed, Samuel T Chao, David Roberge, Norbert Kased, Ryan Shanley, Robert J Weil, John H. Suh, Xianghua Luo, Amit BhattAbstract:Purpose The diagnosis-specific Graded Prognostic Assessment (GPA) was published to clarify prognosis for patients with brain metastases. This study refines the existing Breast-GPA by analyzing a larger cohort and tumor subtype. Methods and Materials A multi-institutional retrospective database of 400 breast cancer patients treated for newly diagnosed brain metastases was generated. Prognostic factors significant for survival were analyzed by multivariate Cox regression and recursive partitioning analysis (RPA). Factors were weighted by the magnitude of their regression coefficients to define the GPA index. Results Significant Prognostic factors by multivariate Cox regression and RPA were Karnofsky performance status (KPS), HER2, ER/PR status, and the interaction between ER/PR and HER2. RPA showed age was significant for patients with KPS 60 to 80. The median survival time (MST) overall was 13.8 months, and for GPA scores of 0 to 1.0, 1.5 to 2.0, 2.5 to 3.0, and 3.5 to 4.0 were 3.4 ( n = 23), 7.7 ( n = 104), 15.1 ( n = 140), and 25.3 ( n = 133) months, respectively ( p Conclusions The Breast-GPA documents wide variation in prognosis and shows clear separation between subgroups of patients with breast cancer and brain metastases. This tool will aid clinical decision making and stratification in clinical trials. These data confirm the effect of tumor subtype on survival and show the Breast-GPA offers significantly more predictive power than the tumor subtype alone.
-
summary report on the graded Prognostic Assessment an accurate and facile diagnosis specific tool to estimate survival for patients with brain metastases
Journal of Clinical Oncology, 2012Co-Authors: Paul W. Sperduto, Penny K. Sneed, Samuel T Chao, Amit Bhatt, David Roberge, Norbert Kased, Zhiyuan Xu, Ryan Shanley, Robert J Weil, Ashley W. JensenAbstract:Purpose Our group has previously published the Graded Prognostic Assessment (GPA), a Prognostic index for patients with brain metastases. Updates have been published with refinements to create diagnosis-specific Graded Prognostic Assessment indices. The purpose of this report is to present the updated diagnosis-specific GPA indices in a single, unified, user-friendly report to allow ease of access and use by treating physicians. Methods A multi-institutional retrospective (1985 to 2007) database of 3,940 patients with newly diagnosed brain metastases underwent univariate and multivariate analyses of Prognostic factors associated with outcomes by primary site and treatment. Significant Prognostic factors were used to define the diagnosis-specific GPA Prognostic indices. A GPA of 4.0 correlates with the best prognosis, whereas a GPA of 0.0 corresponds with the worst prognosis. Results Significant Prognostic factors varied by diagnosis. For lung cancer, Prognostic factors were Karnofsky performance score, ag...
-
The effect of tumor subtype on survival and the graded Prognostic Assessment (GPA) for patients with breast cancer and brain metastases.
Journal of Clinical Oncology, 2011Co-Authors: Paul W. Sperduto, Samuel T Chao, Amit Bhatt, David Roberge, Norbert Kased, Ryan Shanley, Helen A. Shih, John P. Kirkpatrick, Paul D. Brown, Laurie E. GasparAbstract:238 Background: The Diagnosis-Specific Graded Prognostic Assessment (DS-GPA) was published to clarify prognosis for patients with brain metastases. This study refines the existing Breast GPA by analyzing a larger cohort and tumor subtype. Methods: A multi-institutional retrospective database of 400 breast cancer patients treated for newly-diagnosed brain metastases was generated. Prognostic factors significant for survival were analyzed by multivariate Cox regression (MCR) and recursive partitioning analysis (RPA). Factors were weighted by magnitude of their regression coefficients to define the GPA index. A GPA score of 4.0 represents the best prognosis, 0.0, the worst. Results: Significant Prognostic factors by MCR and RPA were Karnofsky Performance Status (KPS), HER2, ER/PR status, and the interaction between ER/PR and HER2. RPA showed age was significant for patients with KPS 60-80. The median survival time (MST) overall was 13.8 months, and for GPA scores of 0-1.0, 1.5-2.0, 2.5-3.0 and 3.5-4.0 was 3....
