SURG-02. Analysis of Prognostic Factors in Patients After En Bloc Resection of Brain Metastases

OBJECTIVE To investigate the survival prognosis and influencing factors in patients with brain metastases undergoing En bloc resection. METHODS Clinical data of 342 brain metastasis patients treated with En bloc resection were retrospectively analyzed. Postoperative recurrence was observed. Kaplan-Meier survival curves were plotted, and log-rank tests were used to compare survival outcomes across different groups. A multivariate Cox regression model was employed to identify factors influencing overall survival (OS). RESULTS Postoperative neurological function improvement, deterioration, and no change were observed in 33.04% (113/342), 5.85% (20/342), and 61.11% (209/342) of patients. The local recurrence rate was 9.06% (31/342). The median OS for all patients was 29.9 months (range: 1.4–146.5 months). Log-rank tests revealed that multiple brain metastases, colorectal or melanoma primary tumors, preoperative extracranial tumors, and preoperative chemotherapy were associated with poorer survival outcomes (all P < 0.05). Intraoperative sodium fluorescein staining, postoperative chemotherapy, and postoperative targeted therapy were associated with better survival outcomes (all P < 0.05). Multivariate Cox regression analysis demonstrated that single brain metastasis (HR = 0.457, 95% CI: 0.301–0.695, P < 0.001), intraoperative sodium fluorescein staining (HR = 0.683, 95% CI: 0.470–0.991, P = 0.045), and postoperative chemotherapy (HR = 0.518, 95% CI: 0.364–0.738, P < 0.001) were linked to longer OS. Conversely, larger tumor diameter (HR = 1.016, 95% CI: 1.002–1.030, P = 0.022), colorectal primary tumors (HR = 2.790, 95% CI: 1.468–5.302, P = 0.002), and preoperative chemotherapy (HR = 1.784, 95% CI: 1.201–2.651, P = 0.004) were associated with shorter OS. Preoperative extracranial tumors showed a borderline increased risk of mortality (HR = 1.397, 95% CI: 0.994–1.963, P = 0.054). CONCLUSION Single brain metastasis, intraoperative sodium fluorescein staining, and postoperative chemotherapy correlate with longer survival, while larger tumor size, colorectal primary tumors, and preoperative chemotherapy are associated with shorter survival.