1339 Dissecting Survival Trends: A Comparative Analysis of Resected Dominant Versus Solitary Brain Metastases

INTRODUCTION: Brain metastases (mets) are the most common intracranial tumors in adults. The decisions to resect brain metastases are dependent on multiple factors: age, number of metastases, systemic therapies, and comorbidities. However, it is unclear if there are survival differences between surgical resection of variable tumor burden states. METHODS: Patients from Emory University’s Electronic Medical Records were retrospectively reviewed and grouped into a solitary or dominant met cohort. Each patient received surgery, radiotherapy, and systemic therapy. Inclusion criteria for this study included age >18, at least 1 or more metastatic brain tumors, follow-up data (KPS) pre-surgery & post-surgery and post 1-year follow-up. Descriptive statistics & survival outcomes were reported. RESULTS: 112 patients (57=solitary, 55=dominant) were evaluated. There were 58 females and 54 males. Cancer types include lung cancer (n=42), breast cancer (n=20), melanoma (n=16), and other cancers (n=34). The median age was 59 for dominant and 65 for solitary cohorts. For both cohorts, the median KPS was 80 at initial presentation. Survival differences after tumor resection showed no difference (p = 0.56). Males were 2.32 times more likely to have an increased hazard of death in 5 years compared to females (p=< 0.01). Progression free survival showed no differences between the cohorts (p=0.49). Multivariate analysis indicated an increase in KPS at 1 year (p=<0.01) and white race (p=0.05) showed a decreased hazard ratio. CONCLUSIONS: Patients with resection of solitary brain metastases display similar overall and progression free survival compared to patients who have one dominant brain metastasis removed. Males display an increased hazard of death compared to female patients.