P08.25CLINICO-PATHOLOGICAL STUDY IN 156 PATIENTS OPERATED FOR BRAIN METASTASES.

Brain metastases are the most common brain tumors in adulthood. They arise from lung, breast, kidney, gastrointestinal cancer, melanoma and other primary cancers. A recent study (Sperduto, JCO 2012) has provided algorythms for prediction of the expected survival in patients with different histologies of the primary tumor, refining previously available risk stratification classes. Increase in survival in patients with brain metastases may be linked to earlier detection, availability of new treatments for primary tumor and adoption of stereotactic surgery/surgery in fit patients. The data obtained by Sperduto need to be validated in other populations of brain metastases patients. We assessed survival in a cohort of 156 patients with brain metastases (all undergoing neurosurgery) followed in 2 Hospitals (Lecco and Varese) in Lombardia over 12 years (2000 to 2012). 75 cases were from lung cancer, 36 breast, 21 melanoma and 12 colorectal and 12 from other sites. Mean time to metastatic brain disease was 4.6 months for lung, 35.4 for colorectal, 52.2 for breast, 61.2 for melanoma and 78.5 for kidney cancer, respectively. Mean survival after diagnosis of metastatic brain disease was 6.9 months for melanoma, 7.2 for colorectal, 14.5 for lung, 26.6 for kidney and 26.9 months for breast-derived metastases. Our data confirm that time to onset of metastatic brain disease is dependent on the type of primary tumor and - in agreement with those reported in Sperduto's graded prognostic assessment database - show the presence of a non-negligible percentage of patients with prolonged survival after diagnosis and treatment of brain metastatic disease.