Classification of Brain Metastases
Patients with brain metastases are a heterogenous population. The epidemiology of brain metastases is addressed elsewhere in this textbook. In the past, outcomes were considered uniformly grim for all patients with brain metastases. We now know that outcomes vary widely by diagnosis (type of primary cancer) and diagnosis-specific prognostic factors. This chapter reviews the history of prognostic classifications for patients with brain metastases and the current state of knowledge in this area. Such classification systems are important for two reasons: (1) they facilitate clinical decision-making regarding whether and what treatment is appropriate and (2) they provide a method for stratification of clinical trials to ensure trials are comparing comparable patients, which is particularly important in such a heterogeneous patient population.