Analysis of blood parameters helps to establish prognosis for patients with brain metastases

Brain metastases are secondary tumours that have spread from primary tumours at other sites in the body (lungs, breast or skin, for example). Approximately 40% of all patients with metastasized cancer develop metastases in their brain. These are the commonest type of malignant brain tumour, are difficult to treat, often cause severe symptoms, such as intense headaches, neurological problems or epilepsy and are often associated with a limited life expectancy. Nevertheless, there are some patients who survive for a long time, despite their brain metastases. Anna Sophie Berghoff, University Department of Internal Medicine I at MedUni Vienna and Vienna General Hospital, member of the Comprehensive Cancer Center (CCC) Vienna and lead author of the study, says: "We asked ourselves whether there are any objective parameters that can provide us with a more stable basis for establishing an accurate prognosis for patients. This is not only important for estimating their life expectancy or for their inclusion in clinical studies but also for deciding on the most appropriate treatment for them."

1,201 patients studied

In their study, which included 1,201 patients with different primary cancers, Berghoff's team of researchers therefore analyzed blood parameters that had not so far been included in oncological prognosis scores. The results show that subnormal levels of red blood pigment (haemoglobin), blood platelets (thrombocytes), white blood cells (leucocytes) and albumin (the main plasma protein) and elevated levels of serum creatinine, lactate dehydrogenase and inflammatory markers (C-reactive protein; CRP) were associated with poorer survival from brain metastases.

Berghoff: "This study has enabled us to show that the investigated parameters have a strong, independent prognostic impact and are therefore to be regarded as objective parameters. This is particularly true of haemoglobin levels and the concentration of CRP and lactate dehydrogenase." The researchers are now recommending that the last three parameters, in particular, be tested in follow-up studies for inclusion in prognosis scores.