Return to work in younger patients with brain metastases who survived for 2 years or more
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https://hdl.handle.net/10037/35437Date
2024-10-01Type
Journal articleTidsskriftartikkel
Peer reviewed
Author
Nieder, Carsten; Aanes, Siv Gyda; Stanisavljevic, Luka; Mannsåker, Bård; Haukland, Ellinor ChristinAbstract
Methods We included patients who survived greater than 2 years after their first treatment, regardless of approach (systemic therapy, neurosurgical resection, whole-brain or stereotactic radiotherapy). The primary endpoint was the proportion of patients who worked 2 years after their initial treatment for brain metastases. Outcomes beyond the 2-year cut-of were also abstracted from comprehensive electronic health records, throughout the follow-up period.
Results Of 455 patients who received active therapy for brain metastases, 62 (14%) survived for>2 years. Twenty-eight were younger than 65 years. The actuarial median survival was 81 months and the 5-year survival rate 53%. For patients alive after 5 years, the 10-year survival rate was 54%. At diagnosis, 25% of patients (7 of 28) were permanently incapacitated for work/retired. Of the remaining 21 patients, 33% did work 2 years later. However, several of these patients went on to receive disability pension afterwards. Eventually, 19% continued working in the longer run. Younger age, absence of extracranial metastases, presence of a single brain metastasis, and Karnofsky performance status 90–100 were common features of patients who worked after 2 years.
Conclusion Long-term survival was achieved after vastly different therapeutic approaches, regarding both upfront and sequential management. Many patients required three or more lines of brain-directed treatment. Few patients continued working in the longer run.