TY  - JOUR
AU  - Wasilewski, David
AU  - Araceli, Tommaso
AU  - Rafaelian, Artem
AU  - Demetz, Matthias
AU  - Asey, Benedikt
AU  - Ersoy, Tunc-Faik
AU  - Dauth, Alice
AU  - Neumeister, Anne
AU  - Peukert, Ricarda
AU  - Pöser, Paul
AU  - Krämer, Christopher
AU  - Bukatz, Jan
AU  - Shaked, Zoe
AU  - Jelgersma, Claudius
AU  - Früh, Anton
AU  - Xu, Ran
AU  - Misch, Martin
AU  - Capper, David
AU  - Ehret, Felix
AU  - Frost, Nikolaj
AU  - Bullinger, Lars
AU  - Keilholz, Ulrich
AU  - Senft, Christian
AU  - Schmidt, Leon
AU  - Krenzlin, Harald
AU  - Ringel, Florian
AU  - Pohrt, Anne
AU  - Meyer, Hanno S
AU  - Gempt, Jens
AU  - Kerschbaumer, Johannes
AU  - Freyschlag, Christian
AU  - Thomé, Claudius
AU  - Simon, Matthias
AU  - Dubinski, Daniel
AU  - Freiman, Thomas
AU  - Schmidt, Nils Ole
AU  - Proescholdt, Martin
AU  - Vajkoczy, Peter
AU  - Onken, Julia
TI  - Practice Variation in Perioperative Dexamethasone Use and Outcomes in Brain Metastasis Resection.
JO  - JAMA network open
VL  - 8
IS  - 4
SN  - 2574-3805
CY  - Chicago, Ill.
PB  - American Medical Association
M1  - DKFZ-2025-00782
SP  - e254689
PY  - 2025
AB  - 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
KW  - Humans
KW  - Dexamethasone: administration & dosage
KW  - Dexamethasone: therapeutic use
KW  - Female
KW  - Male
KW  - Brain Neoplasms: secondary
KW  - Brain Neoplasms: surgery
KW  - Brain Neoplasms: drug therapy
KW  - Brain Neoplasms: mortality
KW  - Middle Aged
KW  - Retrospective Studies
KW  - Aged
KW  - Germany
KW  - Perioperative Care: methods
KW  - Austria
KW  - Propensity Score
KW  - Treatment Outcome
KW  - Dexamethasone (NLM Chemicals)
LB  - PUB:(DE-HGF)16
C6  - pmid:40214989
C2  - pmc:PMC11992604
DO  - DOI:10.1001/jamanetworkopen.2025.4689
UR  - https://inrepo02.dkfz.de/record/300348
ER  -