-
A graded Prognostic Assessment (GPA) for women with breast cancer and brain metastases.
Journal of Clinical Oncology, 2010Co-Authors: Paul W. Sperduto, Ashley W. Jensen, Amit Bhatt, David Roberge, P.k. Sneed, Xianghua Luo, Helen A. Shih, John P. Kirkpatrick, Laurie E. GasparAbstract:1028 Background: The graded Prognostic Assessment (GPA) has been previously published by our group to clarify diagnosis- specific prognosis for brain metastases (BM) patients. The purpose of this s...
Anna Patrikidou - One of the best experts on this subject based on the ideXlab platform.
-
Development of a disease-specific graded Prognostic Assessment index for the management of sarcoma patients with brain metastases (Sarcoma-GPA)
BMC cancer, 2020Co-Authors: Anna Patrikidou, Ryan Shanley, Loic Chaigneau, Nicolas Isambert, Kyriaki Kitikidou, Isabelle Ray-coquard, Thibaud Valentin, Bettina Malivoir, Maryline Laigre, Jacques Olivier BayAbstract:Brain metastases from sarcomatous lesions pose a management challenge owing to their rarity and the histopathological heterogeneity. Prognostic indices such as the Graded Prognostic Assessment (GPA) index have been developed for several primary tumour types presenting with brain metastases (e.g. lung, breast, melanoma), tailored to the specifics of different primary histologies and molecular profiles. Thus far, a Prognostic index to direct treatment decisions is lacking for adult sarcoma patients with brain metastases. We performed a multicentre analysis of a national group of expert sarcoma tertiary centres (French Sarcoma Group, GSF-GETO) with the participation of one Canadian and one Swiss centre. The study cohort included adult patients with a diagnosis of a bone or soft tissue sarcoma presenting parenchymal or meningeal brain metastases, managed between January 1992 and March 2012. We assessed the validity of the original GPA index in this patient population and developed a disease-specific Sarcoma-GPA index. The original GPA index is not Prognostic for sarcoma brain metastasis patients. We have developed a dedicated Sarcoma-GPA index that identifies a sub-group of patients with particularly favourable prognosis based on histology, number of brain lesions and performance status. The Sarcoma-GPA index provides a novel tool for sarcoma oncologists to guide clinical decision-making and outcomes research.
-
Development of a disease-specific graded Prognostic Assessment index for the management of sarcoma patients with brain metastases (Sarcoma-GPA)
BMC Cancer, 2020Co-Authors: Anna Patrikidou, Ryan Shanley, Loic Chaigneau, Nicolas Isambert, Kyriaki Kitikidou, Thibaud Valentin, Bettina Malivoir, Maryline Laigre, Isabelle Ray-coquard, Laurence Moureau-zabottoAbstract:Background Brain metastases from sarcomatous lesions pose a management challenge owing to their rarity and the histopathological heterogeneity. Prognostic indices such as the Graded Prognostic Assessment (GPA) index have been developed for several primary tumour types presenting with brain metastases (e.g. lung, breast, melanoma), tailored to the specifics of different primary histologies and molecular profiles. Thus far, a Prognostic index to direct treatment decisions is lacking for adult sarcoma patients with brain metastases. Methods We performed a multicentre analysis of a national group of expert sarcoma tertiary centres (French Sarcoma Group, GSF-GETO) with the participation of one Canadian and one Swiss centre. The study cohort included adult patients with a diagnosis of a bone or soft tissue sarcoma presenting parenchymal or meningeal brain metastases, managed between January 1992 and March 2012. We assessed the validity of the original GPA index in this patient population and developed a disease-specific Sarcoma-GPA index. Results The original GPA index is not Prognostic for sarcoma brain metastasis patients. We have developed a dedicated Sarcoma-GPA index that identifies a sub-group of patients with particularly favourable prognosis based on histology, number of brain lesions and performance status. Conclusions The Sarcoma-GPA index provides a novel tool for sarcoma oncologists to guide clinical decision-making and outcomes research.