Graded Prognostic Assessment (GPA)
The Graded Prognostic Assessment (GPA) is a scoring system used to estimate survival outcomes in patients with brain metastases.
**GPA Scoring Criteria**
| Factor | Score 0 | Score 0.5 | Score 1.0 |
|---|---|---|---|
| Age | ≥ 60 years | 50-59 years | < 50 years |
| Karnofsky Performance Status (KPS) | < 50 | 50-70 | 80-100 |
| Number of Brain Metastases | > 3 | 2-3 | 1 |
| Extracranial Disease Status | Present | - | Absent |
**Prognostic Groups**
| GPA Score | Median Survival |
|---|---|
| 0.0 - 1.0 | ~3 months |
| 1.5 - 2.0 | ~6 months |
| 2.5 - 3.0 | ~12 months |
| 3.5 - 4.0 | ~24 months |
Interpretation: - The higher the GPA score, the better the prognosis. - GPA is widely used to guide treatment decisions for patients with brain metastases.
Example Usage: To calculate a patient’s GPA score, sum the individual factor scores. For instance, a 45-year-old patient (1.0), KPS 80 (1.0), 2 metastases (0.5), and no extracranial disease (1.0) would have a total GPA score of 3.5, correlating with a median survival of ~24 months.
References: - Sperduto et al., “Graded Prognostic Assessment: A Systematic Approach to Prognostication in Patients with Brain Metastases.”