Midlife brain metastases in the United States: Is male at risk?

Abstract

Background Population‐based estimates of the impact of gender throughout the whole course of brain metastases (BMs) at the time of diagnosis of systemic malignancies are insufficient. We aimed to discover the influence of gender on the presence of BMs in newly diagnosed malignancies and the survival of those patients on a population‐based level. Methods Midlife patients (40 years ≤ age ≤60 years) with newly diagnosed malignancies and BMs at the time of diagnosis were abstracted from the Surveillance, Epidemiology, and End Results (SEER) database of the National Cancer Institute. Clinical variables adjusted patient data. The LASSO regression was performed to exclude the possibility of collinearity. Univariable and multivariable logistic regression analyses were applied to find independent predictors for the presence of BMs, while univariable and multivariable Cox proportional hazard regression analyses were used to determine prognosticators of survival. K‐M curves were used to perform the survival analysis. Result 276,327 population‐based samples met inclusion criteria between 2014 and 2016, and 5747 (2.08%) patients were diagnosed with BMs at the time of diagnosis of systematic malignancies. Among all midlife patients with cancer, 44.02% (121,634) were male, while 51.68% (2970) were male among patients with BMs at the time of diagnosis. The most frequent tumor type was breast cancer (23.11%), and lung cancer had the highest incidence proportion of BMs among the entire cohort (19.34%). The multivariable logistic regression model suggested that female (vs. male, odds ratio [OR] 1.07, 95% CI: 1.01–1.14, p < 0.001) was associated with a higher risk of the presence of BMs at the time of diagnosis. Moreover, in the multivariable Cox model for all‐cause mortality in individuals with BMs at diagnosis, female (vs. male, hazard ratio [HR], 0.86, 95% CI, 0.80–0.92, p < 0.001) was shown to have a lower risk of decreased all‐cause mortality. Conclusion The middle‐aged females were at increased risk of developing BMs, while the middle‐aged males with BMs were at higher risk of having poorer survival.

Improved Survival With Surgical Treatment of Primary Lung Lesions in Non-Small Cell Lung Cancer With Brain Metastases: A Propensity‐Matched Analysis of Surveillance, Epidemiology, and End Results Database

“…Previous studies have shown that in addition to surgery, gender, race, adenocarcinoma, marital status, insurance status, mediastinal lymph nodes and other factors are also related to the prognosis of NSCLC patients with BM (19,(23)(24)(25)(26)(27)(28). It has also been reported (22,29) that the prognosis of lung surgery in NSCLC patients with BM is not related to mediastinal lymph node stage and T stage of lung lesions (11,22).…”

An Update on the General Features of Breast Cancer in Male Patients—A Literature Review

“…However, the actual prevalence may be higher, as these estimates are typically restricted to individuals who are being evaluated for therapy. According to a study presented by Che [ 32 ], most BMs metastasize from lung cancer (40–50%), breast cancer (15–25%), and melanoma (5–20%). However, cancer patients with BMs continue to have a poor prognosis, with a relatively low median survival (2.9 months for newly diagnosed malignancies) and 2-year survival rate (8%).…”

Recent Trends in Synchronous Brain Metastasis Incidence and Mortality in the United States: Ten-Year Multicenter Experience

“…The SEER program suggests arenas for future epidemiological studies of SBMs, which were hardly going forward to determine the exact incidence before 2016, since reporting BMs was not mandated by local and federal registries [ 18 ]. As mentioned in the literature review, 2.03% of all solid cancer patients and 2.08% of midlife patients had synchronous BMs [ 11 , 12 ]. Lung cancer SBMs, breast cancer SBMs, renal cancer SBMs, melanoma SBMs, and colorectal cancer SBMs ranked as the top five in terms of the number of patients in the entire cohort [ 11 ].…”

“…For patients diagnosed with systemic malignant malignancy between 2010 and 2013, information on synchronous brain metastases at the time of primary tumor diagnosis was first available in 2016 [ 11 , 12 , 13 ]. The ten-year (2010–2019) accessible information on synchronous brain metastases (SBMs) better reflected the change in the epidemic pattern over the research period when the analyses were updated to incorporate more recent data released in April 2022 based on the November 2021 submission.…”

“…The study indicated that during diagnosis, synchronous BMs were present in 2.0% of all cancer patients and 12.1% of those with metastatic disease [ 11 ]. The exploration of trustworthy prognosticators for the outcome prediction of synchronous BMs has also received significant research attention [ 12 , 13 ]. For better guiding customized therapy strategies and understanding cancer natural history, descriptive studies are crucial.…”