Department of Oncology and Palliative Medicine, Nordland Hospital, Bodø, Norway;
Department of Clinical Medicine, Faculty of Health Sciences, UiT - The Arctic University of Norway, Tromsø, Norway.
In Vivo. 2022 Mar-Apr;36(2):801-805. doi: 10.21873/invivo.12766.
BACKGROUND/AIM: This study was designed to evaluate the prognostic impact of the previously validated LabBM score (serum lactate dehydrogenase, C-reactive protein, albumin, hemoglobin, platelets) in a new setting, namely patients with a limited number of brain metastases, arbitrarily defined as max. 4 brain lesions, from common tumor types such as lung and breast cancer. A total of 5 metastatic lesions overall were allowed to comply with current definitions of oligometastatic cancer.
For this retrospective single-institution analysis, 101 patients were identified from a previously described, prospectively maintained database.
Twenty-one patients (21%) had extracranial metastases. Non-small cell and small cell lung cancer were the prevailing tumor types (78%). Forty-nine patients (49%) had normal blood test results (LabBM score 0 points). Their median survival (23 months) was significantly longer than that of patients with higher LabBM score. In multivariate analysis, LabBM score, performance status and single brain metastasis were associated with significantly better survival. Limited extracranial metastases did not impair prognosis. Patients with LabBM score 0 had a 5-year survival rate of 27% after surgery (n=24) and 39% after stereotactic radiotherapy (n=13), respectively (p=0.3).
Blood biomarkers can be regarded as surrogate of the metastatic burden in the body, which is not always detectable by imaging methods. In contrast to circulating tumor cells and other emerging markers, the LabBM score is inexpensive. Patients with LabBM score >0 had a 2.8-fold increased risk of death. The score might be helpful in predicting survival improvement provided by ablative local treatment of oligometastases.
背景/目的：本研究旨在评估先前经过验证的 LabBM 评分（血清乳酸脱氢酶、C 反应蛋白、白蛋白、血红蛋白、血小板）在新环境中的预后影响，即转移灶数量有限的患者，任意定义为最大 4 个脑病变，来自常见的肿瘤类型，如肺癌和乳腺癌。总共允许有 5 个转移病变，以符合寡转移癌的当前定义。
对于这项回顾性单中心分析，从以前描述的、前瞻性维护的数据库中确定了 101 名患者。
21 名患者（21%）有颅外转移。非小细胞肺癌和小细胞肺癌是主要的肿瘤类型（78%）。49 名患者（49%）的血液检查结果正常（LabBM 评分 0 分）。他们的中位生存期（23 个月）明显长于 LabBM 评分较高的患者。多变量分析显示，LabBM 评分、表现状态和单发脑转移与生存显著相关。有限的颅外转移并未损害预后。LabBM 评分 0 的患者手术后 5 年生存率为 27%（n=24），立体定向放疗后为 39%（n=13）（p=0.3）。
血液生物标志物可以作为体内转移负担的替代物，而这种替代物并不总是可以通过影像学方法检测到。与循环肿瘤细胞和其他新兴标志物不同，LabBM 评分成本低廉。LabBM 评分>0 的患者死亡风险增加 2.8 倍。该评分可能有助于预测寡转移灶局部消融治疗的生存改善。
