Department of Health Care Management, Berlin University of Technology, Berlin, Germany.
J Neurooncol. 2011 Oct;105(1):83-90. doi: 10.1007/s11060-011-0563-z. Epub 2011 Mar 11.
Extracranial metastases and their frequency by sites have been described as prognostic factors for survival of patients with brain metastasis. However, these factors must be identified and described in more detail for a large series of patients. Using routine data from the largest German health insurance fund, 5,074 patients with brain metastasis who were diagnosed and treated in 2008 were analyzed to identify the frequency and distribution of extracranial metastatic sites concurrent with brain metastasis in relation to age, gender, and tumor type. Brain metastases were observed in males more frequently than in females (56.4 and 43.6% respectively P < 0.001), and were most often from lung (51.2%), breast (12.3%), and unknown (7.5%) primaries. Extracranial metastatic sites were observed in 58.8% of patients; the number of sites was from 1 to 7, with a mean of 1.11. For the 16 most common primary sites the range was from 0.13 to 1.91 . In 11 of these 16 sites, lungs were the most common concurrent metastatic site. Lung cancer, breast cancer, non-Hodgkin's lymphoma, and testicular cancer most commonly metastasized to bone, and bladder cancer to kidneys. Different primary tumors have different frequencies and patterns of extracranial metastatic sites concurrently with brain metastasis. The lung is the most common metastatic site of most primary tumors, bone for a few tumors, and kidneys for bladder cancer. For the unknown primary tumor type, screening for these most common metastatic sites must be intensified, in particular when molecular assessment is not available.
颅外转移及其部位的频率已被描述为脑转移患者生存的预后因素。然而，这些因素必须在更大的患者系列中被识别和更详细地描述。利用来自最大的德国健康保险基金的常规数据，对 2008 年诊断和治疗的 5074 例脑转移患者进行了分析，以确定与年龄、性别和肿瘤类型相关的脑转移时颅外转移部位的频率和分布。脑转移在男性中比女性更常见（分别为 56.4%和 43.6%，P<0.001），最常见的原发灶是肺（51.2%）、乳腺（12.3%）和未知（7.5%）。在 58.8%的患者中观察到颅外转移部位；转移部位的数量从 1 到 7 个，平均为 1.11 个。对于 16 个最常见的原发部位，范围从 0.13 到 1.91。在这 16 个部位中的 11 个中，肺是最常见的同时转移部位。肺癌、乳腺癌、非霍奇金淋巴瘤和睾丸癌最常转移到骨，膀胱癌转移到肾。不同的原发肿瘤同时伴有脑转移的颅外转移部位的频率和模式不同。肺是大多数原发肿瘤最常见的转移部位，骨是少数肿瘤的转移部位，肾是膀胱癌的转移部位。对于未知的原发肿瘤类型，必须加强对这些最常见转移部位的筛查，特别是在没有分子评估的情况下。
