BACKGROUND: Management of @entity1 afflicted with @entity75 requires tailoring of therapeutic strategies based on survival expectations. Therefore, the development of prognostic indices is of critical importance in this @entity1 population. OBJECTIVE: To determine whether the cumulative @entity5 volume (CITV) of @entity75 augments the prognostic value of the lung-specific Graded Prognostic Assessment (GPA) index. METHODS: @entity1 data were derived from 365 @entity2 @entity1 with @entity75 who were consecutively treated with stereotactic radiosurgery at the University of California, San Diego/San Diego Gamma Knife Center. CITV was analyzed to determine the volume cutoff that maximized sensitivity and specificity for 1-year survival. Multivariate Cox proportional hazard modeling was performed, and overall survival was estimated by the Kaplan-Meier method risk stratifying with or without this optimal CITV. The prognostic value of these models (lung-specific GPA    CITV) was quantitatively compared with the use of net reclassification improvement (>0) and integrated discrimination improvement. RESULTS: For the University of California, San Diego/San Diego Gamma Knife Center cohort, the CITV cutoff that had the greatest survival discrimination at 1 year was 4 cm. The addition of CITV to the lung-specific GPA indexes significantly improved the prognostic value of lung-specific GPA, with net reclassification improvement >0 of 0.430 (95% confidence interval, 0.228-0.629) and integrated discrimination improvement of 0.029 (95% confidence interval, 0.004-0.073). These findings were validated in an independent cohort of 1638 @entity2 @entity1 with @entity75 who were treated with stereotactic radiosurgery at the Katsuta Hospital Mito Gamma House in Japan. CONCLUSION: In independent cohorts, the addition of CITV to the lung-specific GPA index significantly improved the prognostic value of this index. ABBREVIATIONS: AUC, area under the receiver-operating characteristic curveBM, brain metastasisCITV, cumulative @entity5 volumeds-GPA, disease-specific Graded Prognostic AssessmentGPA, Graded Prognostic AssessmentIDI, integrated discrimination improvementKHMGH, Katsuta Hospital Mito Gamma HouseKPS, Karnofsky Performance StatusNRI, net reclassification improvementROC, receiver-operating characteristic curveSRS, stereotactic radiosurgeryUCSD/SDGKC, University of California, San Diego/San Diego Gamma Knife Center.

Cumulative XXXX Volume (CITV) Enhances the Prognostic Value of the Lung-Specific Graded Prognostic Assessment (GPA) Model.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'Patient'] @entity2 :: ('MESH:D008175', 'Disease') :: ['lung cancer'] @entity75 :: ('MESH:D001927', 'Disease') :: ['brain metastasis'] @entity5 :: ('MESH:D009369', 'Disease') :: ['intracranial tumor']
@entity5 :: (MESH:D009369,Disease) :: ['Intracranial Tumor']
