Retrospective cohort describes survival and treatment patterns in patients with CNS metastases, highlighting the need for improvement.
BACKGROUND The National Cancer Institute in Mexico (Instituto Nacional de Cancerología, México) cares for over 8,000 new cancer patients every year from most regions of the country. The objective of this study is to describe the information from patients with central nervous system (CNS) metastases treated at our center. METHODS A prospectively maintained database of information on patients diagnosed with CNS metastases from January 2009 to December 2024 was retrospectively analyzed. Inclusion criteria: patients ≥ 16 years, pathological confirmation of a solid malignant tumor in a non-CNS tissue/organ, and imaging confirmed CNS metastases. RESULTS In a cohort of 2,226 patients with CNS metastases, n = 1,604 (72%) were female, age at CNS metastases was 54.5 years (IQR 44.7 – 63.4 years). The most common primary sites were breast (n = 905, 41%), lung (n = 599, 27%), genitourinary (n = 233, 11%), and gynecologic (n = 137, 6%). The most common initial treatment consisted of WBRT and systemic treatment (n = 991, 45%), WBRT (n = 736, 33%), palliative care (n = 183, 8%), surgery followed by WBRT (n = 135, 6%), and systemic treatment (n = 79, 4%). The MOS for those with parenchymal metastases was 10.3 months (95%CI 9.2- 11.4), and for those with neoplastic meningitis was 6.7 months (95%CI 5.3 – 8.1). The MOS of those treated in the years <2010, 2010 to 2014, 2015 to 2019, and ≥ 2020 was: 8.8, 9.6, 11.1, and 9.1 months respectively; P 0.767. CONCLUSION There is an imperative need to improve the survival of patients with CNS metastases in our country.
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