MEMBRAIN PROJECT: PROVISIONAL RESULTS OF UK NATIONAL, PROSPECTIVE AUDIT ON THE MANAGEMENT EVALUATION OF METASTASES IN THE BRAIN. (3rd October 2018)

• Record Type: Journal Article
• Authors: Jung, Josephine; Tailor, Jignesh; Ashkan, Keyoumars; Vergani, Francesco
• Is Part Of: Neuro-oncology. Volume 20(2018)Supplement 5
• Page Start: v347
• Page End: v347
• Publication Date: 2018-10-03
• Subjects: Brain Neoplasms -- Periodicals; Brain -- Tumors -- Periodicals; Brain -- Cancer -- Periodicals; Nervous system -- Cancer -- Periodicals; 616.99481
• DOI: 10.1093/neuonc/noy129.015
• Languages: English
• ISSNs: 1522-8517

Abstract

Abstract: OBJECTIVE: To determine if brain metastasis referrals to the neuro-oncology multidisciplinary team (MDT) in the UK & Ireland comply with current NICE guidelines and to understand how patients are being stratified based on recursive partitioning analysis (RPA) and/or graded prognostic assessment (GPA). METHODS: Prospective multi-centre national audit on all adult patients referred to the local MDT with ≥ 1 cerebral metastasis. After a 2 months trial at King's College Hospital, neurosurgical units were invited to recruit patients prospectively for a period of 4 months from November 2017. Anonymised data on patient age, type/status of primary malignancy, performance status, location/number of metastases, available imaging, treatment recommendations and length to decision making was entered into a secure online database. Follow-up data will be collected after 12 months. RESULTS: A total of 23/32 units participated. By end of February 2018 data on 579 patients (116% of initial target) had been submitted overall. Preliminary results from King's College Hospital indicate a mean of 7 [range 3–13] referred cases per MDT. The median age of referred patients was 66 years [range 28–93 years] with 54.1% females and 45.9% males. Solitary metastases only comprised 44.6% of the referrals and specialist intervention (in the form of surgery or stereotactic radiosurgery) was only recommended in 48.0% of cases. The most common primary tumour was lung (33.8%) followed by melanoma (21.0%) and breast (21.0%); other comprised 24.4% (gastrointestinal 10.8%, renal 6.1%, cancer of unknown primary 4.1%, genito-urinary 3.4%). The national results will be presented at the SBNS meeting in autumn 2018. CONCLUSIONS: The preliminary prospective data is in keeping with our previous audit results. This audit will help to draw up a national picture of brain metastases referrals and inform NICE on current work load and MDT management.