Michel Anna, Rauschenbach Laurèl, Karadachi Hanah, Gümüs Meltem, Ahmadipour Yahya, Darkwah Oppong Marvin, Pöttgen Christoph, Hense Jörg, Özkan Neriman, Wrede Karsten H, Dammann Philipp, Sure Ulrich, Jabbarli Ramazan
Department of Neurosurgery and Spine Surgery, University Hospital Essen, Hufelandstraße 55, 45147, Essen, Germany.
Center for Translational Neuro‑ & Behavioral Sciences (C‑TNBS), University Duisburg Essen, Essen, Germany.
J Neurooncol. 2025 Apr 29. doi: 10.1007/s11060-025-05048-3.
Breast cancer (BC) is one of the most common primary tumor entities that develop brain metastases (BM) during disease progression. Multiple BM are associated with poorer prognosis, but various surgical, radiotherapeutic and systemic treatment approaches improve survival. We aimed to identify prognostic factors and evaluate the overall survival following BM surgery in patients with multiple BCBM.
All metachronous metastasized female patients with resected BCBM at our institution between 2008 and 2019 were included. Data on clinical, radiologic, and histopathologic parameters were recorded and analyzed using univariate and multivariate regression models.
Among the 93 patients included in the final analysis, 30 individuals presented with multiple BM. Compared to patients with single BM, those with multiple BM were more likely to have infratentorial BM (adjusted odds ratio [aOR] 3.35, 95% confidence interval [CI] 1.03-10.83, p = 0.044), HER2(human epidermal growth factor receptor 2)-positive BC (aOR 3.93, 95% CI 1.23-12.53, p = 0.021) and hepatic metastases (aOR 5.86, 95% CI 1.34-25.61, p = 0.019). There was no significant difference in postoperative survival between individuals with multiple (median: 12.5 months) and single BM (17.0 months, p = 0.186). In the multivariate Cox regression analysis, adjuvant radiotherapy (adjusted hazard ratio [aHR] 5.93, 95% CI 1.06-33.26, p = 0.043) and trastuzumab treatment (aHR 4.95, 95% CI 1.72-14.25, p = 0.003) were associated with longer postoperative survival multiple BCBM patients.
BC patients with multiple BM show remarkable postoperative survival, particularly if combined with adjuvant radiotherapy. Our data justify the surgery of multiple BCBM in patients with appropriate clinical condition and feasible location of BM.
乳腺癌（BC）是疾病进展过程中最常见的发生脑转移（BM）的原发性肿瘤实体之一。多发脑转移与较差的预后相关，但多种手术、放疗和全身治疗方法可提高生存率。我们旨在确定多发性乳腺癌脑转移（BCBM）患者脑转移瘤手术后的预后因素并评估其总生存期。
纳入2008年至2019年间在我院接受手术切除的所有异时性转移的女性BCBM患者。记录临床、放射学和组织病理学参数数据，并使用单因素和多因素回归模型进行分析。
在最终分析纳入的93例患者中,30例为多发脑转移。与单发脑转移患者相比，多发脑转移患者更易出现幕下脑转移（校正比值比[aOR]3.35，95%置信区间[CI]1.03-10.83，p = 0.044）、人表皮生长因子受体2（HER2）阳性乳腺癌（aOR 3.93，95%CI 1.23-12.53，p = 0.021）和肝转移（aOR 5.86，95%CI 1.34-25.61，p = 0.019）。多发脑转移患者（中位生存期：12.5个月）和单发脑转移患者（17.0个月，p = 0.186）术后生存期无显著差异。在多因素Cox回归分析中，辅助放疗（校正风险比[aHR]5.93，95%CI 1.06-33.26，p = 0.043）和曲妥珠单抗治疗（aHR 4.95，95%CI 1.72-14.25，p = 0.003）与多发性BCBM患者术后生存期延长相关。
多发脑转移的乳腺癌患者术后生存期显著，尤其是联合辅助放疗时。我们的数据证明，对于临床情况合适且脑转移瘤位置可行的患者，可对多发BCBM进行手术治疗。
