Abstract 5148
Background
Brain metastases (BM) have traditionally been associated with adverse outcome. BOO-NSCLC, however, may represent a distinct population subtype in whom a radical therapeutic approach may be feasible. We aimed to assess the impact of the RPA group classification in this population subtype.
Methods
Retrospective analysis of pts with BOO-NSCLC (1-5 BMs as only metastatic site) treated between 2010-2018 at a single institution. RPA classification and other clinical variables was derived from electronic patient records. Survival analyses were performed with Kaplan Meier and uni- (UV) and multivariable (MV) Cox-regression models. Performance of the survival models was assessed by ROC AUCs and weighted c-indices.
Results
67 pts were identified. Median age: 59 years. The majority were men (71.6%) with adenocarcinoma histology (73.1%). Median-overall survival (mOS) was 20.2 months (95CI%:11.5-28.9). RPA group score was significantly associated with OS: not reached (NR) vs 16.2m vs 4.5m for RPA group I, II and III pts respectively (HR: 5.7; 95%CI: 3-10.8; p < 0.001). The model based on RPA only had a ROC AUC of 79.6% and a c-index of 0.743. T-stage (T1-2 vs T3-4), N-stage (N0-N1 vs N2-N3) and histology were associated with OS in UV cox-regression models, and were included in the MV model (Table). The addition of these variables to the RPA model increased the ROC AUC to 92.3% (p = 0.008) and c-index to 0.854.Table: 1486P UV and MV Cox-Regression survival analysis.
| UNIVARIABLE | MULTIVARIABLE | |||
|---|---|---|---|---|
| HR (95%CI) | p-value | HR (95%CI) | p-value | |
| RPA Group | 5.7 (3-10.8) | <0.001 | 10 (4.5-22.6) | <0.001 |
| T-Stage | 2.8 (1.4-5.7) | 0.004 | 6.2 (2.7-14.7) | <0.001 |
| N-Stage | 2.2 (1.1-4.4) | 0.031 | 1.8 (0.8-3.8) | 0.134 |
| Histology | 1.2 (1.1-1.4) | 0.003 | 1.4 (1.1-1.6) | <0.001 |
Conclusions
RPA group classification may adequately stratify BOO-NSCLC pts into favorable, intermediate and adverse prognostic groups. The addition of histology, T-stage and N-stage of the primary tumor may improve the prognostic accuracy of the model. These findings require prospective validation.
Clinical trial identification
Legal entity responsible for the study
University Hospital La Fe.
Funding
Has not received any funding.
Editorial Acknowledgement
Disclosure
All authors have declared no conflicts of interest.
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