%0 Journal Article
%A Wasilewski, David
%A Araceli, Tommaso
%A Rafaelian, Artem
%A Demetz, Matthias
%A Asey, Benedikt
%A Ersoy, Tunc-Faik
%A Dauth, Alice
%A Neumeister, Anne
%A Peukert, Ricarda
%A Pöser, Paul
%A Krämer, Christopher
%A Bukatz, Jan
%A Shaked, Zoe
%A Jelgersma, Claudius
%A Früh, Anton
%A Xu, Ran
%A Misch, Martin
%A Capper, David
%A Ehret, Felix
%A Frost, Nikolaj
%A Bullinger, Lars
%A Keilholz, Ulrich
%A Senft, Christian
%A Schmidt, Leon
%A Krenzlin, Harald
%A Ringel, Florian
%A Pohrt, Anne
%A Meyer, Hanno S
%A Gempt, Jens
%A Kerschbaumer, Johannes
%A Freyschlag, Christian
%A Thomé, Claudius
%A Simon, Matthias
%A Dubinski, Daniel
%A Freiman, Thomas
%A Schmidt, Nils Ole
%A Proescholdt, Martin
%A Vajkoczy, Peter
%A Onken, Julia
%T Practice Variation in Perioperative Dexamethasone Use and Outcomes in Brain Metastasis Resection.
%J JAMA network open
%V 8
%N 4
%@ 2574-3805
%C Chicago, Ill.
%I American Medical Association
%M DKFZ-2025-00782
%P e254689
%D 2025
%X Variations in perioperative dexamethasone dosing are common in brain metastasis resection, but their impact on patient outcomes remains unclear.To evaluate the association between perioperative dexamethasone dosing and patient outcomes, focusing on overall survival (OS) and progression-free survival (PFS).This retrospective multicenter comparative effectiveness study used data collected from January 2010 to December 2023. Patients with symptomatic brain metastases undergoing primary surgical resection at 7 neurological centers in Germany and 1 in Austria and who had complete records of perioperative dexamethasone dosing were included. Propensity score matching (PSM) was used to control for confounders. Analysis was conducted from March to June 2024.Cumulative perioperative dexamethasone administration over 27 days, dichotomized at 122 mg using maximally selected rank statistics.The primary outcome was OS. Secondary outcomes included extracranial PFS (ecPFS) and intracranial PFS (icPFS) as well as incidence of wound revision surgery after brain metastasis resection. Hazard ratios (HRs) were calculated using Cox proportional hazards models.A total of 1064 patients were included in the analysis. The median (IQR) age was 64 (56-72) years, with 489 female patients (49
%K Humans
%K Dexamethasone: administration & dosage
%K Dexamethasone: therapeutic use
%K Female
%K Male
%K Brain Neoplasms: secondary
%K Brain Neoplasms: surgery
%K Brain Neoplasms: drug therapy
%K Brain Neoplasms: mortality
%K Middle Aged
%K Retrospective Studies
%K Aged
%K Germany
%K Perioperative Care: methods
%K Austria
%K Propensity Score
%K Treatment Outcome
%K Dexamethasone (NLM Chemicals)
%F PUB:(DE-HGF)16
%9 Journal Article
%$ pmid:40214989
%2 pmc:PMC11992604
%R 10.1001/jamanetworkopen.2025.4689
%U https://inrepo02.dkfz.de/record/300348