RMTD-01 PROGNOSTIC SIGNIFICANCE OF STABLE EXTRACRANIAL DISEASE IN PATIENTS WITH INTRACRANIAL METASTATIC DISEASE: INSIGHTS FROM A RETROSPECTIVE POPULATION-BASED STUDY
Bibliographic record
Abstract
Abstract BACKGROUND Intracranial metastatic disease (IMD) is a life-limiting complication of lung cancer, breast cancer, and melanoma. Prior research suggests prolonged survival in patients with stable extracranial disease and IMD (IMD-SE), compared to patients with progressive extracranial disease (IMD-PE). A comprehensive clinical characterization of patients with IMD-SE is lacking. This study aims to investigate clinical characteristics, outcomes, and the impact of patient and treatment factors on survival in patients with IMD-SE vs. IMD-PE. METHODS This retrospective cohort study included patients diagnosed with primary lung cancer, breast cancer, or melanoma, and IMD in Ontario, Canada between April 1, 2010, and August 31, 2019. IMD-SE criteria included no extracranial metastases within 2 months of primary cancer diagnosis and ≥2 rounds of systemic therapy, documented in provincial records. Analyses, including Cox regression, Kaplan-Meier, and logistic regression, assessed overall survival (OS) and associations with IMD-SE. Data analysis occurred between September and December 2023. RESULTS In our analysis of 15,577 patients, 16.0% had IMD-SE, comprising 50.6% lung cancer, 40.0% breast cancer, and 9.3% melanoma. IMD-SE patients showed longer median OS from primary cancer diagnosis (27.72 months vs. 6.54 months in IMD-PE; p<0.0001) and from IMD diagnosis (4.60 months vs. 1.91 months in IMD-PE; p<0.0001). Receipt of systemic therapy and brain surgery decreased the risk of death in IMD-SE patients (HR <0.8), while lung cancer and cranial radiotherapy increased the risk. IMD-SE status was least associated with lung cancer and most associated with age <65 years, systemic therapy, primary radiation, and ≥2 rounds of cranial radiotherapy. CONCLUSION AND RELEVANCE This study provides insights into IMD prognosis, emphasizing the importance of considering extracranial disease progression for survival predictions. Our findings enhance understanding of IMD-SE, guiding refined prognostic assessments and innovative treatments. Future studies should explore additional variables for a comprehensive understanding of factors influencing IMD-SE.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".