{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T19:08:09Z","timestamp":1792523289472,"version":"4.5.0"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2020,4,24]],"date-time":"2020-04-24T00:00:00Z","timestamp":1587686400000},"content-version":"vor","delay-in-days":114,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100011597","name":"Penn State Cancer Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011597","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["LRP 1 L30 CA231572-01"],"award-info":[{"award-number":["LRP 1 L30 CA231572-01"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000048","name":"American Cancer Society","doi-asserted-by":"publisher","award":["CSDG-CCE 133738"],"award-info":[{"award-number":["CSDG-CCE 133738"]}],"id":[{"id":"10.13039\/100000048","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The objectives of this study were to characterize (1) epidemiology of brain metastases at the time of primary cancer diagnosis, (2) incidence and trends of synchronous brain metastases from 2010 to 2015, and (3) overall survival (OS) of patients with synchronous brain metastases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 42 047 patients with synchronous brain metastases from 2010 to 2015 were identified from the Surveillance, Epidemiology, and End Results database. Descriptive analysis was utilized to analyze demographics and incidence. The Kaplan\u2013Meier method and a Cox proportional hazards model were utilized to evaluate potential prognostic factors for OS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The majority of patients were diagnosed from age older than 50 (91.9%). Common primary sites included lung (80%), melanoma (3.8%), breast (3.7%), and kidney\/renal pelvis (3.0%). Among pediatric patients, common primaries included kidney\/renal pelvis and melanomas. The incidence was roughly 7.3 persons\/100 000. Synchronous brain metastases were associated with significantly poorer OS compared to extracranial metastases alone (hazard ratio [HR] =1.56; 95% CI: 1.54\u20131.58; P &amp;lt; .001). Among patients with brain metastases, male gender (HR = 1.60 vs 1.52), age older than 65 years (HR = 1.60 vs 1.46), synchronous liver, bone, or lung metastases (HR = 1.61 vs 1.49), and earlier year of diagnosis (HR = 0.98 for each year following 2010) were associated with significantly poorer OS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The vast majority of brain metastases are from lung primaries. Synchronous brain metastases are associated with poorer OS compared to extracranial metastases alone.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/noajnl\/vdaa041","type":"journal-article","created":{"date-parts":[[2020,4,24]],"date-time":"2020-04-24T14:15:52Z","timestamp":1587737752000},"source":"Crossref","is-referenced-by-count":43,"title":["Epidemiology of synchronous brain metastases"],"prefix":"10.1093","volume":"2","author":[{"given":"Raj","family":"Singh","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Virginia Commonwealth University Health System, Richmond, Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelsey C","family":"Stoltzfus","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Penn State Cancer Institute, Hershey, Pennsylvania, USA"},{"name":"Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanbo","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, London Health Sciences Centre, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander V","family":"Louie","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Odette Cancer Centre\u2014Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric J","family":"Lehrer","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha R","family":"Horn","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Penn State Cancer Institute, Hershey, Pennsylvania, USA"},{"name":"Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua D","family":"Palmer","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, The James Cancer Hospital at the Ohio State University Wexner Medical Center, Columbus, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel M","family":"Trifiletti","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Mayo Clinic, Jacksonville, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul D","family":"Brown","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas G","family":"Zaorsky","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Penn State Cancer Institute, Hershey, Pennsylvania, USA"},{"name":"Department of Public 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