Journal of Neuro-Oncology

, Volume 140, Issue 1, pp 159–164 | Cite as

Factors associated with long-term survival in central nervous system metastases

  • Bernardo Cacho-DíazEmail author
  • Héctor Spínola-Maroño
  • Alberto González-Aguilar
  • Oscar Arrieta
Clinical Study



Cancer is a leading cause of death worldwide; central nervous system metastases (CNSm) are amongst the most common complications of cancer and are associated with high morbidity and mortality. The aim of the study was to associate clinic and oncologic characteristics with the possibility of survival for ≥ 1 year.

Materials and methods

A prospective cohort in two referral centers recollected clinical and oncologic data from patients diagnosed with CNSm. Chronic metastases were defined as those patients that survived for ≥ 12 months after the diagnosis of CNSm.


Of 613 patients with CNSm, 554 had solid tumors as the primary cancer and were included; 405 (73%) were women, the most common primary cancer site were breast, lung and urologic. Chronic CNSm were found in 260 (47%) and were compared to those who did not. After multivariate logistic regression analysis, variables associated with good prognosis (living > 12 months) were: female sex (HR 0.55), single CNSm (HR 0.39), diagnosis of CNSm during initial extension studies or during presentation of cancer (HR 0.43), and occipital location (HR 0.62).


Long-term survival in patients with CNSm remains a topic of debate; their bad prognosis could be changing towards improvement. Clinical findings are typically overlooked in CNSm reports and prognostic scales. After our findings, we propose to include them in forthcoming studies to aid prognostic considerations. Factors associated with prolonged survival found in our study include female gender, timing of CNSm diagnosis, occipital lobe location, and single CNSm.


Brain metastases Central nervous system Survival Prognosis 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Ferlay J, Soerjomataram I, Dikshit R et al (2015) Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J cancer 136:E359–E386. CrossRefGoogle Scholar
  2. 2.
    Nayak L, Lee EQ, Wen PY (2012) Epidemiology of brain metastases. Curr Oncol Rep 14:48–54. CrossRefGoogle Scholar
  3. 3.
    Ostrom QT, Wright CH, Barnholtz-Sloan JS (2018) Brain metastases: epidemiology, 1st edn. Elsevier, New YorkGoogle Scholar
  4. 4.
    Goldberg SB, Contessa JN, Omay SB, Chiang V (2015) Lung cancer brain metastases. Cancer J 21:398–403. CrossRefGoogle Scholar
  5. 5.
    Lombardi G, Di Stefano AL, Farina P et al (2014) Systemic treatments for brain metastases from breast cancer, non-small cell lung cancer, melanoma and renal cell carcinoma: an overview of the literature. Cancer Treat Rev 40:951–959. CrossRefGoogle Scholar
  6. 6.
    Di Lorenzo R, Ahluwalia MS (2017) Targeted therapy of brain metastases: latest evidence and clinical implications. Ther Adv Med Oncol 9:781–796CrossRefGoogle Scholar
  7. 7.
    Cooper JB, Ronecker JS, Tobias ME et al (2018) Molecular sequence of events and signaling pathways in cerebral metastases. Anticancer Res 38:1859–1877. Google Scholar
  8. 8.
    Chamberlain MC, Baik CS, Gadi VK et al (2017) Systemic therapy of brain metastases: non-small cell lung cancer, breast cancer, and melanoma. Neuro Oncol 19:1–24. CrossRefGoogle Scholar
  9. 9.
    Fernandes AW, Wu B, Turner RM (2017) Brain metastases in non-small cell lung cancer patients on epidermal growth factor receptor tyrosine kinase inhibitors: symptom and economic burden. J Med Econ 20:1136–1147. CrossRefGoogle Scholar
  10. 10.
    Pelletier EM, Shim B, Goodman S, Amonkar MM (2008) Epidemiology and economic burden of brain metastases among patients with primary breast cancer: results from a US claims data analysis. Breast Cancer Res Treat 108:297–305. CrossRefGoogle Scholar
  11. 11.
    Gaspar L, Scott C, Rotman M et al (1997) Recursive partitioning analysis (RPA) of prognostic factors in three radiation therapy oncology group (rtog) brain metastases trials. Int J Radiat Oncol Biol Phys 37:745–751CrossRefGoogle Scholar
  12. 12.
    Sperduto PW, Kased N, Roberge D et al (2011) Summary report on the graded prognostic assessment: an accurate and facile diagnosis-specific tool to estimate survival for patients with brain metastases. J Clin Oncol 30:419–425. CrossRefGoogle Scholar
  13. 13.
    Barnholtz-Sloan JS, Yu C, Sloan AE et al (2012) A nomogram for individualized estimation of survival among patients with brain metastasis. Neuro Oncol 14:910–918. CrossRefGoogle Scholar
  14. 14.
    Venur VA, Ahluwalia MS (2015) Prognostic scores for brain metastasis patients: use in clinical practice and trial design. Chin Clin Oncol. Google Scholar
  15. 15.
    Tsukada Y, Fouad A, Pickren JW, Lane WW (1983) Central nervous system metastasis from breast carcinoma. Autopsy study. Cancer 52:2349–2354CrossRefGoogle Scholar
  16. 16.
    Platta CS, Khuntia D, Mehta MP, Suh JH (2010) Current treatment strategies for brain metastasis and complications from therapeutic techniques. Am J Clin Oncol 33:398–407. CrossRefGoogle Scholar
  17. 17.
    Kotecha R, Vogel S, Suh JH et al (2016) A cure is possible: a study of 10-year survivors of brain metastases. J Neurooncol 129:545–555. CrossRefGoogle Scholar
  18. 18.
    Lutterbach J, Bartelt S, Ostertag C (2002) Long-term survival in patients with brain metastases. J Cancer Res Clin Oncol 128:417–425. CrossRefGoogle Scholar
  19. 19.
    Chao ST, Barnett GH, Liu SW et al (2006) Five-year survivors of brain metastases: a single-institution report of 32 patients. Int J Radiat Oncol 66:801–809. CrossRefGoogle Scholar
  20. 20.
    Hall WA, Djalilian HR, Nussbaum ES, Cho KH (2000) Long-term survival with metastatic cancer to the brain. Med Oncol 17:279–286CrossRefGoogle Scholar
  21. 21.
    Takeshima H, Kuratsu J-I, Nishi T, Ushio Y (2002) Prognostic factors in patients who survived more than 10 years after undergoing surgery for metastatic brain tumors: report of 5 cases and review of the literature. Surg Neurol 58(2):118–123CrossRefGoogle Scholar
  22. 22.
    Thiagarajan A, Yamada Y (2017) Radiobiology and radiotherapy of brain metastases. Clin Exp Metastasis 34:411–419. CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Neuro-oncology UnitInstituto Nacional de CancerologíaMexico CityMéxico
  2. 2.Neuro-oncology UnitInstituto Nacional de Neurología y NeurocirugíaMexico CityMexico
  3. 3.Thoracic Oncology UnitInstituto Nacional de CancerologíaMexico CityMexico

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