Multicenter retrospective study of association of perioperative dexamethasone dosing and outcomes in brain metastasis resection

Variations in perioperative dexamethasone dosing are common in brain metastasis resection, but their impact on patient outcomes remains unclear. A retrospective study at seven centers in Germany and one center in Austria evaluated the association between perioperative dexamethasone dosing and patient outcomes, focusing on overall survival (OS), extracranial progression-free survival (ecPFS), and intracranial progression-free survival (icPFS). In this study of 1064 patients, those exceeding the 122-mg cumulative dexamethasone cut point over 27 days had shorter OS, ecPFS, and icPFS than those receiving less than 122 mg cumulatively. The negative association was independent of clinical or prognostic factors, such as tumor volume, edema volume, disease-specific graded prognostic assessment, and adjuvant treatment class. The authors conclude that the findings of this study suggest that variations in perioperative dexamethasone dosing may effect outcomes and stricter dosing protocols should be considered.