Perioperative medicine & outcomes
Practice Variation in Perioperative Dexamethasone Use and Outcomes in Brain Metastasis Resection
Authors' conclusion
In this study, higher cumulative perioperative dexamethasone was associated with reduced OS, icPFS, and ecPFS in patients undergoing brain metastasis resection.
Study context
- Population
- Patients with symptomatic brain metastases undergoing primary surgical resection at 7 centres in Germany and 1 in Austria, 2010–2023included in the analysis
- Participants
- 1,064 patients
- Exposure
- Cumulative perioperative dexamethasone <122 mg vs ≥122 mg over 27 days
- Outcome
- Overall survival (OS)
Methodological detailsmulticentre, propensity-score matched, Data January 2010 to December 2023; analysis March to June 2024, Dose dichotomized at 122 mg using maximally selected rank statistics
- Multicentre
- Propensity-score matched
- Data January 2010 to December 2023; analysis March to June 2024
- Dose dichotomized at 122 mg using maximally selected rank statistics
Main finding
Median OS
Hazard ratio
1.40
95% CI 1.18–1.66
P < 0.001
By group
≥122 mg vs <122 mg
HR 1.40 (95% CI 1.18–1.66); P < 0.001
As reported in the abstract
Observational data: associations, not effects.
Secondary outcomes
Intracranial PFS (icPFS) and extracranial PFS (ecPFS)
- Consistent findings with icPFS and ecPFS
Cumulative dexamethasone dose and hazard for death
- Dose-response association
Original publication
Practice Variation in Perioperative Dexamethasone Use and Outcomes in Brain Metastasis Resection. JAMA Netw Open. Published 1 April 2025. doi:10.
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