Characterizing Survival and Treatment in Synchronous Intracranial Metastases: The Influence of Extracranial Disease
Bibliographic record
Abstract
Cancer patients with synchronous intracranial metastatic disease (IMD) represent a heterogeneous population with varied outcomes. We conducted a retrospective, population-based study of 6,069 patients with sIMD in Ontario, Canada, from 2010–2019, to compare clinical characteristics, treatment patterns, and overall survival (OS) between those with isolated IMD (i-sIMD) and those with extracranial metastases and sIMD (sIMD+ECM) at cancer diagnosis. I-sIMD occurred in 397 (6.9%) patients and was associated with a higher proportion of breast primary cancers, greater comorbidity, and more frequent systemic anti-cancer therapy use. Surprisingly, these patients were less likely to receive stereotactic radiosurgery (SRS) or neurosurgical resection. Regardless, i-sIMD was associated with longer OS than sIMD (5.4 vs. 3.0 months; adjusted HR 0.53; p<0.001), particularly among patients treated with SRS or neurosurgery (20.5 vs. 9.2 months; p<0.001) and patients with breast cancer compared to other solid tumours (20.8 vs. 2.3 months; aHR 0.47; p=0.002). Our findings highlight i-sIMD as a distinct subgroup with more favourable outcomes.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 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) | 0.001 | 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 source (direct Gemma or distilled Codex), 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".